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September 14, 2023
On Sept. 12, the Advisory Committee on Immunization Practices (ACIP) recommended 2023-2024 (monovalent, XBB containing) COVID-19 vaccines as approved by Biologics License Application (BLA) or authorized under Emergency Use Authorization (EUA) for all persons 6 months of age and older. Currently, Comirnaty (Pfizer) and Spikevax (Moderna) are licensed for persons 12 years and older. The Pfizer and Moderna vaccines for children under 12 years of age continue under EUA. Novavax is still awaiting FDA approval. Updated recommendations are inclusive of all 2023-2024 version vaccine products for persons 6 months and older that are approved by the FDA.
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Children 6 months through 4 years of age should complete a primary series including either 2 doses of Moderna or 3 doses of Pfizer vaccine, with at least one of the doses being the new 2023-2024 mRNA COVID-19 vaccine. If they had completed a primary series prior, one dose of the new 2023-2024 vaccine should be given at least 2 months after any previous dose.
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People 5 years of age and older should receive 1 dose of the new 2023-2024 COVID-19 vaccine. If they have received any previous COVID-19 vaccine, the new 2023-2024 vaccine should be given at least 2 months after any previous dose.
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People who are immunocompromised should have 3 doses with at least one of the doses being the new 2023-2024 COVID-19 vaccine. They may also receive additional 2023-2024 COVID-19 vaccine doses based on their clinical situation.
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People over 65 years of age: there is currently no recommendation to receive more than one 2023-2024 vaccine dose; this may be updated as more data become available.
This updated vaccination is especially important for people at high-risk of hospitalization and death. Rates of COVID-19 are rising throughout the country and protection from previous vaccination and disease is waning.
With the recommendation for the new 2023-2024 COVID-19 vaccine, the previous bivalent vaccines are no longer recommended, should be disposed as medical waste, and reported as nonviable in MIIC. Refer to Reporting Nonviable MDH Vaccine to MIIC for further details.
The 2023-2024 vaccine presentations are slightly different from the bivalent vaccines. There are new cap and label colors.
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Pfizer for persons 6 months to 4 years has a yellow cap and needs to be diluted.
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Pfizer for persons 5 years to 11 years has a blue cap.
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Pfizer for persons 12 years and older has a gray cap.
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Moderna for persons 6 months to 11 years has a blue cap and green label.
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Moderna for persons 12 years and older has a blue cap and blue label.
Moderna now has only two vaccine presentations and the dose volume for all Pfizer has been simplified to 0.3ml. Storage and handling will remain the same as it is now.
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A reminder to providers that vaccine cards will not be included anymore with vaccine orders. We suggest providing people with a copy of their Electronic Health Record (EHR), Minnesota Immunization Information Connection (MIIC) record, or tell them to sign up to access a copy of their vaccine record at Docket and MIIC Immunization Records.
MIIC staff are working on changes to the MIIC forecaster logic to align with CDC’s recommendations for the updated COVID-19 vaccine. Please continue to use clinical judgement and the CDC: Interim Clinical Considerations: Use of COVID-19 Vaccines in the United States to inform immunization decisions. These clinical considerations will be updated soon to match new COVID-19 vaccine recommendations.
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