Last updated October 23, 2023.
Table of contents
Summary of recent changes
Guidance for vaccination
Updated 2023-2024 (monovalent, XBB-containing) mRNA Moderna and Pfizer-BioNTech and protein-based Novavax COVID-19 vaccines
COVID-19 vaccination schedule for people who are NOT moderately or severely immunocompromised
COVID-19 vaccination schedule for people who ARE moderately or severely immunocompromised
Additional COVID-19 vaccination considerations
Moderna vaccine materials
Pfizer vaccine materials
Novavax vaccine materials
Infection prevention recommendations for vaccination clinics
Additional resources
On Oct. 3, 2023, the U.S. Food and Drug Administration (FDA) authorized the updated 2023-2024 Novavax COVID-19 vaccine for use in those aged 12 years and older. The previous presentation of Novavax COVID-19 vaccines is no longer authorized for use in the United States.
People aged 12 years and older who got COVID-19 vaccines before September 12, 2023, should get one updated Pfizer-BioNTech, Moderna, or Novavax COVID-19 vaccine.
People aged 12 years and older who have not previously gotten any COVID-19 vaccine doses and choose to get Novavax should get two doses of updated Novavax vaccine to be up to date.
Recommendations for use of the 2023-2024 formulations of COVID-19 vaccines:
- Everyone aged 5 years and older is recommended to receive one dose of updated 2023-2024 COVID-19 vaccine. Updated versions of mRNA Moderna and Pfizer-BioNTech COVID-19 vaccines are now available. Additionally, updated Novavax vaccines are available for people aged 12 years and older.
- Children aged 6 months through 4 years:
- Initial vaccination: should receive either two doses of updated 2023–2024 Moderna or three doses of updated 2023–2024 Pfizer-BioNTech COVID-19 vaccine, or a two-dose series of Novavax vaccine for people aged 12 years and older.
- Received previous doses: need one or two doses of updated 2023–2024 Moderna, updated 2023–2024 Pfizer-BioNTech COVID-19 vaccine, , or updated Novavax vaccine (12 years or older), depending on the number of prior doses.
- People who are moderately or severely immunocompromised:
- Initial vaccination: should receive a three-dose series of updated 2023–2024 Moderna or updated 2023–2024 Pfizer-BioNTech COVID-19 vaccine.
- Received previous mRNA doses: need one or two doses of updated 2023–2024 Moderna or updated 2023–2024 Pfizer-BioNTech COVID-19 vaccine, depending on the number of prior doses.
- May receive one or more additional updated 2023–2024 mRNA COVID-19 vaccine doses following the last recommended updated COVID-19 vaccine dose.
To view all updates, visit CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States.
What you need to know
- The updated 2023-2024 COVID-19 vaccine is recommended at least two months after receiving the last COVID-19 vaccine dose.
- Everyone aged 5 years and older is recommended to receive one dose of an updated 2023-2024 COVID-19 vaccine, regardless of prior COVID-19 vaccination history.
- Children aged 6 months through 4 years should complete a multi-dose initial series (two doses of Moderna or three doses of Pfizer mRNA COVID-19 vaccine) with at least one dose of 2023-2024 COVID-19 vaccine.
- People who are moderately or severely immunocompromised should complete a two- or three-dose initial series with at least one dose of the 2023-2024 COVID-19 vaccine and may receive one or more additional 2023-2024 COVID-19 vaccine doses, informed by the clinical judgment of a health care provider and personal preference and circumstances. Any further additional doses should be administered at least two months after the last updated 2023–2024 COVID-19 vaccine dose. Talk with your health care provider about additional updated 2023-2024 COVID-19 vaccine doses.
- Bivalent mRNA Moderna and Pfizer-BioNTech COVID-19 vaccines and the original (ancestral) Novavax vaccine are no longer authorized for use in the United States.
- An alternative to mRNA COVID-19 vaccines remains available for people who cannot or will not receive an mRNA vaccine. FDA authorized and CDC approved an updated Novavax COVID-19 vaccine. Novavax is authorized as:
- A two-dose primary series to people aged 12 years and older who have not previously gotten any COVID-19 vaccine doses and choose to get the Novavax vaccine.
- A single dose given at least two months after receipt of the last previous dose of COVID-19 vaccine in people previously vaccinated with any COVID-19 vaccine.
- Authorizations or approvals for the updated 2023-2024 Novavax COVID-19 vaccine will be determined by FDA in the near future, with CDC recommendations to follow.
- Johnson & Johnson COVID-19 vaccine is not available in the United States.
- COVID-19 vaccine recommendations will be updated as needed.
The Colorado Department of Public Health and Environment is committed to ensuring that residents and staff in long-term care settings, such as nursing homes, assisted living residences, residential care communities, group homes, and senior housing, have access to COVID-19 vaccines.
The emergence and transmission of new COVID-19 variants highlight the continued need for residents and staff to stay up to date with COVID-19 vaccines. Current vaccines protect against severe illness, hospitalizations, and deaths. However, breakthrough infections in people who are vaccinated may occur.
Residents and health care workers who are vaccinated should get all doses recommended for their age and immune status as soon as they can. Unvaccinated residents and health care workers should get vaccinated with an updated COVID-19 vaccine for 2023-2024 as soon as they can. These updated COVID-19 vaccines have been formulated to more closely target currently circulating variants and provide better protection against serious consequences of COVID-19, including hospitalization and death. Staying up to date with your COVID-19 vaccines reduces your chance of getting seriously sick, needing to be hospitalized, developing Long COVID, or dying due to COVID-19.
Guidance for vaccination
Get vaccinated and stay up to date with your COVID-19 vaccines
COVID-19 vaccines available in the United States are effective at protecting people from getting seriously ill, needing to be hospitalized, and dying. Three safe and effective COVID-19 vaccines are available. There are two updated 2023-2024 mRNA COVID-19 vaccines, one manufactured by Pfizer-BioNTech and another by Moderna. An updated 2023-2024 Novavax COVID-19 vaccine is also available.
As with vaccines for other diseases, people who are up to date have the highest level of protection. CDC recommends that everyone aged 6 months and older receive a COVID-19 vaccine. People aged 6 months and older should receive all doses recommended for them for the highest level of protection. COVID-19 vaccines require multiple doses to build the highest level of protection. Many long-standing, routine vaccines work the same way.
What does it mean to be up to date?
Everyone aged 5 years and older
You are up to date when you get one updated 2023-2024 COVID-19 vaccine.
Children aged 6 months through 4 years
You are up to date when you get all recommended doses, including at least one dose of an updated 2023-2024 COVID-19 vaccine.
People who got the Novavax COVID-19 vaccine
You are up to date when you get the Novavax COVID-19 vaccine doses approved for your age group or when you get one updated 2023-2024 COVID-19 vaccine.
People who got the Johnson & Johnson COVID-19 vaccine
You are up to date when you get one updated 2023-2024 COVID-19 vaccine.
Vaccine recommendations are based on your age, the vaccine you receive, and length of time since your last dose. People who are moderately or severely immunocompromised have different recommendations for COVID-19 vaccines.
References:
- CDC: Stay Up to Date with Your COVID-19 Vaccines
- CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines
Receiving all recommended doses of COVID-19 vaccine is critical to protect staff and residents from getting seriously ill, being hospitalized, or dying.
Current COVID-19 vaccine recommendations are available in CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines.
COVID-19 vaccines: 2023–2024 updated, bivalent, and original
2023–2024 updated COVID-19 vaccines
As of October 3, 2023, the updated 2023-2024 Novavax COVID-19 vaccine has been authorized by FDA and recommended by the CDC for use in those aged 12 years and older.
As of September 12, 2023, the 2023–2024 updated Pfizer-BioNTech and Moderna COVID-19 vaccines are recommended by CDC for use in the United States.
The 2023–2024 updated COVID-19 vaccines more closely targets the XBB lineage of the omicron variant and could restore protection against severe COVID-19 that may have decreased over time. CDC anticipates the updated vaccines will be better at fighting currently circulating variants.
2022–2023 bivalent vaccines
As of September 11, 2023, the bivalent Pfizer-BioNTech and Moderna COVID-19 vaccines are no longer available for use in the United States.
The 2022–2023 bivalent vaccines were designed to protect against both the original virus that causes COVID-19 and the omicron variants BA.4 and BA.5. Two COVID-19 vaccine manufacturers, Pfizer-BioNTech and Moderna, developed bivalent COVID-19 vaccines.
Original vaccines
As of April 18, 2023, the original Pfizer-BioNTech and Moderna COVID-19 vaccines are no longer available for use in the United States.
As of October 3rd, the original Novavax vaccine is no longer available for use in the United States.
As of May 6, 2023, J&J/Janssen COVID-19 vaccine is no longer available for use in the United States.
Previous COVID-19 vaccines were called “original” because they were designed to protect against the original virus that causes COVID-19.
Additional COVID-19 vaccination considerations
Vaccination during a COVID-19 outbreak
Receiving a COVID-19 (SARS-CoV-2) vaccination is critical to protect both staff and residents against COVID-19. Find onsite vaccination clinic guidance for residential care facilities.
Vaccination after a previous or current COVID-19 (SARS-CoV-2) infection
COVID-19 vaccination is recommended for everyone aged 6 months and older, regardless of a history of symptomatic or asymptomatic SARS-CoV-2 infection. This includes people with prolonged post COVID-19 symptoms and applies to all recommended COVID-19 vaccine doses. This recommendation also applies to people who experience SARS-CoV-2 infection before or after receiving any COVID-19 dose.
People with known current SARS-CoV-2 infection should defer any COVID-19 vaccination at least until recovery from the acute illness (if symptoms were present) and criteria to discontinue isolation have been met. For further information, see CDC’s Use of COVID-19 Vaccines in the United States webpage.
Additionally, people who recently had COVID-19 may consider delaying their next vaccine dose by three months from when their symptoms started or, if they had no symptoms, when they first tested positive. Reinfection is less likely in the weeks to months after infection. However, certain factors, such as personal risk of severe disease, local COVID-19 hospital admission level, and the most common COVID-19 variant currently causing illness, could be reasons to get a vaccine sooner rather than later.
Moderna vaccine materials
- Moderna EUA Letter of Authorization - This is the Moderna COVID-19 Vaccine EUA Letter of Authorization reissued September 11, 2023.
- Moderna Approval Letter - This is the approval letter documenting full FDA licensure of the Moderna COVID-19 vaccine (aka Spikevax).
- Fact Sheet for Recipients and Caregivers (Moderna) - This is the fact sheet for recipients and caregivers receiving Moderna COVID-19 vaccine, bivalent formulation.
Pfizer vaccine materials
- Pfizer EUA Letter of Authorization - This is the Pfizer-BioNTech COVID-19 Vaccine EUA Letter of Authorization reissued September 11, 2023.
- Pfizer Approval Letter - This is the approval letter documenting full FDA licensure of the Pfizer COVID-19 vaccine (aka Comirnaty).
- Fact Sheet for Recipients and Caregivers (Pfizer) - This fact sheet is for recipients and caregivers receiving the Pfizer COVID-19 vaccine, bivalent formulation.
Novavax vaccine materials
- Novavax EUA Letter of Authorization - This is the Novavax COVID-19 Vaccine EUA Letter of Authorization reissued on October 3, 2023.
- Fact Sheet for Recipients and Caregivers (Novavax) - 12 Years of Age and Older - This fact sheet is for recipients and caregivers receiving the Novavax COVID-19 vaccine formulated for persons aged 12 years and older.
Infection prevention recommendations for vaccination clinics
Refer to the On-site Vaccine Clinics at Residential Care Facilities guidance for vaccination clinics conducted in residential care facilities. It is important to follow infection prevention recommendations to prevent transmission of COVID-19 within the facility.
Colorado Immunization Information System (CIIS)
Immunization records are confidential, personal medical information. The Colorado Immunization Information System (CIIS) is a lifelong immunization record tracking system under the Colorado Immunization Registry Act of 2007.
CIIS has signed agreements with all participating sites that are authorized to provide information to or access information from CIIS. CIIS and all people and entities that access immunization records are required to maintain the confidentiality of those records.
This Colorado Immunization Information System | Department of Public Health & Environment website provides information about requesting a copy of your immunization records.
CDPHE encourages facilities to obtain CIIS access to view resident immunization records. The facility COVID-19 Vaccination Coordinator, Backup Coordinator or another facility representative must complete the Colorado Immunization Information System (CIIS) training to obtain access to the CIIS system by following these start to finish steps and these instructions. Additionally, see the CIIS Enrollment Requirement Presentation and this CDPHE CIIS General User Training page. Email the Colorado Immunization Information System (CIIS) team at cdphe.ciis@state.co.us.
Additional resources
COVID-19 vaccine resources
- CDPHE's COVID-19 vaccine webpage and vaccine FAQ - These webpages provide COVID-19 vaccine information.
- CDC’s COVID-19 vaccine webpage - This webpage provides information from CDC on COVID-19 vaccines.
- CDC’s Stay Up to Date with your Vaccines - This webpage provides CDC COVID-19 vaccine recommendations.
- Community resources for vaccination clinics and fit testing services - If your facility needs support for fit testing or vaccination, review this online resource during your research for options. Contacting several providers to receive quotes and statements of service offerings will increase your chances of finding a good resource for your facility. If you have additional resources that you have used that you would like to share with other facilities, email cdphe_covid_infection_prevention@state.co.us.
- To find COVID-19 vaccine locations near you: Search vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233.
Long-term care facility resources
- cdphe_covid_infection_prevention@state.co.us - Email questions related to infection prevention, COVID-19 outbreaks, vaccines, testing, and reporting resources for facilities.
- CDPHE long-term and residential care facility webpage - This webpage provides resources to support long-term and residential care facilities.