COVID-19 Vaccines

Understanding COVID-19 Vaccines

Which COVID-19 vaccines are available in the United States? 

On April 18, 2023, the U.S. Food and Drug Administration (FDA) updated the emergency use authorizations for two bivalent mRNA COVID-19 vaccines. The updated bivalent vaccines are composed of previously approved or authorized COVID-19 vaccines against the original strains of SARS-CoV-2 and newer vaccines that provide extra protection against the Omicron variant. Both bivalent vaccines are authorized for anyone who is at least six months old.

• Moderna COVID-19 Vaccine, Bivalent: This bivalent vaccine combines the NIH-funded, FDA-approved mRNA-1273 vaccine (Spikevax) and a vaccine that has more activity against the Omicron BA.4/BA.5 strains. View the infographic to see what is in the original version of the Moderna COVID-19 vaccine.

• Pfizer, Inc., and BioNTech COVID-19 Vaccine, Bivalent: This bivalent vaccine combines the FDA-approved BNT162b2 vaccine (Comirnaty) and a vaccine that has more activity against the Omicron BA.4/BA.5 strains. View the infographic to see what is in the original version of the Pfizer COVID-19 vaccine.

For most adults, a two-dose initial series of a bivalent vaccine protects against SARS-CoV-2 infection and severe COVID-19. For children, the initial series for children includes two or three doses, depending on their age and prior COVID-19 vaccinations.

Two other COVID-19 vaccines have been authorized for certain groups.

• Novavax COVID-19 Vaccine, Adjuvanted: On July 13, 2022, the FDA reauthorized emergency use of this two-dose vaccine series for people age 12 and older. This is the first protein-based COVID-19 vaccine to receive FDA authorization and is similar in design to vaccines against the flu and shingles. The FDA has also authorized Novavax as a booster vaccination for people age 18 and older who cannot access other COVID-19 vaccines, people for whom other COVID-19 vaccines are not clinically appropriate, or people who would not otherwise receive a COVID-19 vaccine.

• Janssen Pharmaceutical Companies of Johnson & Johnson:  On March 13, 2023, the FDA reauthorized emergency use of this vaccine for use in people 18 and older who cannot access other COVID-19 vaccines, people for whom other COVID-19 vaccines are not clinically appropriate, or people who would not otherwise receive a COVID-19 vaccine.

Do I need a booster shot?

Protection against SARS-CoV-2 begins to decrease over time after a person’s first vaccine doses — the primary vaccine series. Additional vaccine doses (booster doses) provide longer-lasting protection against COVID-19. For the best protection from COVID-19, the Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months and older stay up to date on their COVID-19 vaccines, including getting booster doses if eligible.

The FDA has authorized booster doses for the COVID-19 vaccines available in the United States. The eligibility period for a booster dose is based on several factors, including which vaccine you originally received and how long it has been since your last vaccine dose.

People who received a primary vaccine series against only the original strain of SARS-CoV-2 may need only one booster dose of a bivalent vaccine. People who are 65 or older or who are immunocompromised may need more booster doses.

Can children get a vaccine?

Children and teens age 6 months and older can get the Pfizer and Moderna updated bivalent COVID-19 vaccines, and children and teens age 12 and older can get the Novavax COVID-19 vaccine.

Do the vaccines protect against virus variants? 

Studies and current data show that the antibodies our bodies make after vaccination and a booster shot recognize and protect against COVID-19 variants like Omicron. However, studies also show that the protection against Omicron offered by the original COVID-19 booster shots wanes substantially over time. The bivalent mRNA vaccines and booster doses offer increased protection against SARS-CoV-2 infection and severe COVID-19.

Do the vaccines work?

Studies show that COVID-19 vaccines are very effective in preventing COVID-19, even for people at high risk for the disease. By the end of November 2021, scientists estimate that mRNA COVID-19 vaccines had prevented at least 1 million deaths, 10 million hospitalizations, and 36 million SARS-CoV-2 infections in the United States.

Sometimes people who are fully vaccinated get a breakthrough infection, meaning that they test positive for SARS-CoV-2 or become ill with COVID-19. Fully vaccinated people are less likely to become seriously ill, even from COVID-19 variants.

How do I know the vaccines are safe?

Vaccines have very high safety standards, and COVID-19 vaccines are no exception. COVID-19 vaccines have undergone and will continue to undergo the most intensive safety monitoring in U.S. history.

The timeline for creating COVID-19 vaccines was shorter than for other vaccines for many reasons, including the following:

• NIH scientists have been studying mRNA vaccines and coronaviruses for decades. Scientists had a head start because they already knew a lot about how mRNA vaccines work and how to make them.

• Researchers, the federal government, and drug companies came together like never before to cooperate and share resources, making the vaccine testing process more efficient.

• NIH set up the COVID-19 Prevention Network (CoVPN) to coordinate existing research networks and carry out large clinical trials in tens of thousands of people efficiently. Many Americans from diverse communities volunteered to participate in the studies.

• The FDA analyzed data from the clinical trials right away.

The safety of the authorized COVID-19 vaccines is being tracked through the Vaccine Adverse Event Reporting System (VAERS), a unique safety system called v-safe that was established specifically for COVID-19 vaccines, and other systems. Vaccine manufacturers submit monthly safety updates to the FDA. The FDA also inspects vaccine production facilities and checks the quality of vaccine batches.

Do the vaccines have any side effects?

All vaccines may cause some side effects, which are normal signs that your body is making antibodies. These side effects go away in a few days. Many people have no side effects.

Serious side effects that could cause long-term health problems are extremely unlikely after any vaccination, including COVID-19 vaccination. These rare side effects usually appear within six weeks of receiving a vaccine dose. If you have health problems after vaccination, talk to your health care provider and report the problem to VAERS.

Rare cases of heart inflammation have been reported after mRNA COVID-19 vaccination, mainly in male adolescents and young adults.

CDC continues to recommend vaccination for everyone 6 months of age and older, given the greater risk of serious complications related to COVID-19.

How do I get a COVID-19 vaccine?

The federal government is providing FDA-authorized and approved COVID-19 vaccines free to all people living in the United States, regardless of their immigration or health insurance status.

Search Vaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233 to find COVID-19 vaccine locations near you. Contact your state health department to find additional vaccination locations in your area. 

If you have difficulty reaching a vaccination site, you may be able to get an in-home vaccination. Check a list of services that may offer in-home COVID-19 vaccinations in your area.

Should I get a vaccine if I've had COVID-19 in the past?

Studies indicate that vaccination produces a stronger immune response than the one produced by COVID-19 infection. The benefits of vaccination after infection far outweigh any known or potential risks.

To ensure that people who recover from COVID-19 are protected from getting the disease again, CDC recommends that they get vaccinated. The timing of vaccination depends on when a person had COVID-19 and whether and when they received treatment. If you have had COVID-19 and want to be vaccinated, talk to your doctor about when you should get the vaccine. 

Are there any circumstances under which I should not get vaccinated?

Vaccination is recommended for everyone who is eligible. If you have a medical condition and are concerned about how COVID-19 vaccination may affect you, talk to your health care provider about whether getting vaccinated is right for you.

Due to safety concerns, CDC recommends that the Johnson & Johnson/Janssen COVID-19 vaccines only be considered in certain situations.

Are vaccines still being researched?  

New and ongoing studies on vaccines are underway. NIH Institutes and Centers, in partnership with private businesses and other federal agencies, continue to study COVID-19 vaccines and strategies to encourage vaccination within vulnerable communities.

Many current studies are monitoring the health of vaccinated people to determine the vaccines' effectiveness over a longer period of time. Other research aims to develop new vaccines that might protect against current and future types of coronaviruses.