CDC Guidance released on September 1, 2022, recommends that patients 12 and older who received the primary series of any of the authorized COVID-19 vaccines should receive a booster dose of a mRNA bivalent COVID-19 vaccine. The mRNA bivalent booster dose should occur at least two months after the last dose of a COVID-19 vaccine. The bivalent Pfizer BioNTech booster is approved for patients aged 12 years and older and the bivalent Moderna booster is approved for patients aged 18 years and older. The mRNA bivalent vaccines are only available for booster vaccinations. The original monovalent COVID-19 vaccine must be used for the primary series. The original monovalent COVID-19 vaccine can no longer be used for booster doses except for children aged 5-11 who are not eligible for the booster dose of the bivalent COVID-19 vaccine. Since there are now multiple formulations of the mRNA COVID-19 vaccines it will be extremely important for vaccine providers to make sure that the correct vaccine is given to each patient. The CDC definition of up-to-date with COVID-19 vaccine is someone who has completed their primary vaccine series and received the most recent COVID-19 booster vaccine recommended for them by the CDC. It is highly recommended that patients also receive their Influenza vaccine this fall and can receive both the COVID-19 bivalent booster and the influenza vaccine during the same visit. For complete details, the full Health Advisory 659 will be available here when it is published.