With the recent expansion of recommendations for the use of updated (bivalent) COVID-19 vaccines to children ages 6 months through 5 years, providers have asked for more clarification about the COVID-19 vaccination guidance for children, specifically for age 5 years. If you are using a consistent brand, use the vaccine for the appropriate age group, there are no gaps, Moderna and Pfizer just divided their age groups differently. Moderna is 6 months through 5 years, and then 6 years through 11 years. Pfizer is 6 months through 4 years, and then 5 years through 11 years. Both then have the same dose and schedule for all persons over 12 years.  

Moderna primary series:  

• Children currently age 5 years who complete a Moderna primary series may receive either the previously authorized bivalent Pfizer (orange cap vaccine) booster dose or the newly authorized bivalent Moderna booster dose at least two months after completion of the Moderna primary series. 

Pfizer primary series:  

• Children currently age 5 that completed a 2-dose Pfizer primary (orange cap vaccine) series should receive one bivalent Pfizer booster dose at least two months after completion of the primary series or last monovalent booster dose.
• Children currently age 5 that completed a 3-dose Pfizer 6 months through 4 years primary series and now turned 5 years should receive one bivalent Pfizer booster (orange cap vaccine) dose when they turn age 5 years, and it has been at least two months since completing their primary series. A child can get the bivalent booster dose regardless of whether the third primary series dose was a monovalent or bivalent Pfizer vaccine.

• Currently, only the bivalent Pfizer booster dose is authorized for children age 5 years who complete a Pfizer primary series. 

Refer to the Interim Clinical Considerations for Use of COVID-19 Vaccines and COVID-19 Vaccination Interim Clinical Considerations FAQs for further details.