COVID-19 Updates for Virginia

via VDH

Dear Colleague:

This letter provides an update on COVID-19 vaccines.

FDA authorizes and CDC Recommends Simplified COVID-19 Vaccine Schedule

After the U.S. Food and Drug Administration (FDA) revised its emergency use authorizations for the Pfizer and Moderna mRNA COVID-19 vaccines, the Centers for Disease Control and Prevention (CDC) announced simplifying COVID-19 vaccine recommendations on April 19. CDC updated its Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States to provide detailed guidance for providers. We describe the key changes below and advise COVID-19 vaccinators in Virginia to implement these immediately.

  • All mRNA COVID-19 vaccinations will now use the bivalent vaccine formulations; monovalent mRNA vaccines are no longer authorized.
  • CDC recommends that everyone aged 6 years or older who is unvaccinated or has only received monovalent vaccines receive 1 bivalent mRNA COVID-19 vaccine.
  • Children aged 6 months through 5 years are eligible to receive at least one dose of a bivalent vaccine. The number of bivalent doses and timing will depend on the vaccine and their vaccination history.
  • Adults aged 65 years and older are eligible to receive an optional additional bivalent mRNA vaccine dose.
  • Individuals aged 6 years or older who have already received a bivalent mRNA vaccine are not eligible for an additional dose unless they are aged 65 years or older or immunocompromised.
  • Updated vaccine schedules for immunocompromised individuals will be available soon.
  • The updated guidelines do not apply to Novavax and Janssen (J&J) COVID-19 vaccines because they are not bivalent mRNA vaccines.
  • Healthcare providers can check the Virginia Immunization Information System (VIIS) to confirm patient’s vaccine history.
  • CDC and the Virginia Department of Health (VDH) are updating resources for patients and providers and plan to offer webinar training for providers. Training will be announced on CDC’s Clinician Outreach and Communication Activity (COCA) website or VDH’s COVID-19 Vaccine Healthcare Professionals website.

Table. Updated recommendations for bivalent mRNA COVID-19 vaccines for individuals who are not immunocompromised*

COVID-19 Vaccination Status Children aged 6 months to 5 years People aged 6 years or older
Has not yet received any dose Recommended to get at least 1 bivalent vaccine dose. The number of doses depends on age and vaccine type.* Recommended to get 1 dose of a bivalent vaccine.
Has received at least 1 vaccine dose Recommended to get at least 1 bivalent vaccine dose. The number of doses depends on age, vaccine type, and vaccine history.* Recommended to get 1 dose of a bivalent vaccine at least 8 weeks after last monovalent dose. If already received a bivalent vaccine dose, then an additional bivalent vaccine dose is not recommended.†
Individuals aged 65 and older may receive an additional bivalent vaccine at least 4 months after first bivalent dose.

*For more detailed recommendations, refer to CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States. An updated vaccine schedule for individuals who are immunocompromised will be available soon.

Thank you again for your continued partnership. Please visit the Virginia Department of Health website for current clinical and public health guidance on COVID-19 and other information.     


Parham Jaberi, MD, MPH
Acting State Health Commissioner