COVID-19 Vaccines

Full update June 2023

The charts below provide dosing, storage, adverse effects, efficacy, and other information for COVID-19 vaccines approved or authorized in the US and Canada. The American Society of Health System Pharmacists has resources related to COVID-19 vaccines at https://www.ashp.org/COVID-19/Vaccines?loginreturnUrl=SSOCheckOnly. See end of the chart for links to the fact sheets and product labeling.

COVID-19 Vaccines Available in the UNITED STATES

VACCINE^e	DOSE	STORAGE/STABILITY	COMMENTS
Pfizer BioNTech Bivalent (original and Omicron BA.4/BA.5) for ages 6 months through 4 years (Pfizer-BioNTech)/ mRNA MAROON cap and label with MAROON border EUA Requires dilution with 2.2 mL NS per vial.²	Each dose is 0.2 mL IM. Number and timing of doses depends on COVID-19 vaccine history and immunocompetence.² No previous COVID-19 vaccine: give three doses (at week 0, at week 3, and ≥8 weeks after the 2^nd dose).² Previously vaccinated with one dose of the monovalent Pfizer-BioNTech vaccine: give two doses (≥3 weeks after receipt of the monovalent vaccine, and ≥8 weeks after the 2^nd dose).² Previously vaccinated with two doses of monovalent Pfizer-BioNTech vaccine: give a single dose ≥8 weeks after receipt of the 2^nd monovalent dose.² Previously vaccinated with three doses of monovalent Pfizer-BioNTech vaccine: give a single dose ≥2 months after receipt of the 3^rd monovalent dose.² Immunocompromised and previously vaccinated with three doses of Pfizer-BioNTech vaccine (monovalent or bivalent): Give a 4^th dose ≥1 month after the most recent dose. Additional doses can be given at provider discretion.²	Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d. Refrigerator (2^oC to 8^oC) (option if vials arrive frozen or refrigerated): 10 weeks (undiluted); 12 hours (diluted).² Room temperature (up to 25^oC): 12 hours undiluted;²⁷ 12 hours once diluted.² Vaccine should not be used after 18 months from date of manufacture.²	Approval based on efficacy data from the monovalent vaccine, immunogenicity data from the bivalent vaccine in children 6 months through 4 years of age, and immunogenicity data from a different bivalent vaccine (original and Omicron BA.1) in individuals ≥55 years of age.²Also see footnote b. See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.
Pfizer-BioNTech Bivalent (original and Omicron BA.4/BA.5) for ages 5 through 11 years (Pfizer-BioNTech)/ mRNA ORANGE cap and label with ORANGE border EUA Requires dilution with 1.3 mL of NS per vial.²	Each dose is 0.2 mL IM. Number and timing of doses depends on COVID-19 vaccine history and immunocompetence.² No previous COVID-19 vaccine: Give a single dose.² Previously vaccinated with ≥1 dose of a monovalent COVID-19 vaccine: give a single dose ≥2 months after receipt of the monovalent vaccine.² Immunocompromised: a single additional dose can be given ≥2 months after the initial bivalent COVID-19 vaccine. Additional doses can be given at the healthcare provider’s discretion.²	See above.	See above.
Pfizer-BioNTech Bivalent (original and Omicron BA.4/BA.5) for ages≥12 years^a (Pfizer BioNTech)/ mRNA) GRAY cap and label with GRAY border EUA Do NOT dilute.	Each dose is 0.3 mL IM. Number and timing of doses depends on COVID-19 vaccine history and immunocompetence.² Give a single dose. If ≥65 years of age, may give an additional dose ≥4 months later.² Immunocompromised: a single additional dose can be given ≥2 months after the initial bivalent COVID-19 vaccine. Additional doses can be given at the healthcare provider’s discretion.²	Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d. Refrigerator (2^oC to 8^oC) (option if vials arrive frozen or refrigerated): 10 weeks.² Room Temp (up to 25^oC): 12 hours prior to first use; 12 hours after first vial puncture.² Vaccine should not be used after 18 months from date of manufacture.²	See above.
mRNA-1273 Bivalent (original and Omicron BA.4/BA.5) (Moderna)/ mRNA Dark BLUE cap and a label with aGRAYborder³ EUA	6 months through 5 years of age:³ Not previously vaccinated with a COVID-19 vaccine: give two doses (0.25 mL each) IM one month apart. One previous dose of monovalent Moderna COVID-19 vaccine: give a single 0.25 mL dose IM, one month after receipt of the monovalent vaccine. 6 years through 11 years of age:³ Give a single 0.25 mL dose IM. Give ≥2 months after monovalent COVID-19, if applicable. ≥12 years of age:³ Give a single 0.5 mL dose IM. If ≥65 years of age, may give an additional dose ≥4 months later. Immunocompromised:³ 6 months through 5 years of age who have received two 0.25 mL IM doses of monovalent or bivalent Moderna vaccine, an additional 0.25 mL IM dose of Moderna bivalent vaccine can be given ≥1 month after the most recent dose. Additional doses can be given at the healthcare provider’s discretion. Also see PINK cap presentation, below. ≥6 years of age: an additional age-appropriate dose of Moderna bivalent may be administered ≥2 months after the initial dose of Moderna bivalent. Additional doses can be given at the healthcare provider’s discretion.	Shipping/long-term storage (freezer): See footnote d. Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).³ In-use vial: 12 hours.³ Pre-drawn syringe: 12 hours after first puncture of source vial.¹⁰ Room temperature (8^oC to 25^oC): 24 hours total. Discard 12 hours after first puncture.³ Pre-drawn syringe: 12 hours after first puncture of source vial.¹⁰	Approval based on efficacy data from the monovalent vaccine, and immunogenicity data from a different bivalent booster (original and Omicron BA.1) in individuals ≥18 years of age.³ Also see footnote b. See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.
mRNA-1273 Bivalent (original and Omicron BA.4/BA.5) for ages 6 months through 5 years (Moderna)/mRNA Dark PINK cap and a label with a YELLOW box.³ EUA	6 months through 5 years of age: single 0.2 mL IM dose ≥2 months after receipt of Moderna monovalent vaccine.³ Immunocompromised, 6 months through 5 years of age: see Dark BLUE cap and label with GRAY border presentation, above. Pink cap presentation may be used for the additional discretionary doses (0.2 mL).³	Shipping/long-term storage (freezer): See footnote d. Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).³ In-use vial: 8 hours.³ Room temperature (8^oC to 25^oC): 24 hours total. Discard 8 hours after first puncture.³	See above.
NVX-CoV2373 (Novavax)/ Recombinant protein subunit, adjuvanted EUA	Primary series for ≥12 years of age: two 0.5 mL IM doses three weeks apart.¹⁴ An eight-week interval may reduce the risk of myocarditis/pericarditis.²⁵ Individuals ≥12 years of age who previously received one or more doses of Novavax COVID-19 vaccine are recommended to receive a bivalent mRNA vaccine ≥8 weeks after the last dose.²⁵ Use as a booster: in individuals ≥18 years of age who completed primary vaccination with any COVID-19 vaccine and have not received any boosters, and an mRNA vaccine is not available or appropriate, or is refused, Novavax COVID-19 vaccine 0.5 mL IM can be given ≥6 months after completion of primary vaccination.^14,25 Immunocompromised: response may be diminished.¹⁴	Refrigerator (2^oC to 8^oC): 6 hours (in-use vial or pre-drawn syringe).^10,14 Room temperature (≤25^oC): 6 hours (in-use vial or pre-drawn syringe).^10,14	Effectiveness estimates unknown for current variants.²⁰

VACCINE^e

DOSE

STORAGE/STABILITY

COMMENTS

Pfizer BioNTech Bivalent (original and Omicron BA.4/BA.5) for ages

6 months through 4 years

(Pfizer-BioNTech)/

mRNA

MAROON cap and label with MAROON border

EUA

Requires dilution with 2.2 mL NS per vial.²

Each dose is 0.2 mL IM. Number and timing of doses depends on COVID-19 vaccine history and immunocompetence.²

No previous COVID-19 vaccine: give three doses (at week 0, at week 3, and ≥8 weeks after the 2^nd dose).²

Previously vaccinated with one dose of the monovalent Pfizer-BioNTech vaccine: give two doses (≥3 weeks after receipt of the monovalent vaccine, and ≥8 weeks after the 2^nd dose).²

Previously vaccinated with two doses of monovalent Pfizer-BioNTech vaccine: give a single dose ≥8 weeks after receipt of the 2^nd monovalent dose.²

Previously vaccinated with three doses of monovalent Pfizer-BioNTech vaccine: give a single dose ≥2 months after receipt of the 3^rd monovalent dose.²

Immunocompromised and previously vaccinated with three doses of Pfizer-BioNTech vaccine (monovalent or bivalent): Give a 4^th dose
≥1 month after the most recent dose. Additional doses can be given at provider discretion.²

Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d.

Refrigerator (2^oC to 8^oC) (option if vials arrive frozen or refrigerated): 10 weeks (undiluted); 12 hours (diluted).²

Room temperature (up to 25^oC): 12 hours undiluted;²⁷ 12 hours once diluted.²

Vaccine should not be used after 18 months from date of manufacture.²

Approval based on efficacy data from the monovalent vaccine, immunogenicity data from the bivalent vaccine in children 6 months through 4 years of age, and immunogenicity data from a different bivalent vaccine (original and Omicron BA.1) in individuals ≥55 years of age.²Also see footnote b.

See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.

Pfizer-BioNTech Bivalent (original and Omicron BA.4/BA.5) for ages 5 through 11 years

(Pfizer-BioNTech)/

mRNA

ORANGE cap and label with ORANGE border

EUA

Requires dilution with 1.3 mL of NS per vial.²

Each dose is 0.2 mL IM. Number and timing of doses depends on COVID-19 vaccine history and immunocompetence.²

No previous COVID-19 vaccine: Give a single dose.²

Previously vaccinated with ≥1 dose of a monovalent COVID-19 vaccine: give a single dose ≥2 months after receipt of the monovalent vaccine.²

Immunocompromised: a single additional dose can be given ≥2 months after the initial bivalent COVID-19 vaccine. Additional doses can be given at the healthcare provider’s discretion.²

See above.

Pfizer-BioNTech Bivalent (original and Omicron BA.4/BA.5) for ages≥12 years^a

(Pfizer BioNTech)/

mRNA)

GRAY cap and label with GRAY border

EUA

Do NOT dilute.

Each dose is 0.3 mL IM. Number and timing of doses depends on COVID-19 vaccine history and immunocompetence.²

Give a single dose. If ≥65 years of age, may give an additional dose ≥4 months later.²

Immunocompromised: a single additional dose can be given ≥2 months after the initial bivalent COVID-19 vaccine. Additional doses can be given at the healthcare provider’s discretion.²

Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d.

Refrigerator (2^oC to 8^oC) (option if vials arrive frozen or refrigerated): 10 weeks.²

Room Temp (up to 25^oC): 12 hours prior to first use; 12 hours after first vial puncture.²

Vaccine should not be used after 18 months from date of manufacture.²

See above.

mRNA-1273 Bivalent (original and Omicron BA.4/BA.5)

(Moderna)/

mRNA

Dark BLUE cap and a label with aGRAYborder³

EUA

6 months through 5 years of age:³

Not previously vaccinated with a COVID-19 vaccine: give two doses (0.25 mL each) IM one month apart.
One previous dose of monovalent Moderna COVID-19 vaccine: give a single 0.25 mL dose IM, one month after receipt of the monovalent vaccine.

6 years through 11 years of age:³

Give a single 0.25 mL dose IM. Give ≥2 months after monovalent COVID-19, if applicable.

≥12 years of age:³

Give a single 0.5 mL dose IM. If ≥65 years of age, may give an additional dose ≥4 months later.

Immunocompromised:³

6 months through 5 years of age who have received two 0.25 mL IM doses of monovalent or bivalent Moderna vaccine, an additional 0.25 mL IM dose of Moderna bivalent vaccine can be given ≥1 month after the most recent dose. Additional doses can be given at the healthcare provider’s discretion. Also see PINK cap presentation, below.
≥6 years of age: an additional age-appropriate dose of Moderna bivalent may be administered ≥2 months after the initial dose of Moderna bivalent. Additional doses can be given at the healthcare provider’s discretion.

Shipping/long-term storage (freezer): See footnote d.

Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).³ In-use vial: 12 hours.³ Pre-drawn syringe: 12 hours after first puncture of source vial.¹⁰

Room temperature (8^oC to 25^oC): 24 hours total. Discard 12 hours after first puncture.³ Pre-drawn syringe: 12 hours after first puncture of source vial.¹⁰

Approval based on efficacy data from the monovalent vaccine, and immunogenicity data from a different bivalent booster (original and Omicron BA.1) in individuals ≥18 years of age.³ Also see footnote b.

See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.

mRNA-1273 Bivalent (original and Omicron BA.4/BA.5) for ages

6 months through 5 years

(Moderna)/mRNA

Dark PINK cap and a label with a YELLOW box.³

EUA

6 months through 5 years of age: single 0.2 mL IM dose ≥2 months after receipt of Moderna monovalent vaccine.³

Immunocompromised, 6 months through 5 years of age: see Dark BLUE cap and label with GRAY border presentation, above. Pink cap presentation may be used for the additional discretionary doses (0.2 mL).³

Shipping/long-term storage (freezer): See footnote d.

Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).³ In-use vial: 8 hours.³

Room temperature (8^oC to 25^oC): 24 hours total. Discard 8 hours after first puncture.³

See above.

NVX-CoV2373

(Novavax)/

Recombinant protein subunit, adjuvanted

EUA

Primary series for ≥12 years of age: two 0.5 mL IM doses three weeks apart.¹⁴ An eight-week interval may reduce the risk of myocarditis/pericarditis.²⁵

Individuals ≥12 years of age who previously received one or more doses of Novavax COVID-19 vaccine are recommended to receive a bivalent mRNA vaccine ≥8 weeks after the last dose.²⁵

Use as a booster: in individuals ≥18 years of age who completed primary vaccination with any COVID-19 vaccine and have not received any boosters, and an mRNA vaccine is not available or appropriate, or is refused, Novavax COVID-19 vaccine 0.5 mL IM can be given ≥6 months after completion of primary vaccination.^14,25

Immunocompromised: response may be diminished.¹⁴

Refrigerator (2^oC to 8^oC): 6 hours (in-use vial or pre-drawn syringe).^10,14

Room temperature (≤25^oC): 6 hours (in-use vial or pre-drawn syringe).^10,14

Effectiveness estimates unknown for current variants.²⁰

--Continue to the next section for the COVID-19 Vaccines Available in Canada chart.--

COVID-19 Vaccines Available in CANADA

VACCINE^e	DOSE (Primary Series)	DOSE (Booster)	STORAGE/STABILITY	COMMENTS
BNT162b2 for ages 6 months through 4 years (Pfizer-BioNTech)/ mRNA (Comirnaty) MAROON cap and label border¹⁸ Requires dilution with 2.2 mL NS per vial.¹⁸	Primary vaccination for 6 months through 4 years of age: three 0.2 mL (3 mcg) IM doses. The first two doses are given three weeks apart (8-week interval preferred), followed by a 3^rd dose ≥8 weeks after the 2^nd dose.^18,20 Immunocompromised^f: As above plus 4^th dose, with 4 to 8 weeks between each of the four doses.²⁰	N/A	Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d. Refrigerator (2^oC to 8^oC) (option if vials arrive frozen or refrigerated): 10 weeks undiluted; 12 hours once diluted (vial).¹⁸ Room Temp (up to 25^oC): 12 hours (undiluted); 12 hours (once diluted [vial]).¹⁸ Stable in pre-drawn syringe for 12 hours at room temperature (up to 30^oC).¹⁰ Vaccine should not be used after 18 months from date of manufacture.¹⁸	Efficacy against symptomatic infection ~2 months after the third dose was >70% (Omicron-predominant period).²⁰ See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.
BNT162b2 for ≥12 years of age^a (Pfizer-BioNTech)/ mRNA (Comirnaty) GRAY cap and label border¹⁸ Do NOT dilute.¹⁸	Primary vaccination for ≥12 years of age: two 0.3 mL (30 mcg) IM doses 3 weeks apart (8-week interval preferred).^18,20 Immunocompromised^f: As above plus 3^rd dose, with 4 to 8 weeks between each of the three doses.^18,20	Bivalent booster preferred.^20,c Booster (≥12 years of age [approved for ≥16 years]):^c one 0.3 mL (30 mcg) IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the primary series, booster, or infection.^11,18 Immunocompromised^f,h: as above.²⁰	Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d. Refrigerator (2^oC to 8^oC): 10 weeks (unpunctured vial).¹⁸ 12 hours (pre-drawn syringe).¹⁰ Room Temp (up to 25^oC): 12 hours (unpunctured vial or pre-drawn syringe).^10,18Discard vials 12 hours after first puncture.¹⁸ Vaccine should not be used after 18 months from date of manufacture.¹⁸	Case-control data in adults suggests that three doses were 61% effective against symptomatic infection, and 95% effective against severe outcomes from the Omicron variant circulating in Ontario in December 2021.¹³ See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.
BNT162b2 for ages 5 through 11 years (Pfizer-BioNTech)/ mRNA (Comirnaty) ORANGE cap and label border¹⁸ Requires dilution with 1.3 mL of NS per vial.¹⁸	Primary vaccination for 5 to 11 years of age: two 0.2 mL (10 mcg) IM doses 3 weeks apart. (≥8-week interval preferred).^18,20 Immunocompromised: as above plus 3^rd dose, with 4 to 8 weeks between each of the three doses.^18,20	Booster: one 0.2 mL (10 mcg) IM dose ≥6 months after last primary dose.¹⁸	Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d. Refrigerator (2^oC to 8^oC) (option if vials arrive frozen or refrigerated): 10 weeks undiluted; 12 hours once diluted (vial).¹⁸ Room Temp (up to 25^oC): 12 hours (undiluted); 12 hours (once diluted [vial]).¹⁸ Stable in pre-drawn syringe for 24 hours, with no more than 12 hours at room temperature (up to 30^oC).¹⁰ Vaccine should not be used after 18 months from date of manufacture.¹⁸	Efficacy was 68% against hospitalization about one month after the second dose (Omicron BA.1-predominant period).¹⁷ See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.
Pfizer-BioNTech Bivalent booster (original and Omicron BA.4/BA.5) for ≥12 years of age^a (Pfizer-BioNTech)/ mRNA (Comirnaty) GRAY cap and label border.²⁶ Do NOT dilute.²⁶	N/A	Booster (≥12 years of age): one 0.3 mL IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the primary series, booster, or infection.^11,26	Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d. Refrigerator (2^oC to 8^oC): 10 weeks (unpunctured vial).²⁶ Room Temp (up to 25^oC): 12 hours (unpunctured vial).²⁶ Discard vials 12 hours after first puncture.²⁶ Vaccine should not be used after 18 months from date of manufacture.²⁶	Approval based on immunogenicity data from a different bivalent vaccine (original and Omicron BA.1) in individuals ≥55 years of age.²⁶ Also see footnote b. See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.
Pfizer-BioNTech Bivalent booster (original and Omicron BA.4/BA.5) for 5 through 11 years of age (Pfizer-BioNTech)/ mRNA (Comirnaty) ORANGE cap and label border²⁶ Requires dilution with 1.3 mL of NS per vial.²⁶	N/A	Booster (5 through 11 years of age): one 0.2 mL IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the primary series, booster, or infection.^11,26	Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d. Refrigerator (2^oC to 8^oC): 10 weeks (undiluted). 12 hours once diluted.²⁶ Room Temp (up to 25^oC): 12 hours (undiluted). 12 hours once diluted.²⁶ Vaccine should not be used after 18 months from date of manufacture.²⁶	See above.
mRNA-1273 (Moderna)/ mRNA (Spikevax) RED cap and label with a light blue border (0.2 mg/mL)²²	Primary vaccination for ≥12 years of age: two 0.5 mL (100 mcg) IM doses 1 month (4 weeks) apart (8-week interval preferred).^20,22 6 to 11 years of age: two 0.25 mL (50 mcg) IM doses 4 weeks apart (≥8-week interval preferred).^20,22 Immunocompromised^f: as above plus 3^rd dose, with 4 to 8 weeks between each of the three doses.^20,22	Bivalent booster preferred.^20,c Booster (≥12 years of age): one 0.25 mL (50 mcg) IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the primary series, booster, or infection.^11,22 Immunocompromised^f: as above.²⁰	Shipping/long-term storage (freezer): See footnote d. Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).²² In-use vial: 24 hours.²² Pre-drawn syringe: 12 hours from first puncture of source vial.¹⁰ Room Temp (8^oC to 25^oC): unpunctured or in-use vial: 24 hours total.²²Pre-drawn syringe: 12 hours from first puncture of source vial.¹⁰	Case-control data in adults suggests that three doses were 61% effective against symptomatic infection, and 95% effective against severe outcomes from the Omicron variant circulating in Ontario in December 2021.¹³ See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis. Delayed-type hypersensitivity reaction (e.g., large, red area near injection site) reported most often about a week after first shot. May be itchy, painful, warm, or swollen, and can also involve fingers, elbow, or palm. Not a contraindication to subsequent vaccination.¹⁵
mRNA-1273 (Moderna)/ mRNA (Spikevax) ROYAL blue cap and a label with a PURPLE border²² (0.1 mg/mL) Approved for primary series (6 months through 11 years) and 50 mcg booster (≥12 years of age)²²	Primary vaccination for 6 months through 5 years of age: two 0.25 mL (25 mcg) IM doses 4 weeks apart (≥8 weeks preferred).^20,22 Primary vaccination for 6 through 11 years of age: two 0.5 mL (50 mcg) IM doses 4 weeks apart (≥8 weeks preferred).^20,22 Immunocompromised: as above plus 3^rd dose, with 4 to 8 weeks between each of the three doses.^20,22	Bivalent booster preferred.^20,c Booster (≥12 years of age): one 0.5 mL (50 mcg) IM dose≥6 months (≥3 months in the event of heightened epidemiologic risk) after the primary series, booster, or infection.^11,22	Shipping/long-term storage (freezer): See footnote d. Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).²² In-use vial: 24 hours.²² Room Temp (8^oC to 25^oC): in-use vial: 24 hours.²²	Efficacy ~60% against symptomatic Omicron infection (ages 3 to 5 years, 2 weeks to 2 months post-vaccination).¹² See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.
mRNA-1273 Bivalent Booster (original and Omicron BA.1) (Moderna)/ mRNA (Spikevax Bivalent) ROYAL blue cap and label with GREEN border¹	N/A	Booster (6 to 11 years of age): one 0.25 mL (25 mcg) IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the last COVID-19 vaccine dose or infection.^1,20 Booster (≥12 years of age): one 0.5 mL (50 mcg) dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the last COVID-19 vaccine dose or infection.^1,11	Shipping/long-term storage (freezer): See footnote d. Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).¹ In-use vial: 24 hours.¹ Room Temp (8^oC to 25^oC): 24 hours total, in-use or unpunctured.¹	Approval based on immunogenicity data.¹ See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.
mRNA-1273 Bivalent Booster (original and Omicron BA.4/BA.5) (Moderna)/ mRNA (Spikevax Bivalent) ROYAL blue cap and label with GREY border¹⁹	N/A	Booster (≥18 years of age): one 0.5 mL (50 mcg) IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the last COVID-19 vaccine dose or infection.¹⁹	Shipping/long-term storage (freezer): See footnote d. Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).¹⁹ In-use vial: 24 hours.¹⁹ Room Temp (8^oC to 25^oC): 24 hours total, in-use or unpunctured.¹⁹	Approval based on immunogenicity data.¹Also see footnote b. See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.
Ad26.COV2.S Janssen (J&J)/ Viral vector (non-replicating) (Jcovden) mRNA vaccine preferred.²⁰	Primary vaccination for ≥18 years of age: one 0.5 mL IM dose.²⁴ Immunocompromised: as above, plus 2^nd dose, (mRNA vaccine)≥28 days later.²⁰	Bivalent booster preferred.^11,c First Booster (only when all other vaccines are contraindicated): ≥2 months after the first dose.^20,24(As a booster after primary vaccination with an mRNA vaccine, a dosing interval of 3 to 6 months was used in clinical trials.²⁴)	Shipping/long-term storage (freezer): See footnote d. Refrigerator (2^oC to 8^oC): up to 11 months, not to exceed manufacturer expiration date (unpunctured vial).²⁴ In-use vial/pre-drawn syringe: 6 hours.²⁴ Room Temp (9^oC to 25^oC): unpunctured vial: 12 hours.²⁴ In-use vial/pre-drawn syringe: 3 hours.²⁴	Efficacy 54.3% against symptomatic infection two to four months after mRNA booster (Omicron BA.1-predominant period).⁷ See our FAQ, Communicating About COVID-19 Vaccination, for information about thrombosis with thrombocytopenia syndrome (TTS) and other rare side effects of viral vector COVID-19 vaccines.
ChAdOx1-S (AstraZeneca)/Viral vector (non-replicating) (Vaxzevria) mRNA vaccine preferred.²⁰	Primary vaccination for ≥18 years of age: two 0.5 mL IM doses 4 to 12 weeks apart (≥8-week interval preferred).^16,20 Immunocompromised: As above plus 3^rd dose (mRNA vaccine) ≥28 days later.²⁰	N/A	Refrigerator (2^oC to 8^oC): manufacturer expiration date (unpunctured vial); 48 hours (in-use vial).¹⁶ Room Temp (≤30^oC): 6 hours (in-use vial). Vial can be re-refrigerated, but the cumulative storage at room temperature cannot exceed 6 hours, and the total cumulative storage time cannot exceed 48 hours.¹⁶	Efficacy against symptomatic Omicron 45.9% one month after second dose.²¹ See our FAQ, Communicating About COVID-19 Vaccination, for information about thrombosis with thrombocytopenia syndrome (TTS) and other rare side effects of viral vector COVID-19 vaccines.
NVX-CoV2373 (Novavax)/ Recombinant protein subunit, adjuvanted (Nuvaxovid) mRNA vaccine preferred.²⁰	Primary vaccination for ≥12 years of age: two 0.5 mL IM doses three weeks apart (8-week interval preferred).^8,20 Immunocompromised^f: As above, plus 3^rd dose, with 4 to 8 weeks between each of the three doses (mRNA vaccine preferred).²⁰	Bivalent booster preferred.^11,c Booster (≥18 years of age): one 0.5 mL IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the last COVID-19 vaccine dose or infection.^8,11	Refrigerator (2^oC to 8^oC): 12 hours (in-use vial) or 6 hours (pre-drawn syringe).^8,10 Room Temp (≤25^oC): 6 hours (in-use vial or pre-drawn syringe).^8,10	Effectiveness estimates unknown for current variants.²⁰

VACCINE^e

DOSE (Primary Series)

DOSE (Booster)

STORAGE/STABILITY

COMMENTS

BNT162b2 for ages

6 months through 4 years

(Pfizer-BioNTech)/

mRNA

(Comirnaty)

MAROON cap and label border¹⁸

Requires dilution with

2.2 mL NS per vial.¹⁸

Primary vaccination for 6 months through 4 years of age: three 0.2 mL (3 mcg) IM doses. The first two doses are given three weeks apart (8-week interval preferred), followed by a 3^rd dose ≥8 weeks after the 2^nd dose.^18,20

Immunocompromised^f: As above plus 4^th dose, with 4 to 8 weeks between each of the four doses.²⁰

N/A

Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d.

Refrigerator (2^oC to 8^oC) (option if vials arrive frozen or refrigerated): 10 weeks undiluted; 12 hours once diluted (vial).¹⁸

Room Temp (up to 25^oC):

12 hours (undiluted); 12 hours (once diluted [vial]).¹⁸

Stable in pre-drawn syringe for 12 hours at room temperature (up to 30^oC).¹⁰

Vaccine should not be used after 18 months from date of manufacture.¹⁸

Efficacy against symptomatic infection ~2 months after the third dose was >70% (Omicron-predominant period).²⁰

See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.

BNT162b2 for ≥12 years of age^a

(Pfizer-BioNTech)/

mRNA

(Comirnaty)

GRAY cap and label border¹⁸

Do NOT dilute.¹⁸

Primary vaccination for ≥12 years of age: two 0.3 mL (30 mcg) IM doses 3 weeks apart (8-week interval preferred).^18,20

Immunocompromised^f: As above plus 3^rd dose, with 4 to 8 weeks between each of the three doses.^18,20

Bivalent booster preferred.^20,c

Booster (≥12 years of age [approved for ≥16 years]):^c one 0.3 mL (30 mcg) IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the primary series, booster, or infection.^11,18

Immunocompromised^f,h: as above.²⁰

Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d.

Refrigerator (2^oC to 8^oC):

10 weeks (unpunctured vial).¹⁸ 12 hours (pre-drawn syringe).¹⁰

Room Temp (up to 25^oC): 12 hours (unpunctured vial or pre-drawn syringe).^10,18Discard vials 12 hours after first puncture.¹⁸

Vaccine should not be used after 18 months from date of manufacture.¹⁸

Case-control data in adults suggests that three doses were 61% effective against symptomatic infection, and 95% effective against severe outcomes from the Omicron variant circulating in Ontario in December 2021.¹³

See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.

BNT162b2 for ages

5 through 11 years

(Pfizer-BioNTech)/

mRNA

(Comirnaty)

ORANGE cap and label border¹⁸

Requires dilution with

1.3 mL of NS per vial.¹⁸

Primary vaccination for 5 to 11 years of age: two 0.2 mL (10 mcg) IM doses 3 weeks apart. (≥8-week interval preferred).^18,20

Immunocompromised: as above plus 3^rd dose, with 4 to 8 weeks between each of the three doses.^18,20

Booster: one 0.2 mL (10 mcg) IM dose ≥6 months after last primary dose.¹⁸

Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d.

Refrigerator (2^oC to 8^oC) (option if vials arrive frozen or refrigerated): 10 weeks undiluted; 12 hours once diluted (vial).¹⁸

Room Temp (up to 25^oC): 12 hours (undiluted); 12 hours (once diluted [vial]).¹⁸

Stable in pre-drawn syringe for 24 hours, with no more than 12 hours at room temperature (up to 30^oC).¹⁰

Vaccine should not be used after 18 months from date of manufacture.¹⁸

Efficacy was 68% against hospitalization about one month after the second dose (Omicron BA.1-predominant period).¹⁷

See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.

Pfizer-BioNTech Bivalent booster

(original and Omicron BA.4/BA.5) for ≥12 years of age^a

(Pfizer-BioNTech)/

mRNA

(Comirnaty)

GRAY cap and label border.²⁶

Do NOT dilute.²⁶

N/A

Booster (≥12 years of age): one 0.3 mL IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the primary series, booster, or infection.^11,26

Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d.

Refrigerator (2^oC to 8^oC):

10 weeks (unpunctured vial).²⁶

Room Temp (up to 25^oC): 12 hours (unpunctured vial).²⁶

Discard vials 12 hours after first puncture.²⁶

Vaccine should not be used after 18 months from date of manufacture.²⁶

Approval based on immunogenicity data from a different bivalent vaccine (original and Omicron BA.1) in individuals ≥55 years of age.²⁶ Also see footnote b.

See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.

Pfizer-BioNTech Bivalent booster (original and Omicron BA.4/BA.5) for 5 through 11 years of age

(Pfizer-BioNTech)/

mRNA

(Comirnaty)

ORANGE cap and label border²⁶

Requires dilution with

1.3 mL of NS per vial.²⁶

N/A

Booster (5 through 11 years of age): one 0.2 mL IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the primary series, booster, or infection.^11,26

Shipping/long-term storage (ultra-low temp freezer, freezer): See footnote d.

Refrigerator (2^oC to 8^oC):

10 weeks (undiluted). 12 hours once diluted.²⁶

Room Temp (up to 25^oC): 12 hours (undiluted). 12 hours once diluted.²⁶

Vaccine should not be used after 18 months from date of manufacture.²⁶

See above.

mRNA-1273

(Moderna)/

mRNA

(Spikevax)

RED cap and label with a light blue border (0.2 mg/mL)²²

Primary vaccination for ≥12 years of age: two 0.5 mL (100 mcg) IM doses 1 month (4 weeks) apart (8-week interval preferred).^20,22

6 to 11 years of age: two 0.25 mL (50 mcg) IM doses 4 weeks apart (≥8-week interval preferred).^20,22

Immunocompromised^f: as above plus 3^rd dose, with 4 to 8 weeks between each of the three doses.^20,22

Bivalent booster preferred.^20,c

Booster (≥12 years of age): one 0.25 mL (50 mcg) IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the primary series, booster, or infection.^11,22

Immunocompromised^f: as above.²⁰

Shipping/long-term storage (freezer): See footnote d.

Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).²²

In-use vial: 24 hours.²² Pre-drawn syringe: 12 hours from first puncture of source vial.¹⁰

Room Temp (8^oC to 25^oC): unpunctured or in-use vial: 24 hours total.²²Pre-drawn syringe: 12 hours from first puncture of source vial.¹⁰

See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.

Delayed-type hypersensitivity reaction (e.g., large, red area near injection site) reported most often about a week after first shot. May be itchy, painful, warm, or swollen, and can also involve fingers, elbow, or palm. Not a contraindication to subsequent vaccination.¹⁵

mRNA-1273

(Moderna)/

mRNA

(Spikevax)

ROYAL blue cap and a label with a PURPLE border²²

(0.1 mg/mL)

Approved for primary series (6 months through 11 years) and 50 mcg booster (≥12 years of age)²²

Primary vaccination for 6 months through 5 years of age: two 0.25 mL (25 mcg) IM doses 4 weeks apart (≥8 weeks preferred).^20,22

Primary vaccination for 6 through 11 years of age: two 0.5 mL (50 mcg) IM doses 4 weeks apart (≥8 weeks preferred).^20,22

Immunocompromised: as above plus 3^rd dose, with 4 to 8 weeks between each of the three doses.^20,22

Bivalent booster preferred.^20,c

Booster (≥12 years of age): one 0.5 mL (50 mcg) IM dose≥6 months (≥3 months in the event of heightened epidemiologic risk) after the primary series, booster, or infection.^11,22

Shipping/long-term storage (freezer): See footnote d.

Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).²² In-use vial: 24 hours.²²

Room Temp (8^oC to 25^oC): in-use vial: 24 hours.²²

Efficacy ~60% against symptomatic Omicron infection (ages 3 to 5 years, 2 weeks to 2 months post-vaccination).¹²

See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.

mRNA-1273 Bivalent Booster (original and Omicron BA.1)

(Moderna)/

mRNA

(Spikevax Bivalent)

ROYAL blue cap and label with GREEN border¹

N/A

Booster (6 to 11 years of age): one 0.25 mL (25 mcg) IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the last COVID-19 vaccine dose or infection.^1,20

Booster (≥12 years of age): one 0.5 mL (50 mcg) dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the last COVID-19 vaccine dose or infection.^1,11

Shipping/long-term storage (freezer): See footnote d.

Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).¹ In-use vial: 24 hours.¹

Room Temp (8^oC to 25^oC): 24 hours total, in-use or unpunctured.¹

Approval based on immunogenicity data.¹

See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.

mRNA-1273 Bivalent Booster (original and Omicron BA.4/BA.5)

(Moderna)/

mRNA

(Spikevax Bivalent)

ROYAL blue cap and label with GREY border¹⁹

N/A

Booster (≥18 years of age): one 0.5 mL (50 mcg) IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the last COVID-19 vaccine dose or infection.¹⁹

Shipping/long-term storage (freezer): See footnote d.

Refrigerator (2^oC to 8^oC): 30 days after thawing (prior to first use).¹⁹ In-use vial: 24 hours.¹⁹

Room Temp (8^oC to 25^oC): 24 hours total, in-use or unpunctured.¹⁹

Approval based on immunogenicity data.¹Also see footnote b.

See our FAQ, Communicating About COVID-19 Vaccination, for information about myocarditis/pericarditis.

Ad26.COV2.S

Janssen (J&J)/

Viral vector (non-replicating)

(Jcovden)

mRNA vaccine preferred.²⁰

Primary vaccination for ≥18 years of age: one 0.5 mL IM dose.²⁴

Immunocompromised: as above, plus 2^nd dose, (mRNA vaccine)≥28 days later.²⁰

Bivalent booster preferred.^11,c

First Booster (only when all other vaccines are contraindicated): ≥2 months after the first dose.^20,24(As a booster after primary vaccination with an mRNA vaccine, a dosing interval of 3 to 6 months was used in clinical trials.²⁴)

Shipping/long-term storage (freezer): See footnote d.

Refrigerator (2^oC to 8^oC): up to 11 months, not to exceed manufacturer expiration date (unpunctured vial).²⁴ In-use vial/pre-drawn syringe: 6 hours.²⁴

Room Temp (9^oC to 25^oC): unpunctured vial: 12 hours.²⁴ In-use vial/pre-drawn syringe: 3 hours.²⁴

Efficacy 54.3% against symptomatic infection two to four months after mRNA booster (Omicron BA.1-predominant period).⁷

See our FAQ, Communicating About COVID-19 Vaccination, for information about thrombosis with thrombocytopenia syndrome (TTS) and other rare side effects of viral vector COVID-19 vaccines.

ChAdOx1-S

(AstraZeneca)/Viral vector (non-replicating) (Vaxzevria)

mRNA vaccine preferred.²⁰

Primary vaccination for ≥18 years of age:

two 0.5 mL IM doses

4 to 12 weeks apart (≥8-week interval preferred).^16,20

Immunocompromised:

As above plus 3^rd dose (mRNA vaccine) ≥28 days later.²⁰

N/A

Refrigerator (2^oC to 8^oC): manufacturer expiration date (unpunctured vial); 48 hours (in-use vial).¹⁶

Room Temp (≤30^oC): 6 hours (in-use vial). Vial can be re-refrigerated, but the cumulative storage at room temperature cannot exceed 6 hours, and the total cumulative storage time cannot exceed 48 hours.¹⁶

Efficacy against symptomatic Omicron 45.9% one month after second dose.²¹

See our FAQ, Communicating About COVID-19 Vaccination, for information about thrombosis with thrombocytopenia syndrome (TTS) and other rare side effects of viral vector COVID-19 vaccines.

NVX-CoV2373

(Novavax)/

Recombinant protein subunit, adjuvanted

(Nuvaxovid)

mRNA vaccine preferred.²⁰

Primary vaccination for ≥12 years of age: two 0.5 mL IM doses three weeks apart (8-week interval preferred).^8,20

Immunocompromised^f: As above, plus 3^rd dose, with 4 to 8 weeks between each of the three doses (mRNA vaccine preferred).²⁰

Bivalent booster preferred.^11,c

Booster (≥18 years of age): one 0.5 mL IM dose ≥6 months (≥3 months in the event of heightened epidemiologic risk) after the last COVID-19 vaccine dose or infection.^8,11

Refrigerator (2^oC to 8^oC):

12 hours (in-use vial) or 6 hours (pre-drawn syringe).^8,10

Room Temp (≤25^oC): 6 hours (in-use vial or pre-drawn syringe).^8,10

Effectiveness estimates unknown for current variants.²⁰

The adult formulation of the Pfizer-BioNTech vaccine CANNOT be used for children <12 years of age by using a dose-adjusted volume. This is because the resulting volume is too small for an intramuscular injection.⁶
Efficacy: Absolute efficacy of the bivalent booster (Original and Omicron BA.4/BA.5) against hospitalization vs receiving no previous COVID-19 vaccine doses was 84% (95% CI 64% to 93%) in one US cohort.⁴ Absolute efficacy of the bivalent booster against infection vs receiving no previous COVID-19 vaccine doses varied based on age and number of previous monovalent doses and ranged from 19% to 50%.⁵ The bivalent booster was also more effective than previous vaccination with the monovalent booster in regard to preventing infection and hospitalization.^4,5 For the Omicron BA.2-related sublineage XBB.1.5, efficacy of the bivalent booster against symptomatic infection relative to monovalent vaccine alone was 38% to 50% depending on age and time since last dose.⁹ Note that many of the patients in these studies likely had at least some natural immunity, which would reduce relative efficacy of the booster. For the most current CDC-authored vaccine effectiveness studies, see COVID-19 Vaccine Effectiveness Monthly Update at https://covid.cdc.gov/covid-data-tracker/#vaccine-effectiveness.
Bivalent booster (age-appropriate) preferred, regardless of the number of booster doses previously received, and can be offered to all individuals ≥12 years of age, especially those at increased risk.¹¹
See product labeling for storage in ultra-low freezer, freezer, and thawing before use, if applicable.
Tips to minimize vaccine waste include:^10,23
- Maintain the cold chain to prevent waste due to inappropriate storage conditions.
- Maximize doses drawn from multidose vials using:
  - low dead-volume syringes/needles.
  - techniques to minimize leakage (e.g., multiple puncture locations in the rubber stopper, instead of the same location over and over [this can create a larger hole]).
- Draw up an appropriate number of syringes based on expected vaccination appointments for the day.
  - Monitor appointment cancellations and no shows throughout the day. Then draw up afternoon doses based on the revised appointment list.
- Use syringes in order of expiration time, starting with the earliest expiration date.
- Maintain a waiting list to contact people at the end of the day if there are extra doses available.
US: Immunocompromise = solid organ transplant patients or similar level of immunocompromise. For a full list of CDC-recommended conditions, see https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html#immunocompromised.
Canada: See a full list of immunocompromising conditions, see the Canadian Immunization Guide: https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-3-vaccination-specific-populations/page-8-immunization-immunocompromised-persons.html.

Abbreviations: EUA = Emergency Use Authorization; IM = intramuscular; NS = normal saline

The CDC has interim recommendations for COVID-19 vaccine administration errors and deviations available at https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us-appendix.html#appendix-d.

Fact Sheets and Product Labeling

Pfizer-BioNTech vaccine, bivalent. EUA fact sheet for healthcare professionals (US): https://www.fda.gov/media/167211/download
Pfizer-BioNTech vaccine, bivalent. EUA fact sheet for patients (US): https://www.fda.gov/media/167212/download
Moderna vaccine, bivalent EUA fact sheet for healthcare professionals (US): https://www.fda.gov/media/167208/download
Moderna vaccine, bivalent. EUA fact sheet for patients (US): https://www.fda.gov/media/167209/download
Novavax vaccine EUA fact sheet for healthcare professionals (US): https://www.fda.gov/media/159897/download
Novavax vaccine fact sheet for patients (US): https://www.fda.gov/media/159898/download
Current Canadian product monographs for Covid-19 vaccines available in Canada can be found at Health Canada’s Drug Product Database (https://health-products.canada.ca/dpd-bdpp/index-eng.jsp)

References

Product monograph for Spikevax Bivalent. Moderna Therapeutics. Cambridge, MA 02139. February 2023.
FDA. Fact sheet for healthcare providers administering vaccine: emergency use authorization of Pfizer-Biontech COVID-19 vaccine, bivalent (original and Omicron April 28, 2023. BA.4/BA.5). https://www.fda.gov/media/167211/download. (Accessed May 2, 2023).
FDA. Fact sheet for healthcare providers administering vaccine: emergency use authorization of Moderna COVID-19 vaccine, bivalent (original and omicron BA.4/BA.5). April 17, 2023. https://www.fda.gov/media/167208/download. (Accessed May 2, 2023).
Surie D, DeCuir J, Zhu Y, et al.Early Estimates of Bivalent mRNA Vaccine Effectiveness in Preventing COVID-19–Associated Hospitalization Among Immunocompetent Adults Aged ≥65 Years — IVY Network, 18 States, September 8–November 30, 2022. MMWR Morb Mortal Wkly Rep. 2022 Dec 30;71(5152):1625-1630.
Link-Gelles R, Ciesla AA, Fleming-Dutra KE, et al. Effectiveness of Bivalent mRNA Vaccines in Preventing Symptomatic SARS-CoV-2 Infection — Increasing Community Access to Testing Program, United States, September–November 2022. MMWR Morb Mortal Wkly Rep. 2022 Dec 2;71(48):1526-1530.
American Pharmacists Association. Considerations for COVID-19 vaccination in adolescents and children. July 7, 2022. https://www.pharmacist.com/Practice/COVID-19/Know-the-Facts/Considerations-for-COVID-19-vaccination-in-adolescents-and-children. (Accessed May 3, 2023).
Accorsi EK, Britton A, Shang N, et al. Effectiveness of Homologous and Heterologous Covid-19 Boosters against Omicron. N Engl J Med. 2022 Jun 23;386(25):2433-2435.
Product monograph for Nuvaxovid. Novavax. Gaithersburg, MD 20878. February 2023.
Link-Gelles R, Ciesla AA, Roper LE, et al. Early Estimates of Bivalent mRNA Booster Dose Vaccine Effectiveness in Preventing Symptomatic SARS-CoV-2 Infection Attributable to Omicron BA.5- and XBB/XBB.1.5-Related Sublineages Among Immunocompetent Adults - Increasing Community Access to Testing Program, United States, December 2022-January 2023. MMWR Morb Mortal Wkly Rep. 2023 Feb 3;72(5):119-124.
USP. COVID-19 vaccine handling toolkit: operational considerations for healthcare practitioners. Version 6.0. October 2022. https://www.usp.org/covid-19/vaccine-handling-toolkit. (Accessed May 2, 2023).
National Advisory Committee on Immunization (NACI). An Advisory Committee Statement (ACS). Recommendations on the use of bivalent Omicron-containing mRNA COVID-19 vaccines. September 1, 2022. https://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-bivalent-Omicron-containing-mrna-covid-19-vaccines.pdf. (Accessed May 3, 2023).
Fleming-Dutra KE, Ciesla AA, Roper LE, et al. Preliminary Estimates of Effectiveness of Monovalent mRNA Vaccines in Preventing Symptomatic SARS-CoV-2 Infection Among Children Aged 3-5 Years - Increasing Community Access to Testing Program, United States, July 2022-February 2023. MMWR Morb Mortal Wkly Rep. 2023 Feb 17;72(7):177-182.
Buchan SA, Chung H, Brown KA, et al. Estimated Effectiveness of COVID-19 Vaccines Against Omicron or Delta Symptomatic Infection and Severe Outcomes. JAMA Netw Open. 2022 Sep 1;5(9):e2232760.
FDA, Fact sheet for healthcare providers administering vaccine (vaccination providers). Emergency use authorization (EUA) of the Novavax COVID-19 vaccine, adjuvanted to prevent coronavirus disease 2019 (COVID-19). March 28, 2023. https://www.fda.gov/media/159897/download. (Accessed May 2, 2023).
Blumenthal KG, Freeman EE, Saff RR, et al. Delayed large local reactions to mRNA-1273 vaccine against SARS-CoV-2. N Engl J Med 2021;384:1273-1277.
Product monograph for Vaxzevria. AstraZeneca Canada. Mississauga, ON L4Y 1M4. December 2022.
Price AM, Olson SM, Newhams MM, et al. BNT162b2 Protection against the Omicron Variant in Children and Adolescents. N Engl J Med. 2022 May 19;386(20):1899-1909.
Product monograph for Comirnaty. Pfizer. Canada. Kirkland, QC H9J 2M5. March 2023.
Product monograph for Spikevax Bivalent. Original/Omicron BA.4/BA.5. Ingmar Strategies. Oakville, ON L6L 0C4.November 2022.
Government of Canada. COVID-19 vaccine: Canadian Immunization Guide. Date modified: March 22, 2023. https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-26-covid-19-vaccine.html#t4. (Accessed May 3, 2023).
Menegale F, Manica M, Zardini A, et al. Evaluation of Waning of SARS-CoV-2 Vaccine-Induced Immunity: A Systematic Review and Meta-analysis. JAMA Netw Open. 2023 May 1;6(5):e2310650.
Product monograph for Spikevax. Moderna Therapeutics. Cambridge, MA 02139. January 2023.
Coppock K. ISMP provides recommendations for avoiding COVID-19 vaccination administration errors. January 15, 2021. https://www.pharmacytimes.com/view/ismp-provides-recommendations-for-avoiding-covid-19-vaccination-administration-errors. (Accessed May 4, 2023).
Product monograph for Janssen COVID-19 vaccine. Janssen. Toronto, ON M3C 1L9. February 2023.
CDC. Use of COVID-19 vaccines in the United States. Interim clinical considerations. Last updated May 12, 2023. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html. (Accessed May 15, 2023).
Product monograph for Comirnaty Original/Omicron BA.4/BA.5. Pfizer Canada. Kirkland, QC H9J 2M5. April 2023.
CDC. Vaccine storage and handling toolkit. January 2023. https://www.cdc.gov/vaccines/hcp/admin/storage/toolkit/storage-handling-toolkit.pdf. (Accessed May 22, 2023).

Cite this document as follows: Clinical Resource, COVID-19 Vaccines. Pharmacist’s Letter/Pharmacy Technician’s Letter. June 2023. [390606]

COVID-19 Vaccines

Related Articles