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On June 25, FDA changed the license for one of Moderna’s two 2025–2026 formulation COVID-19 vaccines (Spikevax). Spikevax is now licensed for use in people with one or more high risk conditions for serious COVID-19 disease at age 6 months through 64 years. It remains licensed for use in all people age 65 years and older. Previously, children younger than age 12 years received Spikevax under the terms of emergency use authorization (EUA).

In fall 2025, Moderna also will offer a new formulation of mRNA COVID-19 vaccine with the tradename mNexspike. The mNexspike product is licensed for use in children and adults age 12 years through 64 years who are at increased risk of severe COVID-19 disease and for use in all adults age 65 years or older. This product is not licensed or authorized for use in children younger than age 12 years. See the mNexspike labeling for additional information.

Related Links

• FDA: Spikevax web page
• FDA: Spikevax approval letter (PDF)
• FDA: Spikevax package insert (PDF)
• Immunize​.org: Package Inserts and FDA Product Approvals main page

Immunize​.org published its 2025 updates to state policy web pages showing:

• Vaccine-specific maps and data tables summarizing 2025 state immunization requirements for childcare, school, and college entry
• 2025 state vaccine exemption policies for childcare and school entry
• Contact links to each state’s relevant websites with details about their requirements

The data Immunize​.org displays are reviewed and verified by every state immunization program each year. These resources are valuable for vaccine advocates, public health, clinicians, families, and policymakers.

Our updated pages provide links to downloadable PDF versions of each 2025 data table and map. Archived data tables and maps for 2023 and 2024 are also available.



Immunize​.org's August Office Hours sessions will review the content found on the Official Guidance and the State Policies web pages. Register for a session: Wednesday, August 6 at 4:00 p.m. (ET) or Thursday, August 7 at 12:00 p.m. (ET).

Immunize​.org thanks the state immunization personnel who shared their updated information. For questions about a state’s requirements, please contact that state immunization program directly. To ask questions about our site content, contact us.

Related Links

• Immunize​.org: State Immunization Vaccine-Specific Requirements web page
• Immunize​.org: State Exemptions web page
• Immunize​.org: Website Office Hours Webinar: Official Guidance, Part 2 (state resources) (37:11)
• Immunize​.org: Introducing State Immunization Requirements Information (4:00)
• Immunize​.org: Introducing State Immunization Requirements Information (mobile view) (3:53)

Download Immunize​.org’s free 142-page book on adult vaccination to help build your program and train your team: Vaccinating Adults: A Step-by-Step Guide (Guide).



This thorough "how to" guide on adult vaccination provides easy-to-use, practical information covering all essential activities. It helps vaccine providers enhance their existing adult vaccination services or introduce them into any clinical setting.

The Guide is available to download/print either by chapter or in its entirety free of charge. The National Vaccine Program Office and CDC both supported the development of the Guide and provided early technical review.

The Guide is a valuable resource to assist providers in increasing adult vaccination rates. Be sure to get a copy today!

Please note: this guide was produced in 2017, before the COVID-19 era, and reflects the recommendations of that time.

Related Links

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In its August 2024 issue, Pharmacoepidemiology & Drug Safety published Lack of Evidence for Vaccine-Associated Enhanced Disease from COVID-19 Vaccines Among Adults in the Vaccine Safety Datalink. This article won the 2024 Ronald D. Mann Best Paper Award given annually to this journal’s best paper. The prize is cosponsored by the publisher, John Wiley & Sons, Ltd., and by the International Society for Pharmacoepidemiology. An excerpt from the abstract appears below.

Methods: In this cross-sectional study, we assessed COVID-19 severity as a proxy for VAED [vaccine-associated enhanced disease] among 400 adults hospitalized for COVID-19 from March through October 2021 at eight US healthcare systems. Primary outcomes were admission to an intensive care unit (ICU) and severe illness (score ≥6 on the World Health Organization [WHO] Clinical Progression Scale). We compared the risk of outcomes among those who had completed a COVID-19 vaccine primary series versus those who were unvaccinated. We incorporated inverse propensity weights for vaccination status in a doubly robust regression model to estimate the causal average treatment effect.

Results: The causal risk ratio in vaccinated versus unvaccinated was 0.36 . . . for ICU admission and 0.46 . . . for severe illness.

Conclusion: Among hospitalized patients, reduced disease severity in those vaccinated against COVID-19 supports the absence of VAED.

Lead author, Thomas G. Boyce, a pediatric infectious disease specialist at Marshfield Clinic, is a member of the Vaccine Safety Datalink team. Immunize​.org is honored to acknowledge that Dr. Boyce has graciously donated the award honorarium to Immunize​.org to continue our efforts to share information about vaccine safety.

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The World Health Organization (WHO) published WHO Position Paper on Herpes Zoster Vaccines—July 2025 in the July 4 issue of its Weekly Epidemiological Record. This position paper focuses on zoster vaccination and supersedes the 2014 vaccine position paper on varicella and zoster vaccines. It reviews the evidence on the recombinant zoster vaccine (Shingrix, GSK) and provides recommendations on its use. The paper contains off-label recommendations.

The following passage appears in the document:

Herpes zoster [HZ] vaccination should be considered in the context of a life-course approach to immunization. In moving towards this approach, consideration needs to be given to the establishment of vaccination programmes for older adults which contribute to healthy ageing. Structures and strategies put in place for COVID-19 vaccination may be leveraged to deliver HZ vaccines as part of primary care services. Vaccination programmes for older adults could further be used to administer other important vaccines for this age group – such as influenza, RSV and pneumococcal vaccines.

Related Links

• WHO Position Papers in alphabetical order by disease/vaccine at immunize.org
• WHO: Weekly Epidemiological Record (current issue and archives)
• Immunize​.org: Vaccines A–Z: Zoster (Shingles)

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To learn simple tips and tricks for using our website efficiently, please register for our next set of Website Office Hours on Wednesday, August 6 at 4:00 p.m. (ET) or Thursday, August 7 at 12:00 p.m. (ET). The same content will be covered in both sessions.

We will open each 45-minute session with a short, live demonstration on navigating the Official Guidance (state resources) website section. This section is useful for those who want to know about state immunization requirements for school and childcare. You can submit questions when you register or live on Zoom during the session.

Register today for Immunize​.org Website Office Hours (content is the same for both):

• Wednesday, August 6 at 4:00 p.m. (ET)
• Thursday, August 7 at 12:00 p.m. (ET)

The archive of previous Website Office Hours content is posted at Immunize​.org’s "Webinars & Videos" page. These archived programs include Ask the Experts; Clinical Resources; Vaccine Information Statements (VISs); Affiliated Websites; Images, Webinars, Videos, & Social Media; Let's Get Real About Vaccines Website; News & Updates; Official Guidance Part 1 & 2; Publication Archives, Vaccine Timeline, & About Us; Travel Vaccines, Vaccine Confidence, & Addressing Concerns; and Vaccines A–Z.

Mark your calendar for future Immunize​.org Website Office Hours.