FAQs COVID-19 Vaccine

The following questions and answers have been developed by the National Immunisation Office.

In 2025 who is recommended a Spring COVID-19 vaccine booster?

Those who are recommended to receive a Spring booster COVID-19 vaccine are those who are considered at highest risk of infection and have continuously had the highest rates of complications due to COVID-19.

A Spring 2025 COVID-19 booster vaccine is recommended for the following groups only:

those aged 80 years and above
those aged 70-79 years who did not receive a COVID-19 vaccine in the preceding 12 months
those aged 18 years and above living in long term care facilities for older adults
those aged 6 months and older with immunocompromise associated with a suboptimal response to vaccination.

What is the recommended interval for a Spring 2025 COVID-19 vaccine booster?

COVID-19 vaccines may be given in Spring 2025 to the above-mentioned risk groups irrespective of the number of previous doses or types of COVID-19 vaccines, with an interval of six months recommended following any previous COVID-19 vaccine dose or infection.

A minimum interval of three months is permissible in exceptional circumstances e.g., planned immunosuppressive therapy or operational reasons. Antigenically updated mRNA COVID-19 vaccines are the preferred vaccines.

What are NIAC recommendations on those who are advised to be vaccinated outside of the Spring COVID-19 booster vaccination programme

As per the NIAC recommendations, at all times of the year, both during and outside of the seasonal COVID-19 vaccination programmes:

COVID-19 booster vaccines continue to be recommended in pregnancy.
COVID-19 booster vaccines should be offered to anyone commencing planned immunosuppressant therapy who has not had a booster vaccine in the previous 6 months.
COVID-19 vaccines will also continue to be available for primary vaccination courses for those in recommended groups, regardless of the time of the year (see below).

What is the latest recommendation from the National Immunisation Advisory Committee (NIAC) for COVID-19 mRNA vaccine?

On October 31st 2024 NIAC recommended that COVID-19 vaccine Comirnaty® KP.2 is the preferred COVID-19 vaccine for Primary and booster Immunisation against SARS-CoV-2 infection.

Comirnaty® KP.2 30 micrograms (0.3 mls) is indicated for active immunisation to prevent COVID-19 caused by SARS-CoV-2, in individuals 12 years of age and older.

Comirnaty® KP.2 10 micrograms, (0.3 mls) is indicated for active immunisation to prevent COVID-19 caused by SARS-CoV-2, in individuals 5 to 11 years of age inclusive.

Comirnaty® KP.2 3 micrograms, (0.3 mls) is indicated for active immunisation to prevent COVID-19 caused by SARS-CoV-2, in individuals 6 months to 4 years of age inclusive.

What Primary immunisation schedule does NIAC now recommend for ALL COVID-19 vaccines for all those aged 5 and above for vaccination against SARS-CoV-2 infection?

For those aged 5 years and above the recommended primary schedule now consists of a single dose of age-appropriate COVID-19 mRNA vaccine.

What COVID-19 Primary immunisation schedule does NIAC now recommend for all those aged 6 months to 4 years?

For those aged 6 months to 4 years the recommended primary schedule now consists of:

a) Two doses of age-appropriate COVID-19 mRNA vaccine for those with no prior history of SARS-CoV-2 infection.

b) A single dose of age-appropriate COVID-19 mRNA vaccine for those with a prior history* of SARS-CoV-2 infection.

*Prior history of COVID-19 can be confirmed by any of the following; positive PCR test, antigen test or clinical diagnosis. For example, a single dose primary series could be considered in a child who had symptoms consistent with COVID-19 at a time when household contacts tested positive.

What Primary immunisation schedule of COVID-19 vaccine does NIAC now recommend for all those with immunocompromise?

For those with immunocompromising conditions aged 6 months and older, the recommended primary series consists of two doses of an age-appropriate COVID-19 vaccine with an interval of 4 weeks between doses*.

A third dose may be administered following instruction from a relevant specialist physician. The interval recommended is an eight weeks interval between doses two and three, if three doses are required**.

*A minimal interval of three weeks between dose 1 and dose 2 dose may be used if there is urgency to achieve protection.

**A minimal interval of 4 weeks between dose 2 and dose 3 may be used if there is urgency to achieve protection.

This minimum interval applies to the Comirnaty mRNA vaccines only.

What are NIAC updated recommendations for COVID-19 vaccine Primary schedule?

A primary schedule of a COVID-19 vaccine is recommended for:

Those aged 60 years and older.
Those aged 18-59 years living in long term care facilities for older adults.
Those aged 6 months -59 years with:

○ Immunocompromise associated with a suboptimal response to vaccination

○ with medical conditions associated with a higher risk of COVID-19 hospitalisation, severe disease or death.

Health and care workers.
Pregnant adolescents and adults.

What is NIAC’s advice about a Primary COVID-19 vaccination for other groups?

For those aged 6 months-59 years who are healthy, a primary schedule of a COVID-19 vaccine is not routinely recommended.

However, access to a primary scheduleof a COVID-19 vaccine should be available for those in this age group who, following discussion of their reasons with a health care provider (e.g., GP, pharmacist or HSE vaccinator), request vaccination.

What are NIAC recommendations for booster COVID-19 vaccines?

NIAC recommend a seasonal COVID-19 vaccine booster dose in specific at-risk groups only.

What are the latest recommendations regarding primary COVID-19 vaccination and booster COVID-19 vaccination in pregnancy?

Continuing evidence regarding mRNA COVID-19 vaccination during pregnancy has demonstrated it to be safe and effective. During pregnancy mRNA COVID-19 vaccination recommendation is all year and is not seasonal.

The primary schedule, now one dose, may be given at any stage in pregnancy

For pregnant adolescents and adults, a COVID-19 booster vaccine once in pregnancy is recommended if it is more than six months since their previous COVID-19 vaccine or infection. This recommendation is all year round and not seasonal.

COVID-19 vaccine can be given at any stage in pregnancy
the COVID-19 vaccine booster is ideally given between 20-34 weeks’ gestation
If it is more than 12 months since their previous COVID-19 vaccine or infection administration earlier in pregnancy should be considered.

For those who are pregnant and are immunocompromised, a second COVID-19 vaccine booster dose within the same pregnancy may be considered if six months has elapsed since their last booster dose or COVID-19 infection.

Can unvaccinated people who have had COVID‐19 infection have COVID‐19 vaccine?

Yes. People who have had COVID‐19 infection may have COVID‐19 vaccines.

The primary vaccination course should be deferred until clinical recovery from COVID‐19 and at least four weeks after diagnosis or onset of symptoms, or four weeks from the first PCR positive specimen in those who are asymptomatic. Those with persisting symptoms post COVID-19 may be vaccinated unless there is evidence of recent clinical deterioration.

What if somebody with immunocompromise is diagnosed with COVID‐19 infection after a first dose of vaccine of the primary vaccination series?

Those who are immunocompromised and have had COVID-19 infection after their first dose of COVID-19 vaccine should be given the subsequent dose at least four weeks after diagnosis or onset of symptoms.

What is the advice for timing of an mRNA booster dose in someone who has had a breakthrough infection since completing their primary vaccination course?

If a person has had laboratory confirmed (PCR) breakthrough COVID-19 infection/ antigen positive infection with symptoms since completion of their primary course, the mRNA seasonal booster dose should be deferred for at least 6 months. In exceptional circumstances a 3-month interval may be used e.g. if they are starting chemotherapy.

What is the advice for timing of a third vaccine dose (if recommended by a specialist) for an immunocompromised person who has had a breakthrough infection?

If those who are immunocompromised have SARS-CoV-2 infection more than seven days after the second vaccine dose, a third dose of the primary series is not required. They should proceed to their seasonal booster dose as per Table 5a.2 of the National Immunisation Advisory Committee (NIAC) Immunisation Guidelines for Ireland. For those with infection within seven days of their second dose, they should complete the third dose, if recommended by their specialist, after an interval of 8 weeks.

What if a person becomes immunocompromised after receiving their seasonal COVID -19 vaccine booster dose - do they then need an additional dose as well?

No. Individuals with immune compromise at the time of primary COVID-19 vaccination may have a sub-optimal response to the vaccine. They may be recommended a third dose of the extended primary series if advised by their specialist to enhance their response to the primary vaccination course. It is a person’s condition at the time that they receive the primary vaccination course that determines whether or not they need an additional dose.

What if an mRNA seasonal booster dose is given before the minimum interval? Is there a need to repeat the dose?

If the vaccine is given before the minimum interval there is no evidence as to the safety and efficacy of giving a further dose under these circumstances. The dose should not be repeated.

The person (and their parents or guardian if less than 16 years old) should be advised regarding the error and the incident reported. The error should be reported to the HPRA.

What is the advice if someone has received a COVID-19 vaccine outside Ireland and request COVID-19 vaccine?

Those who have documentary evidence of a complete COVID-19 vaccination course with a COVID-19 vaccine authorised by the US FDA, UK MHRA or recommended by WHO should be considered fully vaccinated. For immunocompetent adults and children aged 5 years and above, if they have received one authorised COVID-19 vaccine already they are considered immune
Those who have received a partial or complete course of COVID-19 vaccine not authorised by the US FDA, UK MHRA or recommended by WHO should be offered a course of an EMA authorised COVID-19 vaccine. The minimum interval between the last COVID-19 vaccine dose and an EMA authorised COVID-19 vaccine is four weeks. For immunocompetent adults and children aged 5 years and above, a single dose of COVID-19 vaccine is recommended.

What are NIAC recommendations for Nuvaxovid® Protein Sub unit vaccine when the antigenically updated vaccine BECOMES available?

NIAC advise Protein Subunit vaccines may be used as alternative vaccines in those for whom an mRNA vaccine is contraindicated or declined. Nuvaxovid (antigenically updated) is the preferred alternate and can be used for primary vaccination and/or booster vaccination, in adults and children aged 12 years and above when available.

The preferred alternative vaccine is the antigenically updated Nuvaxovid (Novavax®) vaccine.

However, the antigenically updated Nuvaxovid (Novavax®) is not currently available in Ireland. The HSE has endeavoured to obtain supplies of Nuvaxovid (Novavax®) vaccine for the COVID‐19 vaccination programme for those who have contraindications to mRNA vaccines or prefer non mRNA vaccines.

The HSE is continuing its efforts to obtain supplies of the vaccine. People who require or request a non mRNA vaccine can be advised to phone HSELive at 1800 700 700 to be added to a list to be contacted if/when Nuvaxovid (Novavax®) becomes available.

Nuvaxovid (Novavax®) is a safe and effective vaccine that provides protection against the serious complications of COVID-19 infection including hospitalisation, intensive care unit (ICU) admissions and death.

Can Nuvaxovid (Novavax®) vaccine be used to give a COVID-19 vaccine booster dose?

NIAC recommend that mRNA vaccines are the preferred COVID-19 vaccines however NIAC advise EMA authorised Nuvaxovid (Novavax®) antigenically updated versions may be used for homologous and heterologous boosters in adults and children aged 12 years and older with a contraindication to an mRNA vaccine, or in those who choose not to receive an mRNA vaccine (when the vaccine becomes available).

The minimum interval cannot be used for Nuvaxovid (Novavax®) vaccine.

Is the antigenically updated Nuvaxovid (Novavax®) vaccine recommended in pregnancy?

As there is more limited experience of protein subunit COVID-19 vaccines such as Nuvaxovid (Novavax®) vaccine in those who are pregnant, the vaccine should only be considered when the potential benefits outweigh the potential risks and when mRNA vaccines are contraindicated or declined.

What are the contraindications to Nuvaxovid (Novavax®) vaccine?

Anaphylaxis following a previous dose of the vaccine or any of its constituents including polysorbate 80.

What are the precautions to Nuvaxovid® vaccine?

Acute severe illness; defer until recovery.
Previous history of myocarditis or pericarditis after any COVID-19 vaccine; seek specialist advice.
Allow a four-week interval between mpox vaccine and subsequent Nuvaxovid (Novavax®) vaccine. No interval is required between Nuvaxovid (Novavax®) and subsequent mpox vaccines.

Can GPs or Pharmacists order Nuvaxovid (Novavax®) vaccine?

No, the antigenically updated Nuvaxovid (Novavax®) vaccine when available, will only be provided in HSE clinics.

People need to have an appointment arranged by contacting HSELIVE at 1800700700.

Is myocarditis or pericarditis after an mRNA vaccine or Nuvaxovid (Novavax®) vaccine a contraindication to having a further seasonal booster dose of these vaccines?

NIAC now advise that any person with a diagnosis of myocarditis or pericarditis after any COVID-19 vaccine should be referred to a Cardiologist for advice before proceeding with any further COVID-19 vaccination. Myocarditis is no longer a contraindication to further doses of either the mRNA or Nuvaxovid (Novavax®) vaccines. However, these vaccines may only be administered after a Cardiologist has reviewed the patient and recommended the vaccine.

What symptoms are associated with myocarditis or pericarditis?

Myocarditis or pericarditis usually present with symptoms of chest pain, tachycardia or breathlessness. Vaccinees should always be made aware of these symptoms and told to seek medical advice if such symptoms occur after vaccination.

What are the risks of myocarditis or pericarditis after an mRNA vaccine or a Nuvaxovid (Novavax®) vaccine?

Myocarditis or pericarditis are very rare side effects of the mRNA and Nuvaxovid (Novavax®) vaccines. Very rare side effects may affect up to 1 in 10,000 people.

These conditions have been reported predominantly in young men aged less than 30 years after the Primary COVID-19 vaccine schedule 2nd dose and within 14 days of having the vaccine. Cases have also been observed in females, in other age groups, and after other doses.

Two European studies have estimated the risk of myocarditis in men, after the second dose of the vaccine as:

1 additional case for every 38,000 men aged 12 to 29 (within 7 days)
1 additional case for every 17,500 men aged 16 to 24 (within 28 days)

What are the risks of myocarditis or pericarditis after a booster mRNA and Nuvaxovid® vaccines?

The risk of myocarditis is known to be lower after a booster dose.

What is the risk of myocarditis or pericarditis after COVID-19 infection?

The risk of myocarditis is higher with COVID-19 infection than COVID-19 vaccination. The relative risk (RR) for myocarditis is more than seven times higher in the infection group than after vaccination.

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Are the mRNA and the protein sub unit vaccine Nuvaxovid® COVID-19 vaccines associated with thrombosis and thrombocytopaenia syndrome?

No, the mRNA and the protein sub unit vaccine Nuvaxovid® COVID-19 vaccines are not associated with thrombosis and thrombocytopaenia syndrome.

What are the risks of having several COVID-19 vaccines?

There is no evidence that receiving annual COVID-19 vaccines is associated with any long term side effects and risks to health.

What if the vaccine leaks during administration?

If some of the vaccine leaks out of the syringe during administration this is not a valid dose. A further dose of the vaccine should be administered at a separate site at the same visit.

What if a vaccine is given after the expiry date or after the use before or discard time?

If a vaccine is given after the expiry date or after the use before or discard date and time it is considered an invalid dose, and the dose should be repeated that day or as soon as possible.

This should be explained to the person and a correctly diluted dose of the vaccine should be given as soon as possible. This should be reported to HPRA and an incident report form completed.

What if the whole multi-dose vial of vaccine is administered instead of the recommended dose?

Trial data showed that higher doses of vaccine were not harmful but the person is more likely to have a local reaction with very painful arms at injection site being reported.

Trial data showed that higher doses of the COVID-19 vaccines were not harmful but the person is more likely to have more local and systemic reactions (malaise, fatigue, myalgia, headache, arthralgia and fever) when a higher second dose was given.

The person should be reassured that this is not harmful but that they are more likely to experience the adverse events as above.

They should be given their next dose of vaccine according to the recommended schedule. This should be reported to HPRA and an incident report form completed.

Does a woman who wishes to conceive need to leave any interval after getting COVID‐19 vaccines before getting pregnant?

It is not necessary to leave any interval after having the COVID-19 vaccine and becoming pregnant.

Can COVID‐19 vaccines affect fertility?

There is no biologically plausible reason why the vaccines would affect fertility. The vaccines cannot interact with a person’s DNA. The EMA licensed documentation states that animal studies do not indicate direct or indirect harmful effects on fertility.

Where can COVID‐19 vaccine be given in the event that a person cannot receive the vaccine in the deltoid muscle?

In the event that a person cannot receive the vaccine in the deltoid muscle, the vaccine can be given into the vastus lateralis muscle of the antero-lateral aspect of the thigh.

Can other vaccines be co-administered with COVID-19 vaccines for those aged 12 years and older?

Yes, other vaccines may be co-administered with or at any interval before or after COVID-19 vaccine. If other vaccines are being given at the same time as COVID-19 vaccines it is preferable to give them in different limbs. If administration in different limbs is not feasible or desired, administration in the same limb, separated by at least 2.5cm, is appropriate.

The exception to this is mpox vaccine. There should be an interval of at least four weeks between mpox vaccine and a subsequent COVID-19 vaccine because of the unknown risk of myocarditis. No interval is required between a COVID-19 vaccine and a subsequent mpox vaccine (see Chapter 13a of the Immunisation Guidelines).

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