COVID-19 Vaccines 2026-27 (United States)

full update August 2026

The first chart below provides dosing and storage information for COVID-19 vaccines approved in the US. Links to the prescribing information and the patient package insert are provided in footnote a. A second chart provides information and resources to help you address frequently asked questions about COVID-19 vaccination.

--Information in this chart is from the US product information (prescribing information or fact sheet) cited in footnote a, unless otherwise cited.--

Vaccine	Dosing	Storage/Stability
Comirnaty COVID-19 vaccine, mRNA 2026 to 2027 formula (XFG variant) for patients ≥65 years of age and 12 through 64 years of age with certain risk factors^c,d Pfizer-BioNTech Syringe with gray label border.	For patients ≥12 years of age: Each dose is 0.3 mL (30 mcg) IM. Administer ≥2 months after any previous COVID-19 vaccine dose. Immunocompromised:^b If not previously vaccinated for COVID-19, give three doses (week 0, week 3, ≥4 weeks after the second dose [initial series]). If previously vaccinated with one or two doses of any Pfizer-BioNTech COVID-19 vaccine, complete the remaining dose(s) in the three-dose initial series. Then give one dose of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) after the last dose. For patients who have already completed the initial series of any COVID-19 vaccine, give two doses of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) apart, starting ≥8 weeks after the last dose.⁸	Prefilled glass syringe: Store in refrigerator (2^oC to 8^oC). Room temperature (8^oC to 25^oC): 12 hours total
Comirnaty COVID-19 vaccine, mRNA. 2026 to 2027 formula (XFG variant) for patients 5 years through 11 years of age with certain risk factors^c,d Pfizer-BioNTech Vial with blue cap and label border.	For patients 5 years through 11 years of age. Dose is 0.3 mL (10 mcg) IM. Administer ≥2 months after any previous COVID-19 vaccine dose. Immunocompromised:^b If not previously vaccinated for COVID-19, give three doses (week 0, week 3, ≥4 weeks after the second dose [initial series]). If previously vaccinated with one or two doses of any Pfizer-BioNTech COVID-19 vaccine, complete the remaining dose(s) in the three-dose initial series. Then give one dose of either mRNA COVID-19 vaccine 6 months (minimum 2 months) after the last dose. For patients who have already completed the three-dose initial series of either mRNA vaccine, give two doses of either mRNA COVID-19 vaccine 6 months (minimum 2 months) apart, starting ≥8 weeks after the last dose.⁸	May arrive frozen at ultra-cold temperatures in thermal containers with dry ice. May store in ultra-low temp freezer at -90^oC to -60^oC or transfer to a refrigerator. Refrigerator (2^oC to 8^oC): 10 weeks Room temperature (8^oC to 25^oC): 12 hours total
Spikevax COVID-19 vaccine, mRNA. 2026 to 2027 formula (XFG variant) for patients ≥65 years of age and 12 through 64 years of age with certain risk factors^c,d Moderna Syringe with blue box on label²⁴	For patients ≥12 years of age. Dose is 0.5 mL IM. Administer ≥2 months after any previous COVID-19 vaccine dose. Immunocompromised:^b If not previously vaccinated for COVID-19, give three doses 4 weeks apart.If previously vaccinated with one or two doses of any Moderna COVID-19 vaccine, complete the remaining dose(s) in the initial three-dose series. Then give one dose of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) after the last dose. For patients who have already completed an initial COVID-19 vaccine series, give two doses of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) apart, starting ≥8 weeks (≥3 months for mNexspike] after the last dose.⁸	Store frozen between -50^oC and -15^oC. After thawing: Refrigerator (2^oC to 8^oC): 60 days or until the expiration date on the carton, whichever is first. Room temperature (8^oC to 25^oC): up to 12 hours
Spikevax COVID-19 vaccine, mRNA. 2026 to 2027 formula (XFG variant) for patients 6 months to 11 years of age with certain risk factors^c,d Moderna Syringe with red box on label²⁴	6 months through 23 months of age (dose is 0.25 mL IM): No previous COVID-19 vaccine: give two doses (at month 0 and at month 1). Previously vaccinated with one dose of any Moderna COVID-19 vaccine: one dose ≥1 month after receipt of the previous dose. Previously vaccinated with ≥2 doses of any Moderna COVID-19 vaccine: one dose ≥2 months after receipt of the last previous dose. 2 years through 11 years of age (dose is 0.25 mL IM): give one dose. If previously vaccinated for COVID-19, give ≥2 months after receipt of the last previous dose. Immunocompromised:^b If not previously vaccinated for COVID-19, give three doses 4 weeks apart.If previously vaccinated with one or two doses of any Moderna COVID-19 vaccine, complete the remaining dose(s) in the initial three-dose series. Then give one dose of Spikevax (or Comirnaty if 5 to 11 years of age) 6 months (minimum 2 months) after the last dose. For patients who have already completed the three-dose initial series, give two doses of Spikevax (or Comirnaty if 5 to 11 years of age) 6 months (minimum 2 months) apart, starting ≥8 weeks after the last dose.⁸	Store frozen between -50^oC and -15^oC. After thawing: Refrigerator (2^oC to 8^oC): 60 days or until the expiration date on the carton, whichever is first. Room temperature (8^oC to 25^oC): up to 12 hours
mNexspike COVID-19 vaccine, mRNA. 2026 to 2027 formula (XFG variant) for patients ≥65 years of age, and 12 to 64 years of age with certain risk factors^c,d Moderna Syringe with green box on label²³	For patients ≥12 years of age. Dose is 0.2 mL IM ≥3 months after any previous COVID-19 vaccine dose. Immunocompromised:^b If not previously vaccinated for COVID-19, give three doses 4 weeks apart.If previously vaccinated with one or two doses of any Moderna COVID-19 vaccine, complete the remaining dose(s) in the initial three-dose series. Then give one dose of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) after the last dose. Note: mNexspike and Spikevax can be used interchangeably in the initial series. For patients who have already completed an initial COVID-19 vaccine series, give two doses of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) apart, starting ≥8 weeks (≥3 months for mNexspike] after the last dose.⁸	Store in refrigerator (2^oC to 8^oC) Room temperature stability (8^oC to 25^oC): up to 12 hours
Nuvaxovid COVID-19 vaccine, adjuvanted. 2026 to 2027 formula (XFG variant) for patients ≥65 years of age and 12 through 64 years of age with certain risk factors^c,d Sanofi	For patients ≥12 years of age. Dose is 0.5 mL IM. Give ≥2 months after any previous COVID-19 vaccine dose. Immunocompromised:^b If not previously vaccinated for COVID-19, give two doses 3 weeks apart [initial series]. Then give one dose of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) after the last dose. If previously vaccinated with one or two doses of an mRNA COVID-19 vaccine, complete the initial three-dose series with the mRNA vaccine, then give one dose of Nuvaxovid 6 months (minimum 2 months) after the last dose. If previously vaccinated with one dose of any Novavax vaccine, complete the initial two-dose series. Then give one dose of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) after the last dose. For patients who have already completed the initial series of any COVID-19 vaccine, give two doses 6 months (minimum 2 months) apart, starting ≥8 weeks after the last dose.⁸	Store in refrigerator (2^oC to 8^oC).

Vaccine

Dosing

Storage/Stability

Comirnaty COVID-19 vaccine, mRNA

2026 to 2027 formula (XFG variant) for patients

≥65 years of age and 12 through 64 years of age with certain risk factors^c,d

Pfizer-BioNTech

Syringe with gray label border.

For patients ≥12 years of age:

Each dose is 0.3 mL (30 mcg) IM.
Administer ≥2 months after any previous COVID-19 vaccine dose.
Immunocompromised:^b If not previously vaccinated for COVID-19, give three doses (week 0, week 3, ≥4 weeks after the second dose [initial series]). If previously vaccinated with one or two doses of any Pfizer-BioNTech COVID-19 vaccine, complete the remaining dose(s) in the three-dose initial series. Then give one dose of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) after the last dose. For patients who have already completed the initial series of any COVID-19 vaccine, give two doses of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) apart, starting ≥8 weeks after the last dose.⁸

Prefilled glass syringe:
- Store in refrigerator (2^oC to 8^oC).
- Room temperature (8^oC to 25^oC): 12 hours total

Comirnaty COVID-19 vaccine, mRNA.

2026 to 2027 formula

(XFG variant) for patients

5 years through 11 years of age with certain risk factors^c,d

Pfizer-BioNTech

Vial with blue cap and label border.

For patients 5 years through 11 years of age.

Dose is 0.3 mL (10 mcg) IM.
Administer ≥2 months after any previous COVID-19 vaccine dose.
Immunocompromised:^b If not previously vaccinated for COVID-19, give three doses (week 0, week 3, ≥4 weeks after the second dose [initial series]). If previously vaccinated with one or two doses of any Pfizer-BioNTech COVID-19 vaccine, complete the remaining dose(s) in the three-dose initial series. Then give one dose of either mRNA COVID-19 vaccine 6 months (minimum 2 months) after the last dose. For patients who have already completed the three-dose initial series of either mRNA vaccine, give two doses of either mRNA COVID-19 vaccine 6 months (minimum 2 months) apart, starting ≥8 weeks after the last dose.⁸

May arrive frozen at ultra-cold temperatures in thermal containers with dry ice. May store in ultra-low temp freezer at

-90^oC to -60^oC or transfer to a refrigerator.

Refrigerator (2^oC to 8^oC): 10 weeks
Room temperature (8^oC to 25^oC): 12 hours total

Spikevax COVID-19 vaccine, mRNA.

2026 to 2027 formula (XFG variant) for patients ≥65 years of age and 12 through 64 years of age with certain risk factors^c,d

Moderna

Syringe with blue box on label²⁴

For patients ≥12 years of age.

Dose is 0.5 mL IM.
Administer ≥2 months after any previous COVID-19 vaccine dose.
Immunocompromised:^b If not previously vaccinated for COVID-19, give three doses 4 weeks apart.If previously vaccinated with one or two doses of any Moderna COVID-19 vaccine, complete the remaining dose(s) in the initial three-dose series. Then give one dose of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) after the last dose. For patients who have already completed an initial COVID-19 vaccine series, give two doses of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) apart, starting ≥8 weeks (≥3 months for mNexspike] after the last dose.⁸

Store frozen between -50^oC and -15^oC.
After thawing:
- Refrigerator (2^oC to 8^oC): 60 days or until the expiration date on the carton, whichever is first.
- Room temperature (8^oC to 25^oC): up to 12 hours

Spikevax COVID-19 vaccine, mRNA.

2026 to 2027 formula

(XFG variant) for patients

6 months to 11 years of age with certain risk factors^c,d

Moderna

Syringe with red box on label²⁴

6 months through 23 months of age (dose is 0.25 mL IM):
- No previous COVID-19 vaccine: give two doses (at month 0 and at month 1).
- Previously vaccinated with one dose of any Moderna COVID-19 vaccine: one dose ≥1 month after receipt of the previous dose.
- Previously vaccinated with ≥2 doses of any Moderna COVID-19 vaccine: one dose ≥2 months after receipt of the last previous dose.
2 years through 11 years of age (dose is 0.25 mL IM): give one dose. If previously vaccinated for COVID-19, give ≥2 months after receipt of the last previous dose.
Immunocompromised:^b If not previously vaccinated for COVID-19, give three doses 4 weeks apart.If previously vaccinated with one or two doses of any Moderna COVID-19 vaccine, complete the remaining dose(s) in the initial three-dose series. Then give one dose of Spikevax (or Comirnaty if 5 to 11 years of age) 6 months (minimum 2 months) after the last dose. For patients who have already completed the three-dose initial series, give two doses of Spikevax (or Comirnaty if 5 to 11 years of age) 6 months (minimum 2 months) apart, starting ≥8 weeks after the last dose.⁸

Store frozen between -50^oC and

-15^oC.

After thawing:
- Refrigerator (2^oC to 8^oC): 60 days or until the expiration date on the carton, whichever is first.
- Room temperature (8^oC to 25^oC): up to 12 hours

mNexspike COVID-19 vaccine, mRNA.

2026 to 2027 formula (XFG variant) for patients ≥65 years of age, and 12 to 64 years of age with certain risk factors^c,d

Moderna

Syringe with green box on label²³

For patients ≥12 years of age.

Dose is 0.2 mL IM ≥3 months after any previous COVID-19 vaccine dose.
Immunocompromised:^b If not previously vaccinated for COVID-19, give three doses 4 weeks apart.If previously vaccinated with one or two doses of any Moderna COVID-19 vaccine, complete the remaining dose(s) in the initial three-dose series. Then give one dose of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) after the last dose. Note: mNexspike and Spikevax can be used interchangeably in the initial series. For patients who have already completed an initial COVID-19 vaccine series, give two doses of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) apart, starting ≥8 weeks (≥3 months for mNexspike] after the last dose.⁸

Store in refrigerator (2^oC to 8^oC)
Room temperature stability (8^oC to 25^oC): up to 12 hours

Nuvaxovid COVID-19 vaccine, adjuvanted. 2026 to 2027 formula (XFG variant) for patients ≥65 years of age and 12 through 64 years of age with certain risk factors^c,d

Sanofi

For patients ≥12 years of age.
Dose is 0.5 mL IM.
Give ≥2 months after any previous COVID-19 vaccine dose.
Immunocompromised:^b If not previously vaccinated for COVID-19, give two doses 3 weeks apart [initial series]. Then give one dose of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) after the last dose. If previously vaccinated with one or two doses of an mRNA COVID-19 vaccine, complete the initial three-dose series with the mRNA vaccine, then give one dose of Nuvaxovid 6 months (minimum 2 months) after the last dose. If previously vaccinated with one dose of any Novavax vaccine, complete the initial two-dose series. Then give one dose of any COVID-19 vaccine 6 months (minimum 2 months [minimum 3 months for mNexspike]) after the last dose. For patients who have already completed the initial series of any COVID-19 vaccine, give two doses 6 months (minimum 2 months) apart, starting ≥8 weeks after the last dose.⁸

Store in refrigerator

(2^oC to 8^oC).

Abbreviations: CDC = Centers for Disease Control; IM = intramuscular

US prescribing information used in creation of this chart: Comirnaty (August 2026), mNexspike (August 2026), Nuvaxovid (August 2026), Spikevax (August 2026)
Immunocompromise = solid organ transplant patient or similar level of immunocompromise. For specific conditions, see CDC’s COVID-19 Vaccination Guidance for People Who Are Immunocompromised at https://www.cdc.gov/covid/hcp/vaccine-considerations/immunocompromised.html.
Risk factors: https://www.cdc.gov/covid/risk-factors/index.html.
Some organizations have recommendations for use that differ from the FDA-approved labeling (not all-inclusive):
- American Academy of Family Physicians: https://www.aafp.org/clinical-insights/immunizations-and-vaccines/respiratory-virus-vaccines
- American Academy of Pediatrics: https://www.aap.org/en/patient-care/immunizations/
- American College of Obstetricians and Gynecologists:
  - https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/covid-19-vaccination-considerations-for-obstetric-gynecologic-care
  - https://www.acog.org/clinical-information/maternal-immunization-schedule
- IDSA: https://www.idsociety.org/practice-guideline/Seasonal-RTI-Vaccinations-in-Immunocompromised-Patients/
- CDC: https://www.cdc.gov/vaccines/hcp/imz-schedules/index.html

Frequently asked questions about COVID-19 vaccination

Question	Pertinent information or Suggested Resources
How do COVID-19 vaccines work?	See the CDC’s “COVID-19 Vaccine Basics” at https://www.cdc.gov/covid/vaccines/how-they-work.html.
Do mRNA vaccines affect DNA?	No. COVID-19 vaccines to not interact with DNA in any way.⁵
Can a COVID-19 vaccine cause a COVID-19 infection?	No. COVID-19 vaccines do not contain the COVID-19 virus.⁵
Can a patient get a COVID-19 vaccine if they have a COVID infection?	Patients who have COVID-19 should delay vaccination to avoid exposing healthcare providers and others.⁴ Patients can wait three months after having COVID-19 infection to receive a COVID-19 vaccination.⁴ Reinfection is unlikely in the first months post-infection.⁸ Delaying vaccination for three months may improve vaccine response.⁸ Reasons to get vaccinated sooner include high personal risk of severe disease or high COVID-19 transmission in the community.⁸
How effective are COVID-19 vaccines?	Efficacy of the 2025-26 COVID-19 vaccines in immunocompetent adults was:¹⁵ 55% (53% if ≥65 years of age) for COVID-19 hospitalization 50% (48% if ≥65 years of age) for COVID-19 urgent care or emergency department visits This was a case-control study using US data from September to December 2025. Median time from vaccine receipt was ~47 days.¹⁵
What is the difference between Spikevax and mNexspike?	Spikevax provides mRNA that codes for the COVID-19 spike protein, while mNexspike vaccine provides mRNA that encodes for only two parts of the COVID-19 virus spike protein, so the dose is lower. These two parts (the receptor-binding domain [RBD] and the N-terminal domain [NTD]) are responsible for most of the effective antibody production.²¹ In a clinical trial (n = 11,366 participants ≥12 years of age), mNexspike providing mRNA encoding the RBD and NTD of the original and Omicron BA/4/BA.5 variants was compared to the Moderna COVID-19 vaccine, bivalent (original and Omicron BA.4/BA.5 vaccine [2022-2023]). About 60% of patients had at least one risk factor for severe COVID-19. Relative vaccine efficacy for prevention of symptomatic COVID-19 infection was 9.3% (NNT = 112). Among participants ≥65 years of age, relative vaccine efficacy was 13.5% (NNT = 73).²²
Can COVID-19 vaccines be given with other vaccines?	Generally yes, but there are special considerations for mpox vaccination.¹⁷
What are some common adverse effects of COVID-19 vaccines, and what can be done about them?	As with other vaccines, side effects are usually mild and go away in few days, if they occur at all.⁴ Common side effects include fatigue, muscle pain, headache, chills, nausea, fever, and pain, swelling, and redness in the arm where the vaccine was administered.⁴ It is not recommended to take analgesics before vaccination to prevent side effects, but they can be taken to treat side effects if they occur.⁴ For arm pain and swelling, a clean, cool, wet washcloth can be applied over the area. The patient should keep using their arm normally.⁴
Do COVID-19 vaccines cause heart problems?	Many viruses, including COVID-19, can cause myocarditis and pericarditis.⁶ In one study, patients with COVID-19 had almost 16 times the risk of myocarditis compared with patients who did not have COVID-19.¹⁴ Although rare, the COVID-19 vaccine has been associated with myocarditis and pericarditis.⁶ Myocarditis associated with COVID-19 vaccination is less common and less severe than with COVID-19 infection.⁷ Most cases associated with COVID-19 vaccination are mild, transient, and resolve on their own.⁷ The incidence of myocarditis/pericarditis in the first week after receipt of the 2023-2024 COVID-19 vaccine was ~8 cases/million doses in patients 6 months through 64 years of age, and ~27 cases/million doses in males 12 through 24 years of age.¹⁸ Waiting at least 8 weeks between doses may decrease risk.^8,9
Do COVID-19 vaccines cause Bell’s palsy?	Bell’s palsy has been reported after COVID-19 infection and vaccination.²⁰ It is unclear if mRNA COVID-19 vaccines are associated with Bell’s palsy.¹³Some data suggest that vaccination may have a protective effect.²⁰
Do COVID-19 vaccines cause Guillain-Barre syndrome?	mRNA COVID-19 vaccines do not seem to be associated with Guillain-Barre syndrome.¹¹ Guillain-Barre syndrome is rare and more common after COVID-19 infection than after vaccination.¹⁶
Will COVID-19 vaccination cause a positive COVID test?	No. It does not affect the results of COVID-19 diagnostic tests.¹²Although it can cause a positive antibody test for spike protein IgM/IgG, this is not a diagnostic test.¹²
Can antibody testing be used to assess the need for COVID-19 vaccination?	Antibody testing should not be used to determine a person’s need for COVID-19 vaccination.¹² Antibody testing is appropriate in the context of public health and epidemiologic purposes, and for fulfilling the case definition of multisystem inflammatory response syndrome.¹²
Do you need to stick with the same vaccine every year?	Generally no, but immunocompromised patients should ideally receive the same vaccine for the initial series.⁸The exception is that Spikevax and mNexspike can be used interchangeably.⁸
Should a child receive one or two doses of Spikevax if they turn 2 years of age during the two-dose series?	Individuals turning from 23 months to 2 years of age during the vaccination series should receive both doses of Spikevax.
Do COVID-19 vaccines prevent “long COVID”?	Vaccination is the best available tool to prevent long COVID.¹ Vaccination may reduce the risk of long COVID-19 by almost 20% in the seven months post-vaccination.³
Can patients who are pregnant or breastfeeding get a COVID vaccine?	COVID-19 vaccinations are recommended for people who are pregnant, trying to get pregnant, or who might become pregnant in the future, and for people who are breastfeeding.¹⁰ Over a million patients have received an mRNA COVID-19 vaccine before or during pregnancy, including hundreds of thousands of pregnant or breastfeeding patients.^2,19 Data supports no increased risk of miscarriage, ectopic pregnancy, preterm birth, stillbirth, or birth defects, and no effect on fertility.^2,19

Question

Pertinent information or Suggested Resources

How do COVID-19 vaccines work?

See the CDC’s “COVID-19 Vaccine Basics” at https://www.cdc.gov/covid/vaccines/how-they-work.html.

Do mRNA vaccines affect DNA?

No. COVID-19 vaccines to not interact with DNA in any way.⁵

Can a COVID-19 vaccine cause a COVID-19 infection?

No. COVID-19 vaccines do not contain the COVID-19 virus.⁵

Can a patient get a COVID-19 vaccine if they have a COVID infection?

Patients who have COVID-19 should delay vaccination to avoid exposing healthcare providers and others.⁴
Patients can wait three months after having COVID-19 infection to receive a COVID-19 vaccination.⁴
- Reinfection is unlikely in the first months post-infection.⁸
- Delaying vaccination for three months may improve vaccine response.⁸
- Reasons to get vaccinated sooner include high personal risk of severe disease or high COVID-19 transmission in the community.⁸

How effective are COVID-19 vaccines?

Efficacy of the 2025-26 COVID-19 vaccines in immunocompetent adults was:¹⁵
- 55% (53% if ≥65 years of age) for COVID-19 hospitalization
- 50% (48% if ≥65 years of age) for COVID-19 urgent care or emergency department visits
This was a case-control study using US data from September to December 2025. Median time from vaccine receipt was ~47 days.¹⁵

What is the difference between Spikevax and mNexspike?

Spikevax provides mRNA that codes for the COVID-19 spike protein, while mNexspike vaccine provides mRNA that encodes for only two parts of the COVID-19 virus spike protein, so the dose is lower. These two parts (the receptor-binding domain [RBD] and the N-terminal domain [NTD]) are responsible for most of the effective antibody production.²¹
In a clinical trial (n = 11,366 participants ≥12 years of age), mNexspike providing mRNA encoding the RBD and NTD of the original and Omicron BA/4/BA.5 variants was compared to the Moderna COVID-19 vaccine, bivalent (original and Omicron BA.4/BA.5 vaccine [2022-2023]). About 60% of patients had at least one risk factor for severe COVID-19. Relative vaccine efficacy for prevention of symptomatic COVID-19 infection was 9.3% (NNT = 112). Among participants ≥65 years of age, relative vaccine efficacy was 13.5% (NNT = 73).²²

Can COVID-19 vaccines be given with other vaccines?

Generally yes, but there are special considerations for mpox vaccination.¹⁷

What are some common adverse effects of COVID-19 vaccines, and what can be done about them?

As with other vaccines, side effects are usually mild and go away in few days, if they occur at all.⁴
Common side effects include fatigue, muscle pain, headache, chills, nausea, fever, and pain, swelling, and redness in the arm where the vaccine was administered.⁴
It is not recommended to take analgesics before vaccination to prevent side effects, but they can be taken to treat side effects if they occur.⁴
For arm pain and swelling, a clean, cool, wet washcloth can be applied over the area. The patient should keep using their arm normally.⁴

Do COVID-19 vaccines cause heart problems?

Many viruses, including COVID-19, can cause myocarditis and pericarditis.⁶
- In one study, patients with COVID-19 had almost 16 times the risk of myocarditis compared with patients who did not have COVID-19.¹⁴
Although rare, the COVID-19 vaccine has been associated with myocarditis and pericarditis.⁶
- Myocarditis associated with COVID-19 vaccination is less common and less severe than with COVID-19 infection.⁷
- Most cases associated with COVID-19 vaccination are mild, transient, and resolve on their own.⁷
- The incidence of myocarditis/pericarditis in the first week after receipt of the 2023-2024 COVID-19 vaccine was ~8 cases/million doses in patients 6 months through 64 years of age, and ~27 cases/million doses in males 12 through 24 years of age.¹⁸
Waiting at least 8 weeks between doses may decrease risk.^8,9

Do COVID-19 vaccines cause Bell’s palsy?

Bell’s palsy has been reported after COVID-19 infection and vaccination.²⁰
It is unclear if mRNA COVID-19 vaccines are associated with Bell’s palsy.¹³Some data suggest that vaccination may have a protective effect.²⁰

Do COVID-19 vaccines cause Guillain-Barre syndrome?

mRNA COVID-19 vaccines do not seem to be associated with Guillain-Barre syndrome.¹¹
Guillain-Barre syndrome is rare and more common after COVID-19 infection than after vaccination.¹⁶

Will COVID-19 vaccination cause a positive COVID test?

No. It does not affect the results of COVID-19 diagnostic tests.¹²Although it can cause a positive antibody test for spike protein IgM/IgG, this is not a diagnostic test.¹²

Can antibody testing be used to assess the need for COVID-19 vaccination?

Antibody testing should not be used to determine a person’s need for COVID-19 vaccination.¹²
Antibody testing is appropriate in the context of public health and epidemiologic purposes, and for fulfilling the case definition of multisystem inflammatory response syndrome.¹²

Do you need to stick with the same vaccine every year?

Generally no, but immunocompromised patients should ideally receive the same vaccine for the initial series.⁸The exception is that Spikevax and mNexspike can be used interchangeably.⁸

Should a child receive one or two doses of Spikevax if they turn 2 years of age during the two-dose series?

Individuals turning from 23 months to 2 years of age during the vaccination series should receive both doses of Spikevax.

Do COVID-19 vaccines prevent “long COVID”?

Vaccination is the best available tool to prevent long COVID.¹
Vaccination may reduce the risk of long COVID-19 by almost 20% in the seven months post-vaccination.³

Can patients who are pregnant or breastfeeding get a COVID vaccine?

COVID-19 vaccinations are recommended for people who are pregnant, trying to get pregnant, or who might become pregnant in the future, and for people who are breastfeeding.¹⁰
Over a million patients have received an mRNA COVID-19 vaccine before or during pregnancy, including hundreds of thousands of pregnant or breastfeeding patients.^2,19 Data supports no increased risk of miscarriage, ectopic pregnancy, preterm birth, stillbirth, or birth defects, and no effect on fertility.^2,19

References

CDC. Long COVID basics. May 6, 202.. https://www.cdc.gov/long-covid/about/index.html (Accessed August 6, 2026).
CDC. COVID-19 vaccination for women who are pregnant or breastfeeding. February 10, 2026. https://www.cdc.gov/covid/vaccines/pregnant-or-breastfeeding.html. (Accessed August 15, 2026).
Butzin-Dozier Z, Ji Y, Wang LC, et al. COVID-19 vaccination timing, relative to acute COVID-19, and subsequent risk of long COVID. EBioMedicine. 2026 Jul 24;130:106382.
CDC. Getting your COVID-19 vaccine. June 10, 2025. https://www.cdc.gov/covid/vaccines/getting-your-covid-19-vaccine.html. (Accessed August 4, 2026).
CDC. COVID-19 Vaccine Basics. September 3, 2024. https://www.cdc.gov/covid/vaccines/how-they-work.html. (Accessed August 4, 2026).
Fairweather D, Beetler DJ, Di Florio DN, et al. COVID-19, Myocarditis and Pericarditis. Circ Res. 2023 May 12;132(10):1302-1319.
Buoninfante A, Andeweg A, Genov G, Cavaleri M. Myocarditis associated with COVID-19 vaccination. NPJ Vaccines. 2024 Jun 28;9(1):122.
CDC. Interim Clinical Considerations for Use of COVID-19 Vaccines in the United States. November 4, 2025.. https://www.cdc.gov/covid/downloads/hcp/interim-clinical-considerations.pdf (Accessed August 5, 2026).
Wallace M, Moulia D, Blain AE, et al. The Advisory Committee on Immunization Practices' Recommendation for Use of Moderna COVID-19 Vaccine in Adults Aged ≥18 Years and Considerations for Extended Intervals for Administration of Primary Series Doses of mRNA COVID-19 Vaccines - United States, February 2022. MMWR Morb Mortal Wkly Rep. 2022 Mar 18;71(11):416-421.
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Cite this document as follows: Clinical Resource, COVID-19 Vaccines 2026-27 (United States). Pharmacist’s Letter/Pharmacy Technician’s Letter/Prescriber Insights. September 2026. [420966]

COVID-19 Vaccines 2026-27 (United States)

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