The following questions and answers have been developed by the National Immunisation Office.
In August 2025 what are the latest recommendations from the National Immunisation Advisory Committee for a COVID-19 vaccine?
A COVID-19 vaccine is now recommended twice each year for the following groups only:
- those aged 80 years and above
- 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.
Those who are recommended to receive a COVID-19 vaccine twice each year are those who are considered at highest risk of infection and have continuously had the highest rates of complications due to COVID-19
A COVID-19 vaccine is now recommended once each year for the following groups only:
- those aged 60 - 79 years
- Those aged 6 months to 59 years with medical conditions associated with a higher risk of COVID-19 hospitalisation, severe disease or death.
A COVID-19 vaccine is now recommended in each pregnancy for:
- Pregnant adolescents and adults with immunocompromise or with medical conditions associated with a higher risk of COVID-19 hospitalisation, severe disease or death.
Which groups with no underlying medical problems should have access to a COVID-19 vaccine?
Access to a COVID-19 vaccine once each year should be available for:
- Health and care workers* with no underlying medical problems who chose to receive a vaccine
- Pregnant adolescents* and adults* who following discussion with a healthcare provider chose to receive a vaccine
- adults aged 18 to 59 years* who following discussion with a healthcare provider choose to receive a vaccine
*Health and care workers, pregnant adolescents and adults and adults aged 18 to 59 years with immunocompromise or medical conditions should follow the recommendations listed above.
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What is the recommended interval between COVID-19 vaccines?
COVID-19 vaccines if indicated may be given to the above-mentioned risk groups irrespective of the number of previous doses or types of COVID-19 vaccines.
A COVID-19 vaccine can be given six months following the last COVID19 vaccine or SARS-CoV-2 infection. In exceptional circumstances, an interval of three months may be used (such as planned immunosuppressive therapy or operational reasons). Antigenically updated mRNA COVID-19 vaccines are the preferred vaccines.
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When are the COVID-19 vaccines recommended by NIAC?Although there is no established SARS-CoV-2 seasonality, for operational reasons, autumn and spring continue to be the preferred time for COVID-19 vaccination campaigns.
However, the timing of these campaigns may be altered in response to changing epidemiology.
Vaccines should also be available outside of defined seasonal campaigns where clinically indicated including but not limited to pregnancy, previously unvaccinated, or new period of immunosuppression..
- COVID-19 vaccines will also continue to be available for vaccination courses for those in recommended groups, regardless of the time of the year (see below).
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What is the latest recommendation from the National Immunisation Advisory Committee (NIAC) for COVID-19 mRNA vaccine?
In August 2025 NIAC has recommended that COVID-19 vaccine Comirnaty® LP.8.1 is the preferred COVID-19 vaccine for immunisation against SARS-CoV-2 infection.
Comirnaty® LP.8.1 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® LP.8.1 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® LP.8.1 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.
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What schedule does NIAC recommend for ALL COVID-19 vaccines for all those aged 5 years and older who are immunocompetent and have never been vaccinated against SARSCoV-2 infection?
For those aged 5 years and above who are immunocompetent the recommended schedule now is one dose of age-appropriate COVID-19 mRNA vaccine.
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What COVID-19 immunisation schedule does NIAC recommend for all those aged 6 months to 4 years?
For those aged 6 months to 4 years the recommended schedule remains:
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
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What COVID-19 vaccine schedule does NIAC now recommend for all those with immunocompromise who have never been vaccinated against SARS-CoV-2 infection?
For those with immunocompromising conditions aged 6 months and older who have never been vaccinated, the recommended vaccination schedule is 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 week interval between doses two and three, if three doses are required*.
*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.
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What are NIAC recommendations for those aged 6 months to 59 years who have never been vaccinated?
Access to a COVID-19 vaccine should be available for all those aged six months to 59 years who have never been vaccinated against SARS - CoV-2 infection regardless of their risk of COVID-19 who, following discussion of their reasons with a healthcare provider such as, general practitioner (GP), pharmacist or Health Service Executive (HSE) vaccinator, request vaccination
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What are NIAC recommendations for Nuvaxovid® Protein Sub unit vaccine when the antigenically updated vaccine BECOMES available?
NIAC advises
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 vaccination in adults and children aged 12 years and above when available.
The preferred alternative vaccine is the antigenically updated Nuvaxovid (Novavax®) vaccine.
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.
However Nuvaxovid (Novavax) is not currently available in Ireland. 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.
The minimum interval cannot be used for Nuvaxovid® vaccine.
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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.
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What are the contraindications to Nuvaxovid (Novavax®) vaccine?
Anaphylaxis following a previous dose of the vaccine or any of its constituents including polysorbate 80.
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What are the precautions to Nuvaxovid (Novavax®)?
- 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® vaccine. No interval is required between Nuvaxovid® and subsequent mpox vaccines.
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Can GPs or Pharmacists order Nuvaxovid® 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.
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What are the latest recommendations regarding 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.
A COVID-19 vaccine is now only recommended in each pregnancy for:
- pregnant adolescents and adults with immunocompromise
- pregnant adolescents and adults with medical conditions associated with a higher risk of COVID-19 hospitalisation, severe disease or death.
- access to a COVID-19 vaccine once each year should be available for pregnant adolescents and adults who following discussion with a healthcare provider chose to receive a vaccine.
- 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 vaccine dose or COVID-19 infection.
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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 COVID‐19 recommended vaccination 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.
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What if somebody with immunocompromise is diagnosed with COVID‐19 infection after a first dose of vaccine of the COVID‐19 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.
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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 is not required.. 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.
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What if a person becomes immunocompromised after receiving their COVID -19 vaccine dose - do they then need an additional dose as well?
No. Only individuals with immunocompromise at the time of COVID-19 vaccination may have a sub-optimal response to the vaccine. They may be recommended a third dose of COVID-19vaccine if advised by their specialist to enhance their response to the COVID‐19 vaccine. . It is a person’s condition at the time that they receive the initial COVID-19 vaccination e that determines whether or not they need an additional dose.
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What if an mRNA COVID‐19 vaccine dose is given before the minimum interval? Is there a need to repeat the dose?
If the vaccine is given before the 3 months 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.
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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.
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Is myocarditis or pericarditis after an mRNA vaccine or Nuvaxovid (Novavax®) vaccine a contraindication to having a further COVID -19 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.
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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.
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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)
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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.
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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 to health.
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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.
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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.
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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.
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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.
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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.
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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.
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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 vaccines. 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 separate limbs is not feasible or desired, administration in the same limb, separated by at least 2.5 cm, 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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This page was updated on 5th September 2025
