09/23/24 Health Advisory: 2024–2025 Respiratory Illness Season Vaccine Recommendations

| September 23, 2024
Gloved hand squeeze bicep while giving a shot.

Summary

  • Everyone 6 months or older should get 2024–2025 COVID-19 and flu vaccine.
  • 2024–2025 COVID-19 vaccine formulations are updated to a monovalent vaccine based on the Omicron JN.1 lineage of SARS-CoV-2:
    • Moderna and Pfizer (for people 6 months or older): KP.2 strain.
    • Novavax (for people 12 years or older): JN.1 strain.
  • Updated 2024–2025 flu vaccines are trivalent and protect against an H1N1, H3N2, and a B/Victoria lineage virus. This season’s vaccine is updated with a new flu A(H3N2) virus.
  • Updated RSV (respiratory syncytial virus) vaccination recommendation for older adults: Everyone 75 years or older should get RSV vaccine, as should those 60–74 years old at increased risk of severe RSV.
  • CDC (Centers for Disease Control and Prevention) expects supplies of nirsevimab (Beyfortus) RSV monoclonal antibody for infants and young children to be adequate for the 2024–2025 season.
  • Co-administration of COVID-19, flu, and RSV vaccines is safe.
  • Vaccination is one of best ways to prevent severe disease and hospitalization.

COVID-19 vaccine recommendations

For most people, the minimum interval between their last 2023–2024 COVID-19 vaccine dose and their 2024–2025 COVID-19 vaccine dose is 8 weeks. There are exceptions for people completing a multidose initial vaccination series, including:

  • Children 6 months–4 years old.
  • People 6 months or older who are moderately or severely immunocompromised.
  • People 12 years or older who get Novavax.

Learn more in CDC’s detailed vaccination schedules for people who are not moderately or severely immunocompromised and people who are moderately or severely immunocompromised.

People who are not moderately or severely immunocompromised

Initial vaccination

  • 6 months–4 years old:
    • 2 doses of 2024–2025 Moderna.
    • OR 3 doses of 2024–2025 Pfizer.
  • 5–11 years old:
    • 1 dose of 2024–2025 Moderna.
    • OR 1 dose of 2024–2025 Pfizer.
  • 12 years or older:
    • 1 dose of 2024–2025 Moderna.
    • OR 1 dose of 2024–2025 Pfizer.
    • OR 2 doses of 2024–2025 Novavax.

Got previous doses of COVID-19 vaccine

  • 6 months–4 years old:
    • 1 or 2 doses of 2024–2025 mRNA vaccine from the same manufacturer as initial vaccination, depending on the vaccine and number of prior doses.
  • 5–11 years old:
    • 1 dose of 2024–2025 Moderna.
    • OR 1 dose of 2024–2025 Pfizer.
  • 12 years or older:
    • 1 dose of 2024–2025 Moderna.
    • OR 1 dose of 2024–2025 Pfizer.
    • OR 1 dose of 2024–2025 Novavax.

Additional doses

An additional dose of 2024–2025 COVID-19 vaccine for people 65 years or older who are not moderately or severely immunocompromised is not currently recommended. ACIP (Advisory Committee on Immunization Practices) will monitor data and update recommendations as needed.

People who are moderately or severely immunocompromised

Initial vaccination

  • 6 months–4 years old:
    • 3 doses of 2024–2025 Moderna.
    • OR 3 doses of 2024–2025 Pfizer.
  • 5–11 years old:
    • 3 doses of 2024–2025 Moderna.
    • OR 3 doses of 2024–2025 Pfizer.
  • 12 years or older:
    • 3 doses of 2024–2025 Moderna.
    • OR 3 doses of 2024–2025 Pfizer.
    • OR 2 doses of 2024–2025 Novavax.

Got previous doses of a COVID-19 vaccine

Recommended COVID-19 vaccine and number of 2024–2025 doses are based on age and vaccination history.

Additional doses

People 6 months or older who are moderately or severely immunocompromised may get 1 or more additional age-appropriate doses of 2024–2025 COVID-19 vaccine.

Flu vaccine recommendations

  • CDC recommends everyone 6 months or older get updated 2024–2025 flu vaccine to reduce the risk of flu and its potentially serious complications.
  • Some children 6 months–8 years old need 2 doses of flu vaccine, including those who:
    • Are getting flu vaccine for the first time.
    • Previously got only 1 dose of flu vaccine.
    • Have an unknown vaccination history.
  • People who are pregnant or might be pregnant during flu season should get flu vaccine.
  • Pregnant people and those with certain medical conditions or those who are immunocompromised should not get live, attenuated intranasal flu vaccine.
  • Adults 65 years or older are recommended to preferentially get high dose or adjuvanted flu vaccine.
  • It is ideal for most people to get flu vaccine in September or October. Continue to offer flu vaccine throughout the season, as long as flu viruses are circulating.

RSV vaccine recommendations

To protect infants and young children

CDC recommends choosing 1 of these to protect infants and young children against severe RSV:

  • Abrysvo RSV vaccine during pregnancy.
  • Nirsevimab (Beyfortus) RSV monoclonal antibody for infants and some older babies.

Most infants will not need both.

Abrysvo maternal vaccination

  • September–January.
  • 1 dose at 32–36 weeks gestation.
  • Abrysvo is the only FDA-approved RSV vaccine for pregnant people.

Nirsevimab (Beyfortus) monoclonal antibody

  • October–March.
  • CDC anticipates supplies of nirsevimab (Beyfortus) will be adequate this season.
  • CDC recommends 1 dose for infants younger than 8 months who were born shortly before or are entering their first RSV season (typically fall through spring) if:
    • The mother did not get RSV vaccine during pregnancy.
    • You don’t know the mother’s RSV vaccination status.
    • The infant was born within 14 days of maternal RSV vaccination.
  • 1 dose for children 8–19 months old who are at increased risk for severe RSV disease and entering their second RSV season. That includes children who:
    • Are American Indian or Alaska Native.
    • Have chronic lung disease of prematurity and require medical support during the 6 months before the start of their second RSV season.
    • Have severe immunocompromise.
    • Have severe cystic fibrosis.
  • Except in rare circumstances, infants younger than 8 months who are born 14 or more days after their mother got RSV vaccine don’t need nirsevimab (Beyfortus). Learn more about special situations and populations.

Recommendations for adults

  • 3 RSV vaccines are licensed for use in adults 60 years or older:
    • Arexvy by GSK.
    • mRESVIA by Moderna.
    • Abrysvo by Pfizer.
  • CDC recommends 1 dose of RSV vaccine for:
    • Adults 75 years or older.
    • Adults 60–74 years old who are at increased risk of severe RSV disease because of things like:
      • Cardiovascular disease.
      • Lung disease.
      • End stage renal disease or dependence on hemodialysis or other renal replacement therapy.
      • Diabetes mellitus with end-organ damage.
      • Severe obesity.
      • Liver disorders.
      • Neurologic or neuromuscular conditions.
      • Hematologic disorders.
      • Moderate or severe immune compromise.
      • Frailty.
      • Living in nursing homes or other long-term care facilities that assist with activities of daily living.
      • Other chronic medical conditions or risk factors that a healthcare provider determines might increase the risk of severe disease due to respiratory infection.

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