Remember the rush to get a COVID-19 shot when the vaccines first arrived? Hundreds of millions of people rolled up their sleeves and got jabbed to protect themselves and others from the virus.
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Today, of course, the pandemic is over, but COVID-19 continues to circulate and infect people around the world. It’s not gone.
That’s why being up to date on COVID-19 vaccinations remains a global health priority, says infectious disease specialist Kristin Englund, MD. Here’s what you need to be considered fully vaccinated for COVID-19.
COVID-19 vaccination recommendations
COVID-19 continues to evolve with new variants and subvariants emerging. Dozens of different strains have been reported since 2020. Today, omicron and its offshoots are the predominant variants circulating.
As the virus goes through these changes, your body’s defense against these new attackers needs to be reinforced. “Mutations to the virus go well beyond what the initial vaccines covered,” says Dr. Englund.
That’s why the U.S. Centers for Disease Control and Prevention (CDC) recommends getting an updated 2023–2024 COVID-19 vaccine to better protect yourself against newer variants and serious illness.
Three updated 2023–2024 vaccines are available: Pfizer-BioNTech, Moderna and Novavax.
COVID-19 vaccination guidance from the CDC varies by a person’s age, vaccination record and health condition. Here’s a rundown:
Children aged 6 months to 4 years
Recommendations for this age group are:
- Children previously vaccinated against COVID-19 should get one or two doses of an updated Moderna or Pfizer-BioNTech vaccine depending on which vaccine and number of doses they previously received.
- Children who haven’t been vaccinated against COVID-19 should get two or three doses of an updated vaccine, depending on whether they receive the Moderna or Pfizer-BioNTech vaccine (or a combination of the two).
Children aged 5 years to 11 years
One updated Moderna or Pfizer-BioNTech vaccine is recommended for children in this age group who are either unvaccinated or previously got a vaccine before September 12, 2023.
People aged 12 and older
Recommendations for this age group are:
- People previously vaccinated against COVID-19 should get one dose of any updated vaccine if the previous COVID-19 vaccination was before September 12, 2023 (if it was Moderna or Pfizer-BioNTech) or October 3, 2023 (if it was Novavax).
- People who haven’t been vaccinated against COVID-19 should get either one dose of the updated Moderna or Pfizer-BioNTech vaccine or two doses of the updated Novavax vaccine.
Adults age 65 and older
For this age group, an additional dose of any updated COVID-19 vaccine is recommended at least four months following the first updated dose.
People who are immunocompromised
Those who are moderately or severely immunocompromised may benefit from additional doses of an updated COVID-19 vaccine. Talk to your healthcare provider about your specific timing needs.
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How long does COVID-19 immunity last?
Vaccines train your immune system to recognize and destroy harmful invaders (such as COVID-19). They teach your body to protect itself by giving intel on potential threats. (Basically, it’s a biological cheat sheet.)
It takes about two weeks after getting a COVID-19 vaccination for your body to build up immunity against the virus, says Dr. Englund. After that, you’re considered “fully vaccinated” against COVID-19.
Data from the CDC shows the effectiveness of COVID-19 vaccines. A 2024 report shows that people who received an updated vaccine were 54% less likely to get COVID-19. (The findings focus on the four months from mid-September 2023 to January 2024.)
But that protective power naturally declines over time. Dr. Englund says COVID-19 vaccines generally hold firm against the virus for about a year. After that, the shielding effect loses some oomph.
New COVID-19 variants also can lessen the effectiveness of vaccines over time.
“As the virus mutates and changes the vaccine loses some of its efficacy in addition to waning over time,” explains Dr. Englund. “Getting an updated vaccine is important to protect yourself and those around you.”
Does ‘natural immunity’ make a difference?
Getting COVID-19 also educates your immune system on the virus and offers some security against future infection. But like vaccines, that immunity lessens over time and doesn’t cover new variants.
The CDC recommends getting an updated COVID-19 vaccine even if you have had the virus. (The suggested wait time is 90 days after infection.)
Research shows that people who don’t get vaccinated after recovering from COVID-19 are more likely to get reinfected than those who get an updated vaccine to boost their natural immunity.
How many people have some COVID-19 immunity?
More than 98% of the population in the United States has some protective immunity against COVID-19 through vaccination, prior infection or some combination of the two, according to the CDC.
But CDC data shows that a much smaller percentage has received an updated COVID-19 vaccine.
Long-term outlook for COVID-19 vaccinations
Looking ahead, Dr. Englund envisions vaccination against COVID-19 following a similar pattern as what’s done for influenza (aka, the flu). In other words, an annual shot to guard against infection and serious illness.
There’s even work underway on a combined flu/COVID-19 vaccine.
“This all falls under the concept of public health,” says Dr. Englund. “Getting vaccinated is part of our moral obligation to make sure we’re doing everything we can to lower the spread of these viruses and protect those around us.”
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