mRNA SARS-CoV-2 vaccine
Updated · Methodology
First line
Prevention of severe COVID-19 ≥6 months. Per CDC ACIP 2024, annual dose of current composition for risk groups. Dose 0.25 mL (booster) or 0.5 mL (primary series).
Sources
ICD-10: Z25.8 · ICD-11: QC01.9
First line
Spikevax during breastfeeding. Fully compatible for the same reasons as Comirnaty. Hale L1.
Sources
ICD-10: Z23 · ICD-11: QC00
Same as Comirnaty (Pfizer): mRNA encoding full-length spike in lipid nanoparticles. Higher mRNA dose (50–100 µg vs 30 µg in Comirnaty) gives a stronger antibody response but more reactogenicity. Comparable effectiveness.
Recommended in any trimester.
Fully compatible. Hale L1.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
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COVID-19 vaccine, mRNA (Moderna) is evaluated for the following indications with varying evidence strength: COVID-19 prevention (evidence tier A), Vaccination during breastfeeding (evidence tier A). See the full indication matrix with dosing and citations above on this page.
Common side effects of COVID-19 vaccine, mRNA (Moderna) (≥ 1 in 100): Injection-site pain (90%), Fatigue (70%), Headache, Myalgia, Fever (15–30%) – more often than Comirnaty. See the Safety section for uncommon and serious reactions.
Recommended in any trimester.
Fully compatible. Hale L1.
COVID-19 vaccine, mRNA (Moderna) is contraindicated in: Anaphylaxis to components; Myocarditis after previous dose. Full list in the Safety section.
COVID-19 vaccine, mRNA (Pfizer-BioNTech), Hepatitis A vaccine, inactivated, Hepatitis B vaccine, recombinant, HPV vaccine, nonavalent, MMR – measles, mumps, rubella vaccine (live), RSV vaccine, recombinant (maternal), Inactivated influenza vaccine, Pneumococcal conjugate vaccine PCV20