COVID vaccine recommendations for fall 2025

With a new COVID variant spreading and changing vaccine recommendations, many people want to know if they can, or should, get a COVID booster. Talk to your clinician or pharmacist today about what you can do to protect you and your loved ones.

At the end of May, the current HHS secretary announced, on a social media platform, that COVID boosters will only be recommended for adults with at least one underlying health condition. This decision was made by an unusual process, which is described more below. These moves have concerned a number of societies of physicians who care for patients including the American Academy of Pediatrics (AAP) and American College of Obstetrics and Gynecology (ACOG), and has led to confusion about what vaccines are available and who can get them.

What are the currently available vaccines?

#️⃣ There are 3 vaccines for COVID available in the US made by Moderna, Pfizer-BioNTech, and Novavax.

🪩 Two of the vaccines are made by Moderna and Pfizer-BioNTech and use the mRNA-lipid nanoparticle method.

🚨Nerd alert: Lipid nanoparticle mRNA vaccines are made by using a tiny fatty shell with the instructions for making one important part of the virus, the spike protein, to which the immune system makes antibodies. In the case of COVID/SARS-CoV-2 it is called spike.

🛞 The Novavax vaccine is protein-based with an immune enhancer called an adjuvant.

🚨Nerd alert: This type of vaccine is made up of the ready-made spike and an adjuvant, which is added to protein vaccines to help activate the immune response. In this case Novavax uses their company’s own adjuvant.

Do the current vaccines protect against the types of the virus that are currently circulating?

🔄 The SARS-CoV-2 virus causes COVID and has been changing continuously since it began infecting people in late 2019.

👫 Each time the virus changes, it gains some ability to spread more easily and/or get around the immune protection from previous vaccination or infection.

⏩ When the virus changes a lot, we call it a new lineage or variant, like delta and omicron.

▶️ When the virus changes a little bit, we call it a subvariant.

🦠The current SARS-CoV-2 viruses that are infecting people around the world are related to the omicron and JN.1 variants.

✅ The three available vaccines are still working against these variants.

🔄The World Health Organization (WHO) and US vaccine experts recommended using the LP8.1 subvariant of JN.1 to update the available vaccines for fall 2025.

🚨Nerd alert: The LP8.1 is a subvariant of JN.1 that was first found in the US in July 2024. Once LP8.1 was found, it rapidly became, and remains, the most common variant infecting people in the US and around the world. LP8.1 had a few changes that possibly made it more resistant to the protection from previous infection or vaccination.

At the end of May 2025, the Vaccines and Related Biological Products Advisory Committee (VRBPAC) recommended to the FDA that the COVID boosters for this fall be monovalent and target JN.1, preferably the LP8.1 subvariant. This means that vaccine manufacturers will most likely make updated vaccines that contain only one part of SARS-CoV-2 (monovalent) and only from the LP8.1 subvariant.

What about the new variant called Nimbus?

🦠 NB1.8.1 also called “Nimbus” was first found in the US earlier in 2025 through airport screening programs [archived link] . It is a subvariant of the JN.1 variant.

#️⃣ The numbers show that NB1.8.1 is rapidly spreading. As of the middle of June, it was responsible for 37% of all the reported COVID cases [archived link on 6/13/2025], which was double the previous week. As of June 21 it has increased again to 43% [archived link on 6/30/2025].

⬆️ NB1.8.1 will likely become the dominant variant very soon. Since the variant is spreading so fast, the World Health Organization deemed it a variant under monitoring (VUM).

⚔️ Some reports link NB1.8.1 with symptoms of fatigue and an extreme sore throat (Razor-blade throat), but infection generally causes the same symptoms as previous variants.

🏥 In some countries, there have been reports of increased COVID hospitalizations due to NB1.8.1, but at this time it is uncertain if the variant causes more severe illness. More data is needed.

🧑🏿‍🤝‍🧑🏽 When scientists compared NB1.8.1 to previous variants, there were hints that the virus gained changes that allow it to spread more easily, which makes sense based on how fast it is currently spreading around the world.

👍 The good news is that those same studies also suggest that vaccinated people still have protective antibodies that counteract the NB1.8.1 variant. Different people may have different amounts of these antibodies, and remember that antibodies help protect against severe disease.

What are the current COVID recommendations and how have they changed?

People over 65:
- Old Recommendation: Get a COVID vaccine if you have not received one and get shots when your doctor recommends them. For example, ahead of surges in COVID that happen in winter and spring.
- New proposed recommendation: Recommendations have not changed.
- What is supported by the data and professional medical organizations?
  - People over 65 are still at the highest risk for severe disease, hospitalization, and death from COVID.
  - As you age, your immune system is less effective.
  - As you age, it is also more likely that you have one or more underlying conditions that increase your chances of getting more sick if you get COVID.

Healthy adults 18-64:
- Old recommendation: Get a COVID vaccine if you have not received one and get an annual booster.
- New proposed recommendation: A COVID vaccine or booster is not needed.
  - Healthy adults might still be able to get a COVID booster, if they can find a pharmacy or clinician who will administer it. However, because the current CDC has removed it from the list of recommended vaccines, insurance may not cover the cost of the vaccine or the doctor visit. Some pharmacies currently state that the vaccine is up to $200 without insurance.
- What is supported by the data and professional medical organizations?
  - The Weekly Morbidity and Mortality Report from the CDC in February 2025 [archived link] provided data showing that a booster dose of the updated (2024) COVID vaccine gave improved protection from emergency and urgent care visits for all adults compared to those who did not receive a booster.
  - The Infectious Disease Society of America (IDSA) released a statement[archived link] saying that the new recommendations will “negatively impact health” and urges insurance companies to continue to cover the COVID vaccine.

People 18-64 with at least one underlying medical condition:
- Old recommendation: Get a COVID vaccine if you have not received one and get an annual booster.
- New proposed recommendation: Recommendations have not changed.
  - The list of underlying conditions [archived link] is long, and you should check with your provider to see if you qualify.

Healthy children 6 months to 17 years:
- Old recommendation: Get a COVID vaccine if you have not received one and get an annual booster.
- New proposed recommendation: Parents should consult with their child’s pediatric provider in a “shared clinical decision making” process to determine if a child should receive an initial COVID vaccine or any boosters.
- What is supported by the data and professional medical organizations?

The American Academy of Pediatrics (AAP) released a statement in May 2025[archived link] is in support of keeping the COVID vaccine on the schedule of recommended vaccines for children to make sure children have access and that insurance will cover the vaccine.
Children are still at risk for severe disease. In fact, data presented to the previous ACIP at their April 2025 meeting showed that, on average, 41% of children aged 6 months to 17 years who were hospitalized for COVID between Oct 2022 and Aug 2024 had no underlying condition [archived link]. However, it is important to note that older children hospitalized for COVID were more likely to have an underlying condition, and that this increased with age. You should talk with your clinician about your child’s specific case.
Children vaccinated for COVID are also at reduced risk for long COVID. Check out this previous post for more information about long COVID in children.

Pregnant people:
- Old recommendation: All pregnant people should get a COVID vaccine/booster [archived link] because pregnancy is a risk factor [archived link] for more severe COVID disease [archived link].
- New proposed recommendations: The COVID vaccine is no longer needed for pregnant people despite pregnancy being previously considered one of the underlying medical conditions listed on the CDC website [archived link] .
- What is supported by the data and professional medical organizations?

The American College of Obstetrics and Gynecology (ACOG) continues to recommend that all pregnant people be vaccinated. Illness, including COVID, is dangerous during pregnancy, and the more serious the illness, the more dangerous it is for the growing baby.
CDC data show [archived link] that nearly 90% of infants under 6 months who were hospitalized for COVID were from a birth parent who had no documentation of vaccination against COVID during pregnancy. Thus, vaccination during pregnancy correlates with fewer infants getting severely ill if they get COVID.
Since the COVID vaccine is not given to babies under 6 months, vaccination during pregnancy helps make protective antibodies that are transferred to the baby during pregnancy and passed to the baby after birth in breastmilk [archived link before the recommendations were changed]. These antibodies are the only defense mechanism for vulnerable babies before their own immune system develops enough to handle the infection and before they are old enough to get the vaccine.

How has the process of reviewing and recommending vaccines changed?

Traditionally, decisions about vaccine recommendations follow an orderly process with checks and balances to ensure that those recommendations are based on sound scientific data. First, the Advisory Committee on Immunization Practices (ACIP) meets and evaluates all of the available data at a meeting that is open to the public. This committee is normally made up of 17 people with complementary expertise in immunology, virology, vaccines, and public health, and even has non-scientists on it to provide the public’s viewpoint. If any one of the members has a conflict, they don’t vote on that vaccine. Once the committee reviews the data, they vote and make recommendations to the CDC director. The CDC director then makes the final decision and announces the recommendations. If they recommend a vaccine for a particular population, insurance companies are generally required to cover the cost of those vaccines. Recently, the current Secretary of HHS removed all the members of ACIP and replaced them with 7 new members that did not go through the normal screening process to determine if they have appropriate qualifications and ensure that they don’t have major conflicts of interest. There is also no current director of the CDC. Moreover, the current Secretary of HHS announced the new vaccine recommendations on social media. All of these moves are highly unusual and have led organizations like the American Association of Pediatricians (AAP) to release a statement saying that they will continue to publish their “own evidence-based recommendations and schedules.”

The bottom line is that these changes may affect your access to the COVID vaccine. It is important to talk to your clinician to decide if and when to get the COVID vaccine, if you have not already, or get an extra shot before the next surge of COVID cases.

Stay well,

Those Nerdy Girls

Want to know more?

How the Advisory Committee for Immunization Practices makes vaccine recommendations

CDC COVID vaccine recommendations before the changes to ACIP [archived link for previous recommendations]

Safety of COVID vaccines during pregnancy

No adverse associations of COVID vaccine and pregnancy

Clinical review of COVID vaccination during pregnancy

Lack of increased spontaneous abortions after COVID vaccination (https://jamanetwork.com/journals/jama/fullarticle/2784193) and (https://www.nejm.org/doi/10.1056/NEJMc2113891)

Vaccines are safe and effective for pregnant people and infants

No evidence of increased adverse pregnancy outcomes, but reduced stillbirth

Dangers of getting COVID while pregnant