COVID-19 Vaccine Recommendations

Page last updated/reviewed 10/13/2023.

COVID-19 vaccines are safe and effective. The County of San Diego is following federal and state guidelines and working with community partners to provide vaccinations to the public.

People can stay up-to-date with COVID-19 vaccination by completing a primary series and receiving the most recent booster dose recommended for them by the Centers for Disease Control and Prevention (CDC) (see Table 1 and Table 2).

  • If you have completed your primary series, but are not yet eligible for a booster, you are also considered up to date.
  • If you become ill with COVID-19 after you received all COVID-19 vaccine doses recommended for you, you are also considered up-to-date. You do not need to be re-vaccinated or receive an additional booster. 

Terminology for COVID-19 Vaccines

  • Primary series: Initial vaccination which can range from a single dose to a 3-dose series depending on the vaccine product and a person’s age and immune status. 
  • Additional dose: A dose of vaccine administered after the primary series to people who may be less likely to mount a protective immune response after initial vaccination. 
  • Booster dose: A subsequent dose of vaccine administered to enhance or restore protection which might have waned over time after primary series vaccination.
  • Bivalent vaccine (“updated vaccine”): The updated (bivalent) boosters are called “bivalent” because they protect against both the original virus that causes COVID-19 and the Omicron variant BA.4 and BA.5.
  • Up-to-date: You are up-to-date with your COVID-19 vaccines when you have completed a COVID-19 vaccine primary series and got the most recent booster dose recommended for you by the CDC.
    • If you have completed your primary series—but are not yet eligible for a booster—you are also considered up-to-date.
    • If you become ill with COVID-19 after you received all COVID-19 vaccine doses recommended for you, you are also considered up-to-date. You do not need to be revaccinated or receive an additional booster.

Clinical Guidance for COVID-19 Vaccines

Table 1: COVID-19 Vaccine Timing/Routine Schedule

Source: California Department of Public Health, 2023. https://eziz.org/assets/docs/COVID19/IMM-1396.pdf

Table 2: COVID-19 Vaccine Timing/Schedule for Those Who are Severely Ill or Who Have Very Weak Immune Systems

Source:  California Department of Public Health, 2023.   https://eziz.org/assets/docs/COVID19/IMM-1396.pdf

Medical Guidance for Specific Populations and Conditions

Booster Recommendations

Updated COVID-19 Booster_March2023 - Updated COVID-19 Booster

Boosters are an important part of protecting yourself or your child from getting seriously ill or dying from COVID-19. The Centers for Disease Control and Prevention (CDC) recommend one updated (bivalent) booster dose:

  • For everyone aged 5 years and older if it has been at least 2 months since your last dose.
  • For children aged 6 months-5 years who completed the Moderna primary series and if it has been at least 2 months since their last dose.
  • As of March 16, 2023, the CDC recommends one updated (bivalent) booster dose for children aged 6 months-4 years who completed the Pfizer 3-dose primary series with the monovalent Pfizer-BioNTech COVID-19 vaccine and if it has been at least 2 months since their last dose. 
    • **If children aged 6 months-4 years received the first two doses with monovalent Pfizer-BioNTech, then they should complete their 3-dose primary series with Pfizer-BioNTech COVID-19 Vaccine, Bivalent. The children in this group are not eligible for a booster dose of a bivalent vaccine at this time.
  • On April 19, 2023, following the Food and Drug Administration (FDA) regulatory action, the CDC’s Advisory Committee on Immunization Practices (ACIP) expressed their support to allow an additional updated (bivalent) vaccine dose for adults ages 65 years and older, and additional doses for people who are immunocompromised.

The updated (bivalent) boosters are called "bivalent" because they protect against both the original virus that causes COVID-19 and the Omicron variant BA.4 and BA.5. Previous boosters called "monovalent" because they were designed to protect against the original virus that causes COVID-19. They also provide some protection against Omicron, but not as much as the updated (bivalent) boosters.

  • Click here to find out when to get a booster.
  • Click here for Reasons to Get a COVID-19 Vaccine and Booster.

Booster Doses for WHO-Listed COVID-19 Vaccines Not Approved in the United States

People who received a WHO-listed COVID-19 vaccine not approved by the FDA are eligible to receive a single booster dose of Pfizer-BioNTech COVID-19 vaccine if they fall into one of the groups at increased risk for serious complications of COVID-19 or exposure to SARs-CoV-2 as detailed in Considerations for Use of COVID-19 Vaccines. 

As of January 25, 2023, CDC recommends one updated (bivalent) booster dose:

  • For everyone aged 5 years and older if it has been at least 2 months since your last dose.
  • For children aged 6 months–4 years who completed the Moderna primary series and if it has been at least 2 months since their last dose.

As of March 16, 2023, CDC recommends one updated (bivalent) booster dose:

  • For children aged 6 months–4 years who completed the Pfizer 3-dose primary series with the monovalent Pfizer-BioNTech COVID-19 vaccine and if it has been at least 2 months since their last dose.