For Health Care Providers
COVID-19 Vaccination Guidance

Overview of the COVID-19 vaccination schedule

CDC recommends that people ages 6 months and older receive at least one bivalent mRNA COVID-19 vaccine. An overview of COVID-19 vaccination is summarized below; detailed schedules can be found in the CDC: Clinical Guidance for COVID-19 Vaccination.

Bivalent mRNA vaccines

The number of bivalent doses varies by age, vaccine, previous COVID-19 vaccines received, and the presence of moderate or severe immune compromise.

For people who are NOT moderately or severely immunocompromised:

• At the time of initial vaccination, depending on vaccine product, children ages 6 months to 4 years are recommended to receive two or three bivalent mRNA vaccine doses; children age 5 years are recommended to receive one or two bivalent mRNA vaccine doses.
• People ages 6 years and older who are unvaccinated or previously received only monovalent vaccine doses are recommended to receive one bivalent mRNA vaccine dose.
• People ages 65 years and older have the option to receive one additional bivalent mRNA vaccine dose.

For people who are moderately or severely immunocompromised:

• At the time of initial vaccination, people ages 6 months and older are recommended to receive three bivalent mRNA doses.
• People ages 6 months and older who previously received only monovalent doses are recommended to receive one or two bivalent mRNA vaccine doses, depending on age and vaccine product.
• People who previously received a bivalent mRNA vaccine dose(s) have the option to receive one or more additional bivalent mRNA doses.

Novavax COVID-19 vaccine

People ages 12 years an older who previously received one or two monovalent Novavax COVID-19 primary series dose(s) are recommended to receive one bivalent mRNA vaccine dose. The monovalent Novavax COVID-19 vaccine remains authorized for use as a two-dose primary series and as a booster dose in certain limited situations.

Vaccine dosage and administration

In general, CDC recommends that people receive the age-appropriate vaccine product and dosage based on their age on the day of vaccination in accordance with the recommended intervals for that age group. However, for COVID-19 vaccination there are exceptions for children who receive the Pfizer-BioNTech COVID-19 vaccine and transition from age 4 to 5 years during the three-dose vaccination series and children who transition from age 5 years to 6 years during the Moderna COVID-19 vaccination series (see Transitioning from a younger to older age group).

Vaccination reminders

Vaccination reminders are critical to ensure compliance with vaccine dosing intervals and to achieve optimal vaccine effectiveness.

Use these tips for COVID-19 vaccine reminders:

• Use reminder/recall systems through MIIC or your electronic health record (her). In MIIC, utilize the Client Follow-Up (CFU) feature to learn which of your clients are recommended/overdue for vaccine. For user guidance on CFU in MIIC, please visit Client Follow-Up MIIC User Guidance and Training Resources.
• Partner with MDH to text your clients who are recommended or overdue for COVID-19 vaccine. The process of getting this activity set up and implemented is very simple and the maintenance is automated. MDH has successfully implemented texting with several organizations. Please reach out to the MIIC Help Desk to get started. For more information refer to Reminder/Recall Using Text Messages (PDF).
• Make sure each person getting vaccinated knows how long they must wait in between their vaccinations.
• When needed, make every attempt to schedule the next dose appointment at the time of the first dose, or schedule both appointments when scheduling the first appointment.
• Complete a COVID-19 vaccination record card (vaccine manufacturer, lot number, date of dose received, and the date the next dose is due) for each person who is vaccinated. Encourage them to keep the card and bring it to the next dose appointment.
• If the vaccination record card is full, start a new card and staple both cards together.
• If the patient has a smartphone, ask them to:
  • Take a photo of their vaccination card and/or enter the date when the next vaccine is due into their electronic calendar.
  • Sign up for the Docket app to securely access their full immunization history in MIIC. For sign up instructions, refer to Easy Access to Your and Your Family's Immunization Records (PDF).