Health Advisory

Summary

• An updated COVID-19 vaccine is available for the 2023-2024 season. As of September 12, 2023, mRNA vaccines produced by Moderna and Pfizer-BioNTech and approved and authorized by the Food and Drug Administration, are recommended by the Centers for Disease Control and Prevention (CDC) for use in the United States. CDC recommends all persons ages 6 months and older receive the new 2023-2024 COVID-19 vaccine.
• Studies by the manufacturers show that the updated vaccines induce high levels of neutralizing antibodies against currently circulating COVID-19 variants including XBB.1.5, EG.5, and the BA.2.86 variant of concern.
• Only 26% of Fairfax Health District residents received a COVID-19 bivalent booster. The proportion is substantially lower for individuals under age 65, especially pediatric populations.
• COVID-19 vaccinations remain the best protection against COVID-19 hospitalizations, deaths, and suffering from the effects of long COVID. Healthcare providers are urged to identify and remind patients who have not received the 2023-2024 COVID-19 vaccine to do so.
• See the Virginia Department of Health Clinician Letter sent by the State Health Commissioner regarding the updated COVID-19 vaccines.

Suggested Actions

Vaccine Distribution

• Become a COVID-19 vaccine provider if you are not already.
  • For your insured clients, you will be able to order chargeable COVID-19 vaccines through your distributors of other vaccines. Most vaccine formulations will be available in single-dose vials or syringes.
  • For uninsured populations, COVID-19 vaccines can be ordered through the Virginia Vaccines for Adults and the Virginia Vaccines for Children programs.
• Free vaccine for uninsured children and uninsured/underinsured adults also is available at doctors’ offices, clinics and pharmacies that participate in the Vaccines for Children and Vaccine for Adults Bridge Access programs.
• The Fairfax Health District will not be conducting mass COVID-19 vaccination events. A limited supply of vaccines will be available by appointment for uninsured and underinsured individuals. Most Fairfax County residents seeking COVID-19 vaccines will need to get vaccinated at either their healthcare provider’s office or a pharmacy.
• As CDC recommends that children who are 6 months – 4 years of age receive the same product for all COVID vaccine doses, pediatric providers may need to stock both Moderna and Pfizer-BioNTech vaccine.
  • Strategies such as batching of appointments should be considered to ensure vaccine is not wasted from Pfizer-BioNTech multi-dose vials.

Clinical Considerations

• Bivalent mRNA vaccines are no longer authorized for use and should be disposed of in accordance with existing provider agreements.
• Healthcare providers should be familiar with CDC recommendations and clinical considerations for the use of SARS-CoV-2 vaccines. 
• Everyone aged 5 years and older should receive 1 dose of the updated 2023-2024 COVID-19 vaccine at least 2 months after getting the last dose of any COVID vaccine.
• Children ages 6 months-4 years (see Table 1 of CDC’s Interim Clinical Considerations at the above link):
  • Initial vaccination: should receive either 2 doses of updated 2023-2024 Moderna or 3 doses of updated 2023-2024 Pfizer-BioNTech COVID-19 vaccine;
  • Received previous mRNA doses: need 1 or 2 doses of updated 2023-24 Moderna or Pfizer-BioNTech COVID-19 vaccine, depending on number of prior doses.
• People who are moderately or severely immunocompromised (see Table 2 of CDC’s Interim Clinical Considerations at the above link):
  • Initial vaccination: should receive 3-dose series of updated 2023-2024 Moderna or Pfizer-BioNTech COVID-19 vaccines;
  • Received previous mRNA doses: need 1 or 2 doses of updated 2023-2024 Moderna or Pfizer-BioNTech COVID-19 vaccine, depending on number of prior doses;
  • May receive 1 or more additional updated 2023-2024 Moderna or Pfizer-BioNTech COVID-19 vaccine doses.
• The 2023-24 COVID-19 vaccine and annual flu shots can be administered at the same time.
• Healthcare providers are the most trusted professional source of information about vaccines. Help your patients understand the importance of vaccination, provide a strong recommendation, build confidence in vaccines, discuss any concerns, and support the decision-making process.
• Providers may contact FCHD for any questions about the information provided at HDHealthProviders@fairfaxcounty.gov.