Children ages 6 months through 4 years who had completed the Pfizer 3-dose monovalent COVID-19 vaccine series may now receive a bivalent booster if it has been at least 8 weeks since they completed the monovalent series. On Tuesday, March 14, the Food and Drug Administration (FDA) amended the emergency use authorization (EUA) of the Pfizer COVID-19 vaccine, bivalent so that these children can receive a bivalent booster product. On March 17, the CDC also recommended this update.

• Children 6 months through 4 years of age who completed their 3-dose primary series with only the monovalent Pfizer COVID-19 vaccine are now eligible to receive a single bivalent booster dose of the Pfizer COVID-19 vaccine. There should be at least 8 weeks between the third dose of the primary series and a bivalent booster dose. 
• No additional doses of any COVID-19 vaccine product are recommended for children 6 months through 4 years of age who received their primary series two doses of monovalent Pfizer COVID-19 vaccine followed by a third dose of Pfizer bivalent product since December 2022. These children have already received a dose of bivalent vaccine and are considered up to date and are expected to have protection against serious COVID-19 outcomes.   

For details on FDA’s authorization, refer to their media statement Coronavirus (COVID-19) Update: FDA Authorizes Bivalent Pfizer-BioNTech COVID-19 Vaccine as Booster Dose for Certain Children 6 Months through 4 Years of Age.

The FDA EUA fact sheets for health care providers and recipients and caregivers have been updated and can be found at Pfizer-BioNTech COVID-19 Vaccine. CDC has updated the Interim Clinical Considerations for Use of COVID-19 Vaccines. MDH is currently updating resources to reflect this change and can be found at COVID-19 Vaccine Providers.