Amid uncertainty over how the Trump administration would handle COVID-19 vaccination policy for the upcoming respiratory virus season, the U.S. Food and Drug Administration (FDA) has approved updated vaccines from Pfizer, Moderna, and Novavax, but with significant usage limitations.
Unlike previous broad authorizations, the new approvals restrict eligibility for many age groups, requiring recipients under 65 years to have at least one underlying health condition that places them at higher risk of severe illness. The shots remain fully approved for adults 65 years and older.
Pfizer and BioNTech announced that their updated Comirnaty vaccine is designed to target the LP.8.1 sublineage of the SARS-CoV-2 virus. According to the partners, distribution will begin “immediately” to ensure availability across the country. Comirnaty is now approved for individuals aged 5 through 64 years who have an underlying condition, and for everyone 65 years and older. This marks the first time Comirnaty has received full approval for children, who previously only had access under emergency use authorization.
Moderna secured approval for two updated vaccines. Spikevax, tailored to LP.8.1, is authorized for people as young as six months through age 64 with at least one underlying condition, and for all individuals 65 and older. Its second vaccine, mNEXSPIKE, is approved beginning at age 12, with the same condition-based restrictions for those under 65.
Novavax also gained FDA approval for its protein-based vaccine for individuals 12 and older with an underlying condition, as well as for all adults over 65. CEO John Jacobs stated that the company will “work with our partner Sanofi to provide access to a protein-based, non-mRNA COVID-19 vaccine” during the fall season.
The approvals come after heightened speculation that the administration might curtail or ban COVID-19 vaccines altogether. On Aug. 27, Health and Human Services Secretary Robert F. Kennedy Jr. outlined the administration’s regulatory approach on X, saying it provides “science, safety and common sense” while ensuring continued access for vulnerable groups. Kennedy also confirmed that prior Emergency Use Authorizations (EUAs) have been revoked, narrowing Pfizer and BioNTech’s approval to children aged five and above.
As part of the FDA’s new requirements, manufacturers must conduct additional trials. Pfizer and BioNTech are expected to study their vaccine in adults aged 50 to 64 without underlying conditions, with results due in 2027.
The decisions prompted criticism from the American Academy of Pediatrics (AAP). President Susan Kressly said the move to restrict children’s access to vaccines is “deeply troubling.” She added that as respiratory virus season begins, limiting vaccine availability poses a risk to children and their families. The AAP continues to recommend COVID-19 vaccination for all children ages six months through 23 months.
Investment analysts at William Blair noted that while there had been speculation about ending vaccine use, the FDA’s actions remained aligned with earlier guidance focusing on seniors and high-risk populations, calling this consistency important for “industry integrity.”
The approvals follow broader policy changes introduced by Kennedy earlier this year, including the removal of routine COVID-19 vaccination recommendations for healthy children and pregnant women. Late Wednesday, the White House dismissed CDC director Susan Monarez at Kennedy’s urging, citing disagreements over vaccine policy.
The updated vaccines will now move to the CDC’s Advisory Committee on Immunization Practices for recommendation discussions, expected by the end of September. Kennedy previously replaced the 17-member panel with eight new appointees, some with documented histories of vaccine criticism.
