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Updated Clinical Considerations for Recommendations for COVID-19 Vaccine 2nd Booster Dose

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Updated Clinical Considerations for Recommendations for COVID-19 Vaccine 2nd Booster Dose

On March 30, 2022, The Centers for Disease Control and Prevention (CDC) issued important updates to the Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States. The Michigan Department of Health and Human Services supports the below guidance for COVID-19 vaccination from the CDC and this updated guidance should be followed and put into clinical practice. The updates are outlined below.

  1. Added guidance for 2nd booster doses:
    1. People ages 12 through 17 years of age who are moderately or severely immunocompromised may choose to receive a second booster dose using Pfizer-BioNTech COVID-19 vaccine at least 4 months after the first booster dose.
    2. People ages 18 years and older who are moderately or severely immunocompromised may choose to receive a second booster dose using an mRNA COVID-19 vaccine (Pfizer or Moderna*) at least 4 months after the first booster.
    3. Adults ages 50 years and older who are not moderately or severely immunocompromised may choose to receive a second booster dose using an mRNA COVID-19 vaccine (Pfizer or Moderna*) at least 4 months after the first booster dose.
    4. People ages 18 through 49 years who are not moderately or severely immunocompromised and who received Janssen (Johnson & Johnson) COVID-19 Vaccine as both their primary series dose and booster dose may receive a second booster dose using an mRNA COVID-19 vaccine (Pfizer or Moderna*) at least 4 months after the first Janssen booster dose.

      *Moderna booster dose volume is 0.25mL for the Red cap and 0.5mL for the Blue cap
  2. Clarification of Safety issues for:
    1. Multisystem Inflammatory Syndrome in children (MIS-C) and adults (MIS-A)
    2. Myocarditis
  3. Moderna COVID-19 Vaccine supply:
    1. Red Cap vial¹: For Primary series and booster dose preparation
      1. For use in people 18 years and older
      2. No dilution required
      3. Dose volume for primary series: 0.5mL
      4. Dose volume for booster dose: 25mL
    2. Blue Cap vial¹: For Booster dose only preparation
      1. For use in people 18 years and older
      2. No dilution required
      3. Cannot be used for primary series
      4. Dose volume for booster: 5mL

¹Either Moderna COVID-19 Vaccine supplied in a vial with a red cap (0.25 mL injection volume), or Moderna COVID-19 Vaccine supplied in a vial with a blue cap (0.5 mL injection volume) can be used to administer a 50-µg booster dose.

Updated EUAs: