Late last week, the Advisory Committee on Immunization Practices (ACIP), with approval from the Centers for Disease Control and Prevention (CDC), recommended the updated Moderna and Pfizer-BioNTech bivalent COVID-19 boosters.

The updated, or bivalent boosters, target the most recent Omicron subvariants, BA.4 and BA.5, that are more contagious and more resistant than earlier strains of Omicron.

The bivalent COVID-19 vaccine will be administered as a single booster dose to those who previously completed a primary series of COVID-19 vaccine. Eligible individuals should wait at least two months after receiving their primary series or prior monovalent booster before receiving the bivalent booster. Individuals with a prior COVID-19 infection should wait three months from symptom onset or a positive test (if asymptomatic) before receiving the bivalent booster.

The approval and recommendation to use the monovalent Pfizer-BioNTech COVID-19 boosters for persons aged 12 years and older and the monovalent Moderna COVID-19 booster for persons 18 and older are repealed and replaced with recommendations to use the updated bivalent vaccine. This means individuals do not need to choose which booster to receive as there is only one booster available; the bivalent is now the sole booster.

The recommendations also confirmed that co-administration of the bivalent and influenza vaccine are allowed without contraindications. Therefore, providers should offer both influenza and COVID-19 vaccines during vaccine clinics if a person is eligible for both.

Next Steps for Providers

What does “up-to-date” mean for LTC vaccine mandate compliance?

The American Health Care Association (AHCA) team is in contact with CMS and CDC to discuss the implications of the new bivalent booster in LTC settings. While we wait to hear details back from CMS, providers are left to decide how they want to proceed—but it appears that immediate action on reclassifying residents’ and staff’s up-to-date status is not necessary until we learn more from CMS.

WHCA/WiCAL recommends reaching out to your LTC pharmacy to access bivalent vaccine for your residents and staff as soon as practicable.

AHCA/NCAL has been meeting with the CDC and LTC pharmacy partners to ensure LTC remains a top priority for access to this booster. Facilities should contact their LTC pharmacies and schedule bivalent booster and influenza clinics for the coming months.