Most healthy adults aged 12 to 64 need one updated COVID-19 vaccine dose per year, given each fall when the new formula becomes available. Adults 65 and older are recommended to get two doses per year, spaced six months apart. Young children may also need more than one dose depending on their vaccination history. The schedule has settled into an annual pattern similar to the flu shot, with the vaccine formula updated each year to match circulating virus strains.
The Annual Schedule for Most Adults
For the 2025-2026 season, adults aged 12 to 64 are recommended to receive a single dose of the updated vaccine at least 8 weeks after their last COVID-19 vaccine dose. Three vaccine options are available for this age group: Moderna (Spikevax), Pfizer-BioNTech, and Novavax. A newer Moderna formulation (mNexspike) requires a slightly longer wait of at least 3 months after your last dose.
This once-a-year approach reflects how COVID-19 vaccination has evolved. Each spring, an FDA advisory committee reviews which virus variants are circulating and selects a strain for the upcoming fall’s vaccine. For the 2025-2026 formula, that committee met in May 2025 and chose a JN.1-lineage strain called LP.8.1 to more closely match the viruses spreading in the U.S. The updated shots typically become available in September or October.
Why Adults 65 and Older Get Two Doses
If you’re 65 or older, the CDC recommends two doses of the updated vaccine each season rather than one. You get the first dose when it becomes available in the fall, then a second dose six months later. The minimum gap between those two doses is 2 months for most vaccine types and 3 months for Moderna’s mNexspike formulation, though the recommended interval is a full six months.
The reasoning comes down to how well protection holds up over time. Real-world data from the 2024-2025 season showed that among adults 65 and older, the updated vaccine reduced COVID-related hospitalizations by about 42% in the first two months and 47 to 48% between two and four months. Protection didn’t dramatically drop off in that window, but older adults face higher baseline risk of severe illness, and a second dose provides a renewed boost heading into the spring and summer months when the first dose’s protection may be fading.
Schedule for Children
Children’s schedules depend on age and whether they’ve been vaccinated before.
- Ages 6 to 23 months: Children in this age group receive Moderna and typically need two doses spaced 4 to 8 weeks apart. Kids who already completed an initial vaccine series need one dose of the updated formula, given at least 8 weeks after their last shot.
- Ages 2 to 4 years: Previously vaccinated children get one dose of the updated vaccine, at least 8 weeks after their last dose. Those who have never been vaccinated need a two-dose series.
- Ages 5 to 11 years: One dose of the updated vaccine (Moderna or Pfizer-BioNTech), at least 8 weeks after the last dose.
If You’re Immunocompromised
People with moderately or severely weakened immune systems, such as those undergoing chemotherapy, taking immunosuppressive medications, or living with advanced HIV, may receive additional doses beyond what’s recommended for the general population. The minimum interval is 2 months after any updated COVID-19 vaccine dose. There’s no set cap on the number of extra doses. The timing and frequency are individualized based on a conversation with a healthcare provider, since immune response varies widely depending on the specific condition and treatment involved.
Timing After a Recent COVID Infection
If you recently tested positive for COVID-19, you’re still recommended to get your updated vaccine, but you can wait up to 3 months before doing so. A recent infection gives your immune system a temporary boost, so delaying the shot lets you maximize the benefit of both your natural immune response and the vaccine. This isn’t a hard rule. If you’d rather get vaccinated sooner, especially heading into a holiday season or travel, that’s considered acceptable.
Why the 8-Week Minimum Matters
Across nearly every age group, the standard minimum interval between COVID-19 vaccine doses is 8 weeks. This isn’t arbitrary. Spacing doses at least 8 weeks apart may reduce the already-small risk of myocarditis and pericarditis (inflammation in or around the heart) that has been associated with COVID-19 vaccines, particularly in younger males. It also gives your immune system enough time to build a full response to the first dose before being stimulated again. If you’re scheduling your shot around travel or an upcoming event, plan to get it at least a couple of weeks beforehand so your body has time to develop strong protection.
How Long Protection Lasts
Vaccine protection doesn’t vanish overnight, but it does gradually decline. Data from the 2024-2025 season found that the updated shot reduced COVID hospitalizations by roughly 42 to 48% among older adults over the first four months. Protection against milder illness wanes faster than protection against hospitalization, which is one reason the vaccine continues to prevent the worst outcomes even as its ability to block infection fades.
This gradual decline is the core reason for annual updates. By the time a new fall formula arrives, last year’s dose is typically 10 to 12 months old and was designed for a strain that may no longer dominate. Getting the new formula each fall resets your protection with antibodies better matched to whatever is currently circulating.