On Feb. 22, 2022, the Center of Disease Control and Prevention (CDC) updated its COVID-19 vaccination guidance with additional information to help vaccine providers determine the optimal interval between the first and second dose of an mRNA vaccine series, based on the individual patient.
The updated recommendation allows for people 12 through 64 years of age, particularly males 12 through 39 years, to receive their second mRNA COVID-19 (Pfizer and Moderna) primary series dose up to 8 weeks after their first dose. This new recommendation is based on the latest safety and effectiveness data, CDC: Myocarditis and COVID-19 Vaccine Intervals: International Data and Policies (www.cdc.gov/vaccines/acip/meetings/downloads/slides-2022-02-04/11-COVID-Moulia-508.pdf). Extending the time interval between primary mRNA COVID-19 vaccine doses to 8 weeks may help lower the (small) risk of myocarditis and pericarditis, which has been associated mostly among adolescent and young adult males with mRNA COVID-19 vaccination. It may also help increase how long protection lasts against COVID-19.
However, this update does not apply to everyone.
Providers should continue to recommend the 3-week or 4-week intervals for Pfizer and Moderna products respectively for people who are moderately or severely immunocompromised, adults 65 years and older, and others who may need early protection due to concern about an increased risk of severe illness from COVID-19 or high levels of community transmission.
This updated guidance is specific to the mRNA (Pfizer-BioNTech or Moderna) COVID-19 vaccine primary series and is only for patients who have not yet started their series or who haven’t yet received their second dose.
The interval between COVID-19 mRNA vaccine doses is best determined by considering the balance of risks and benefits, based on the person’s age and health conditions.
For additional details, including updated vaccination tables, refer to the CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines: Primary series (www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html).