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Updated May 8, 2023

As of April 18, 2023, COVID-19 Monovalent mRNA vaccines (Pfizer BioNtech, Comirnity ©, Moderna, Spikevax©), are no longer authorized for use in the United States. These have been replaced with new bivalent vaccines that have proven to be more effective against new and emerging COVID-19 variants.

As of June 1, 2023, DHEC Health Clinics will only administer Moderna bivalent vaccine.

Who is eligible for a booster dose or additional booster dose of bivalent COVID-19 vaccine?

  • Most individuals who have not yet, depending on age, previously vaccinated with a monovalent COVID-19 vaccine received a dose of a bivalent vaccine may receive a single dose of a bivalent vaccine.
  • Individuals 65 years of age and older who have received a single dose of a bivalent vaccine may receive one additional dose at least four months following their initial bivalent dose.
  • Most individuals with certain kinds of immunocompromises who have received a bivalent COVID-19 vaccine may receive a single additional dose of a bivalent COVID-19 vaccine at least 2 months following a dose of a bivalent COVID-19 vaccine, and additional doses may be administered at the discretion of, and at intervals determined by, their healthcare provider. However, for immunocompromised individuals 6 months through 4 years of age, eligibility for additional doses will depend on the vaccine previously received.

If you have completed your primary (monovalent) series, plus a single bivalent booster dose, no additional booster is authorized at this time for most individuals (see exceptions below)

  • Most individuals who have already received a single dose of the bivalent vaccine are not currently eligible for another dose. The FDA intends to make decisions about future vaccination after receiving recommendations on the fall strain composition at an FDA advisory committee in June.

If you have not yet been vaccinated against COVID-19

  • Most unvaccinated individuals may receive a single dose of a bivalent vaccine, rather than multiple doses of the original monovalent mRNA vaccines.
  • Children 6 months through 5 years of age who are unvaccinated may receive a two-dose series of the Moderna bivalent vaccine (6 months through 5 years of age) OR a three-dose series of the Pfizer-BioNTech bivalent vaccine (6 months through 4 years of age). Children who are 5 years of age may receive two doses of the Moderna bivalent vaccine or a single dose of the Pfizer-BioNTech bivalent vaccine. 

Boosters for Children ages 6 months through 5 years of age

  • Children 6 months through 5 years of age who have received one, two or three doses of a monovalent COVID-19 vaccine may receive a bivalent vaccine, but the number of doses that they receive will depend on the vaccine and their vaccination history.

Which primary vaccine series did you complete?

Pfizer-BioTech or Comirnaty

Moderna or SpikeVax

Janssen (J&J)

NovaVax

PRIMARY VACCINE SERIES COMPLETED

Pfizer-BioNTech or
Comirnaty
Prior to April 18, 2023

You may get a single bivalent booster dose if:

It’s been at least 2 months since completing a primary series AND you are age 6 months

If eligible, you may get a single bivalentmRNA booster dose of:

  • Pfizer-BioNTech
  • Moderna

PRIMARY VACCINE SERIES COMPLETED

Moderna or
Spikevax
Prior to April 18, 2023

You may get a single bivalent booster dose if:

It’s been at least 2 months since completing a primary series AND you are age 6 months

If eligible, you may get a single bivalentmRNA booster dose of:

  • Pfizer-BioNTech
  • Moderna

PRIMARY VACCINE SERIES COMPLETED

Janssen (J&J)

You may get a single bivalentmRNA bivalent booster dose if:

It’s been at least 2 months since completing a primary series AND you are age 18+

If eligible, you may get a single bivalentmRNA bivalent booster dose of:

  • Pfizer-BioNTech
  • Moderna

PRIMARY VACCINE SERIES COMPLETED

Novavax

You may get a single bivalentmRNA bivalent booster dose if:

It’s been at least 2 months since completing a primary series AND you are age 12+

If eligible, you may get a single bivalentmRNA booster dose of:

  • Pfizer-BioNTech
  • Moderna

mRNAmonovalent vaccines are no longer authorized for booster doses.

People ages 18 years and older who have completed a primary vaccination using any COVID-19 vaccine and have not received any previous booster dose(s) may receive a monovalent Novavax booster at least 6 months after completion of the primary series if they are unable (i.e., contraindicated or not available) or unwilling to receive an mRNA vaccine and would otherwise not receive a booster dose.

For more information, visit www.fda.gov/covid19vaccines

Other Important Considerations

  • There are four COVID-19 vaccines that are authorized or approved to prevent COVID-19 in the United States. Pfizer-BioNTech or Moderna vaccines are preferred.
  • You may want to discuss your individual risks and benefits with your healthcare provider.
  • "Mixing and matching" of vaccines for boosters for those 18 and up is acceptable. The CDC recommends mRNA vaccines, such as Pfizer-BioNTech and Moderna, as a booster dose. The Johnson & Johnson vaccine, as a booster dose, may be considered in certain situations, such as:
    • The patient has had a severe reaction after receiving a mRNA vaccine dose, or has a severe allergy to an ingredient in Pfizer-BioNTech or Moderna vaccines.
    • The patient wants to receive Novavax and they are unable or unwilling to receive a mRNA vaccine and would otherwise not receive a booster dose.
    • The patient wants to receive Johnson & Johnson/Janssen COVID vaccine despite safety concerns.
  • For people who are immunocompromised, all doses (first 2 and additional 3rd dose) should be with the same vaccine product.
  • For non-immunocompromised people, you may want to consider your individual risks and benefits and/or discuss with your healthcare provider to decide which booster product to use.

Data Supporting Need for a Booster Shot

Studies show after getting vaccinated against COVID-19, protection against the virus and the ability to prevent infection with variants may decrease over time and be less effective against the Omicron variant. However, a booster vaccine dose can increase protection against symptomatic Omicron infection from about 35% to 76%, and can have even higher effectiveness at preventing hospitalizations and death.

Find a COVID-19 Vaccine

Visit scdhec.gov/vaxlocator or call 1-855-472-3432.

References:

https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/work.html

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html

Frequently Asked Questions

No, vaccines reduce the risk of COVID-19, including the risk of severe illness and death among people who are fully vaccinated. While COVID-19 vaccines are effective, studies have shown some decrease in vaccine effectiveness against infection over time. Current vaccines are expected to protect against severe illness, hospitalizations, and deaths due to infection with the Omicron variant. The recent emergence of the Omicron variant further emphasizes the importance of vaccination, boosters, and prevention efforts to protect against COVID-19.

So far, reactions reported after getting the Pfizer-BioNTech or Moderna booster shot were similar to that of the two-shot primary series. Fatigue and pain at the injection site were the most commonly reported side effects, and overall, most side effects were mild to moderate. However, as with the two-shot primary series, serious side effects are rare, but may occur. Similarly, reactions after the second dose of the Janssen vaccine were similar to those experienced with the first dose.

Reactions after getting a COVID-19 vaccine can vary from person to person. Reactions reported after getting a booster shot are like those after the two-dose or single-dose primary shots. Fever, headache, fatigue, and pain at the injection site were the most reported side effects, and overall, most side effects were mild to moderate. Vaccination protects you from severe COVID-19 infection even if you have side effects after vaccination.

The CDC recommends everyone stay up to date with COVID-19 vaccines for their age group:
Children and teens aged 6 months - 17 years
Adults aged 18 years and older

Yes, Pfizer-BioNTech COVID-19 should be given as a single booster dose for all individuals aged 12 and older at least 5 months after completion of the Pfizer primary vaccination series. A second booster is recommended for ages 12 and up who are moderately or severely immunocompromised.

No, it is not too late to get a booster so you can still get your booster at the later date. The single booster dose should be given as close to 2 months after completing a primary series. However, there is no known “expiration period” after which you cannot get the booster.

Yes, but it is recommended you get the shots in separate arms.

Yes, COVID-19 vaccines may be administered without regard to timing of other vaccines. This includes simultaneous administration of COVID-19 vaccine and other vaccines on the same day. If multiple vaccines are administered at a single visit, each shot can be given in a different injection site. If a patient is due for more than one vaccine, providers are encouraged to offer all the vaccines at the same visit.

Yes. However, you should defer getting the booster at least until clinical syndrome has completely resolved.
Talk with your health care provider to help you decide about booster choice and timing.

No. A booster dose of Janssen vaccine is not recommended for you.

You may receive a dose of Pfizer or Moderna as a booster at least two months following the Janssen dose and after the clinical condition has stabilized.

Talk with your health care provider.

No data are available on the safety of administering either Janssen or mRNA booster dose for this situation.

You do have the option to receive a Pfizer or Moderna booster at least two months after the Janssen dose. At this time, there is no known increased risk of GBS after Pfizer-BioNTech or Moderna vaccination.

Janssen may still be used as a booster, particularly if your GBS occurrence was more than 42 days after vaccination or was assessed as related to a non-vaccine factor.

Talk with your healthcare provider.

If you had a severe allergic reaction (anaphylaxis) to Janssen vaccine or to the first or second dose of Pfizer or Moderna, you should not receive that same vaccine as a booster dose.

You have the option of receiving Janssen if you were severely allergic to Pfizer or Moderna, or receiving Pfizer or Moderna if you had severe reaction to Janssen.

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