Updated 2024–2025 COVID-19 vaccines: who should get them—and when

SARS-CoV-2, the virus that causes COVID-19, killed more than 75,000 people last year and was linked to nearly a million hospitalizations. Yet only 22.5% of adults and 14% of children received the 2023-2024 updated COVID-19 vaccine.

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Getting a dose of the 2024–2025 updated COVID-19 vaccine is the best way to update immunity and stay protected, according to Sandra Adamson Fryhofer, MD, the AMA's liaison to the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP).

With COVID-19 cases on the rise once more, patients should take advantage.

“We certainly hope uptake of this new vaccine will be better,” said Dr. Fryhofer.

The ACIP in June voted to recommend the updated vaccines. The Food and Drug Administration (FDA) in late August authorized and approved the Pfizer and Moderna mRNA versions of the 2024–2025 updated COVID-19 vaccine, as well as the updated protein-based Novavax vaccine.

Once FDA gave the green light, the vaccine was on its way to clinics and pharmacies around the country.

Everyone 6 months or older should get a dose of the updated COVID-19 vaccine.

“This is a universal recommendation, just like the one we have for flu,” said Dr. Fryhofer, who discussed eligibility, timing of dosage, and differences between vaccine platforms in a recent episode of “AMA Update.”

Adults and children are more likely to get vaccinated if their physician recommends it, she noted.

“A strain change”

The updated vaccine is not a new vaccine. Rather, “it's just a strain change. Just like we do for flu vaccine each season, we update the strains each year,” said Dr. Fryhofer.

Last year’s version of the vaccine specifically targeted Omicron XBB.1.5, which is no longer circulating. The dominant lineage is now JN.1, which has several variants.

Both mRNA vaccines target the KP.2 strain of the JN.1 lineage, whereas the Novavax version targets the JN.1 lineage. KP.2 gained traction this past spring, although a closely related strain, KP.3.1.1, is now the dominant COVID variant.

As of Aug. 20, 2024, COVID-19 variant KP.3.1.1 accounted for 37% of new COVID illnesses, and KP.2.3 is at 14.4%, said Dr. Fryhofer.

Another JN.1 variant, LB.1, has been gaining traction. “These new COVID vaccines have been updated to give you the best protection from JN.1-based variants,” said Dr. Fryhofer.

Visit the AMA COVID-19 resource center for physicians for clinical information, guides and resources, and updates on advocacy and medical ethics.

Who should get the vaccine?

Two-thirds of COVID-19-related hospitalizations are among patients 65 or older, but unlike last year, additional updated doses are not recommended for those 65 or older at this time—but that could change.

“People with immunocompromising conditions not only need at least one updated dose. They may need more. And of course, those under 5 years old may need more than one updated dose if they're still completing their primary mRNA series,” said Dr. Fryhofer.

While the CDC recommends vaccination for everyone 6 months old and up, only the mRNA Pfizer and Moderna versions are authorized for those under 12 years old.

The updated Novavax vaccine, by contrast, is authorized only for those aged 12 or older.

“For those who go with Novavax for all their doses, FDA authorization reiterates the importance of an initial two-dose primary Novavax series with those doses given at least three weeks apart,” said Dr. Fryhofer.

“So that's who can get them, but the big question is when,” said Dr. Fryhofer.

Timing on vaccination

Some differences exist between the two vaccine platforms on the timing of doses.

For the updated mRNA vaccines, the CDC and FDA recommend a dose at least two months after the last dose of any COVID vaccine. Anyone who recently had COVID-19 can wait a little longer—at least three months after infection—to maximize immune response to vaccination.

The FDA’s approach to the updated Novavax vaccine isn’t as straightforward, said Dr. Fryhofer.

“It depends on the type of vaccine you received in the past and the number of doses,” she said. Individuals can get a dose of the updated Novavax vaccine at least two months after their last mRNA COVID vaccine dose.

Or, they can get the updated Novavax vaccine at least two months after previous completion of a Novavax two-dose primary series. The updated Novavax vaccine can be used to complete this primary series.

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