In welcome news to many who are immunocompromised, the U.S. Food and Drug Administration (FDA) recently approved the next COVID-19 vaccine booster dose for certain groups. The booster is called a “bivalent” vaccine because it protects against both the original and omicron variants of the virus that causes COVID-19. Shortly after the FDA approval, the Centers for Disease Control and Prevention (CDC) released a statement with a new set of recommendations in line with the FDA’s actions.

People over 65 and those considered immunocompromised will now be able to get a second bivalent booster. For anyone who hasn’t been vaccinated for COVID-19, the vaccine process is now streamlined.

Who Can Get the Additional Dose?

People in the following groups can receive a second dose of the bivalent version of the Moderna or Pfizer vaccine:

• People 65 years of age and older, if it has been at least four months since their first bivalent vaccine booster
• Most people who are considered immunocompromised, if it has been at least two months since their first bivalent dose

In a move that may be surprising to some, the FDA and CDC have also allowed health care providers to offer future bivalent booster doses when they deem it necessary for a person under their care who has a compromised immune system. That could mean no longer having to wait on government agencies to make new recommendations if your physician believes you could benefit from another vaccine dose.

The decision to offer these groups an additional dose of the booster vaccine is driven by research that shows immunity in older people decreases over time and is replenished by getting another vaccine dose. Other research results make a similar argument for the need of extra doses for people with compromised immune systems.

What About Children and Those Not Yet Vaccinated?

The FDA also wanted to simplify guidance for everyone who has never had any kind of COVID-19 vaccine, as well as for children’s vaccinations. Most people who are not vaccinated can now just get a single dose of the bivalent vaccine (either Pfizer or Moderna) instead of the two doses of the original Pfizer and Moderna vaccines they previously needed to be considered fully vaccinated.

Why the change to a single dose of the bivalent booster for initial vaccination? According to the FDA, almost everyone 5 years old and up in the U.S. has some level of antibodies — either from being infected with the virus that causes COVID-19 or from vaccination against the virus. Because of that foundation of antibodies, a single dose of the most up-to-date vaccine should provide adequate protection against severe illness and complications from COVID-19.

Children under 6 years old who are not vaccinated can do one of the following:

• Get a two-dose series of the Moderna bivalent vaccine (for children who are 6 months to 5 years old)
• Get a three-dose series of the Pfizer bivalent vaccine (for children who are 6 months to 4 years old)
• Get a single dose of the Pfizer bivalent vaccine (for children who are 5 years old)

Children who have had any number of doses of an original COVID-19 vaccine may get one of the bivalent vaccine boosters. In this case, the number of bivalent booster doses will depend on what they’ve had before and which bivalent version they are going to receive.

What About the Rest of Us?

For everyone who doesn’t fit into these categories and had a single dose of the bivalent booster already, there will be a few more months of waiting until the FDA and CDC release their vaccination plans for the general population in the fall.

One thing is clear though: The monovalent (original) versions of the Pfizer and Moderna vaccines will no longer be recommended in the U.S. for anyone.

Talk to Your Doctor

If you believe you fit into one of the groups mentioned above who are eligible for a second bivalent booster dose, talk to your doctor as soon as possible to confirm you should receive one. If you’re 65 or older, the process should be straightforward. However, if you’re under 65 and immunocompromised, it’s worth having a discussion with your health care provider about what these new recommendations could mean for your vaccination and treatment plans going forward.

Manuel Penton, M.D. is a medical editor at MyHealthTeam. Learn more about him here.