COVID-19 Update for Virginia


COVID-19 Update for Virginia

September 9, 2022

Dear Colleague:

I am writing to provide you with brief updates on COVID-19.

CDC Recommends Updated COVID-19 Boosters

    • On August 31, 2022, the U.S. Food and Drug Administration (FDA) granted Emergency Use Authorization for the updated Pfizer and Moderna COVID-19 bivalent vaccines to be used as booster doses for the prevention of severe SARS-CoV-2 infection in people aged 12 years and older at least two months following a completed primary series or booster vaccination.
      • The bivalent vaccines, also known as “updated boosters,” contain messenger RNA (mRNA) components of the original strain of SARS-CoV-2 and the BA.4 and BA.5 lineages of the Omicron variant of SARS-CoV-2.
    • After a meeting of the Advisory Committee on Immunization Practices (ACIP) to discuss the vaccines, the Centers for Disease Control and Prevention (CDC) recommended on September 1, 2022, that both updated boosters be placed into use.
      • The Pfizer-BioNTech COVID-19 Vaccine, Bivalent, is authorized for use as a single booster dose in individuals aged 12 years and older.
      • The Moderna COVID-19 Vaccine, Bivalent, is authorized for use as a single booster dose in individuals aged 18 years and older. 
    • Monovalent mRNA COVID-19 vaccines are no longer authorized as booster doses for individuals aged 12 years and older.  Only individuals aged 5–11 years can receive a monovalent booster dose at this time. 
  • Healthcare providers should report vaccine administration errors to the Vaccine Adverse Event Reporting System (VAERS). To file an electronic report, please see the VAERS website.

Coadministration of COVID-19 and Other Vaccines

  • With influenza (flu) season approaching, providers are encouraged to offer flu, COVID-19, and other age-appropriate recommended vaccines during the same visit to people with no known contraindication(s).
  • There is no minimum interval between COVID-19 vaccination and monkeypox vaccination (either JYNNEOS or ACAM2000).  However, adolescent or young adult males might consider waiting four weeks after monkeypox vaccination before receiving a COVID-19 vaccine, because of the observed risk for myocarditis and/or pericarditis after receipt of ACAM2000 and mRNA (i.e., Moderna and Pfizer-BioNTech) and Novavax COVID-19 vaccines and the unknown risk for myocarditis and/or pericarditis after JYNNEOS.
  • For more information, please see CDC’s Interim Clinical Considerations and Best practices for administering multiple vaccines.


  • EVUSHELD is a long-acting monoclonal antibody (mAb) medication that is FDA authorized for pre-exposure prophylaxis (PrEP) against COVID-19. The drug is given as two intramuscular injections every 6 months. 
  • It’s indicated for adults and children aged 12 years and older, weighing at least 88 pounds, moderately to severely immunocompromised, or for people who have experienced a severe adverse reaction to a COVID-19 vaccine such that an additional COVID-19 vaccine would be medically contraindicated.
  • EVUSHELD is not meant as a substitute for a COVID-19 vaccine in people who are

eligible for COVID-19 immunization but elect not to receive it.

  • The U.S. Department of Health and Human Services, Administration for Strategic Preparedness and Response (HHS/ASPR) has noted that EVUSHELD use is not as robust as expected. HHS has a large supply of EVUSHELD available at no cost to patients.  VDH encourages clinicians who treat immunocompromised patients to consider using EVUSHELD.
  • Further information for patients and caregivers: Fact Sheet for Patients, Parents, and Caregivers Emergency Use Authorization (EUA) of Evusheld

Thank you again for your continued partnership.  Please visit the Virginia Department of Health website for current clinical and public health guidance on COVID-19 and other information.       


Colin M. Greene, MD, MPH
State Health Commissioner