Know the Latest About Bivalent COVID-19 Boosters

Please see the FDA announcement authorizing Moderna and Pfizer-BioNTech Bivalent COVID-19 Vaccines for Use as a Booster Dose in Younger Age Groups.


You’ll hear lots of questions about updated COVID-19 boosters.

All boosters of Pfizer-BioNTech for patients age 12 and up and Moderna for 18 and up are now bivalent...with 2 mRNA components.

They’ll still cover the original SARS-CoV-2 virus...but also Omicron BA.4/BA.5, the variants currently circulating.

Be aware that a bivalent COVID-19 booster can be given to anyone age 12 and up if they’ve completed the primary series...and it’s been at least 2 months since their last COVID-19 vaccine dose.

Keep in mind that the number of original monovalent boosters a person has had doesn’t affect whether to get an updated bivalent booster.

But UNvaccinated individuals still need a PRIMARY series with the original vaccines first...before a bivalent booster.

If your hospital gives COVID-19 bivalent vaccines, expect to dispense just ONE for a patient...additional boosters aren’t recommended, even for immunocompromised patients.

Anticipate orders for whichever age-appropriate bivalent booster you have in stock.

Draw up 0.3 mL (30 mcg) for Pfizer-BioNTech or 0.5 mL (50 mcg) for Moderna bivalent boosters. Stay alert for errors.

Don’t be surprised if clinicians urge eligible patients at higher risk of severe COVID-19 (age over 65, immunocompromised, etc) to get an updated booster promptly.

But it’s okay if a lower-risk patient prefers to wait 3 months after COVID-19 infection to get try to stretch out immunity.

Clinicians will also address questions about efficacy or safety of the updated COVID-19 boosters.

Human data for COVID-19 vaccines with Omicron BA.1...and animal data with BA.4/ a better immune response against Omicron versus another original monovalent booster.

And side effects are expected to be similar.

Use our resource, COVID-19 Vaccines, for info on doses, storage, etc.

Key References

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Hospital Pharmacy Technician's Letter. October 2022, No. 381001

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