Nonsevere pneumonia
Overview
Infection control measures: these include isolation, source control, and transmission precautions r53
Supportive care: for all patients; in hospitalized patients, such care includes oxygenation and ventilation, conservative fluid support, and measures to prevent common complications (eg, pressure injury, stress ulceration, secondary infection) r24
Antiviral agents
Systemic corticosteroid therapy is suggested or recommended for most hospitalized patients with an oxygen requirement r24
Immunomodulators of other classes are used to diminish an excessive inflammatory response (eg, monoclonal antibodies against interleukin-6 receptors, such as tocilizumabr109 and sarilumabr110; Janus kinase inhibitors, such as baricitinibr111 and tofacitinibr112; monoclonal antibody vilobelimabr113 against complement activity)
Antithrombotic therapy
Monoclonal antibodies with antiviral action (against SARS-CoV-2 spike protein)
Convalescent plasma continues to be investigated; only high-titer formulations have shown any benefitr144
Several medications with a mechanism of action that could potentially alter response to COVID-19 have been evaluated either for use in treatment and prevention, or for discontinuation to prevent harms r147
Other options not currently recommended under NIH, Infectious Diseases Society of America, and WHO guidelines (although some are still under study in clinical trials) r2r86r87
Product name | Manufacturer | Active ingredient | Age range for use | Comments |
---|---|---|---|---|
Moderna COVID-19 vaccine, 2023-2024 formula | ModernaTX | Nucleoside-modified messenger RNA encoding the spike (S) glycoprotein of the SARS-CoV-2 Omicron variant lineage XBB.1.5 | 6 months or older | • Used under EUA in the United States for ages 6 months to 11 years and full FDA approval for ages 12 years or older |
Pfizer-BioNTech COVID-19 vaccine, 2023-2024 formula | Pfizer-BioNTech | Nucleoside-modified messenger RNA encoding the spike (S) glycoprotein of SARS-CoV-2 Omicron variant lineage XBB.1.5 | 6 months or older | • Used under EUA in the United States for ages 6 months to 11 years and full FDA approval for ages 12 years or older |
Novavax COVID-19 vaccine, adjuvanted | Novavax | Recombinant spike protein (rS) of SARS-CoV-2 | 12 years or older | • Used under EUA in the United States |
Manufacturer | Age | Dose 1 | Dose 2 | Dose 3 | Dose 4 | Notes |
---|---|---|---|---|---|---|
Schedule for unvaccinated individuals who are NOT moderately to severely immunocompromised | ||||||
Moderna | 6 months to 4 years | Primary (dark blue/green), 0.25 mL | In 4 to 8 weeks, primary (dark blue/green), 0.25 mL | NA | Children who transition from 4 years to 5 years during primary series should receive 2 doses of dark blue/green, 0.25 mL | |
Moderna | 5 years to 11 years | Primary (dark blue/green), 0.25 mL | NA | NA | ||
Moderna | 12 years or older | Primary (dark blue/blue), 0.5 mL | NA | NA | ||
Pfizer | 6 months to 4 years | Primary (yellow/yellow), 0.3 mL | In 3 to 8 weeks, primary yellow/yellow), 0.3 mL | In at least 8 weeks, primary yellow/yellow), 0.3 mL | Yellow formulation requires dilution; children who transition from 4 years to 5 years during primary series should receive 3 doses of yellow/yellow, 0.3 mL | |
Pfizer | 5 years to 11 years | Primary (blue/blue), 0.3 mL | NA | NA | ||
Pfizer | 12 years or older | Primary (gray/gray), 0.3 mL | NA | NA | ||
Novavax | 12 years or older | Primary (royal blue/no color), 0.5 mL | In 3 to 8 weeks, primary (royal blue/no color), 0.5 mL | In at least 8 weeks after last primary dose, should receive either Moderna or Pfizer booster | ||
Schedule for unvaccinated individuals who ARE moderately to severely immunocompromised | ||||||
Moderna | 6 months to 4 years | Primary (dark blue/green), 0.25 mL | In 4 weeks, primary (dark blue/green), 0.25 mL | In at least 4 weeks, primary (dark blue/green), 0.25 mL | At clinician's discretion, additional dose(s) of Moderna only at an interval of at least 2 months | |
Moderna | 5 years to 11 years | Primary (dark blue/green), 0.25 mL | In 4 weeks, primary (dark blue/green), 0.25 mL | In at least 4 weeks, primary (dark blue/green), 0.25 mL | At clinician's discretion, additional dose(s) of Moderna or Pfizer at an interval of at least 2 months | |
Moderna | 12 years or older | Primary (dark blue/blue), 0.5 mL | In 4 weeks, primary (dark blue/blue), 0.5 mL | In at least 4 weeks, primary (dark blue/blue), 0.5 mL | At clinician's discretion, additional dose(s) of Moderna or Pfizer at an interval of at least 2 months | |
Pfizer | 6 months to 4 years | Primary (yellow/yellow), 0.3 mL | In 3 weeks, primary (yellow/yellow), 0.3 mL | In at least 8 weeks, primary (yellow/yellow), 0.3 mL | Yellow formulation requires dilution; at clinician's discretion, additional dose(s) of Pfizer only at an interval of at least 2 months | |
Pfizer | 5 years to 11 years | Primary (blue/blue), 0.3 mL | In 3 weeks, primary (blue/blue), 0.3 mL | In at least 4 weeks, primary (blue/blue), 0.3 mL | At clinician's discretion, additional dose(s) of Pfizer or Moderna at an interval of at least 2 months | |
Pfizer | 12 years or older | Primary (gray/gray), 0.3 mL | In 3 weeks, primary (gray/gray), 0.3 mL | In at least 4 weeks, primary (gray/gray), 0.3 mL | At clinician's discretion, additional dose(s) of Pfizer or Moderna at an interval of at least 2 months | |
Novavax | 12 years or older | Primary (royal blue/no color), 0.5 mL | In 3 to 8 weeks, primary (royal blue/no color), 0.5 mL | In at least 8 weeks after last primary dose, should receive either Moderna or Pfizer booster | At clinician's discretion, additional dose(s) of Moderna or Pfizer at an interval of at least 2 months |
Age | Prior doses | Recommended doses | Notes |
---|---|---|---|
Schedule for individuals who are NOT moderately to severely immunocompromised | |||
6 months to 4 years | 1 dose Moderna | 1 dose Moderna (dark blue/green), 0.25 mL, 4 to 8 weeks after prior dose | |
6 months to 4 years | 2 or more doses Moderna | 1 dose Moderna (dark blue/green), 0.25 mL, at least 8 weeks after last dose | |
6 months to 4 years | 1 dose Pfizer | 2 doses Pfizer (yellow/yellow), 0.3 mL: first dose 3 to 8 weeks after prior dose, second dose at least 8 weeks after first 2023-2024 formula dose | Yellow formulation requires dilution |
6 months to 4 years | 2 or more doses Pfizer | 1 dose Pfizer (yellow/yellow), 0.3 mL, at least 8 weeks after last dose | Yellow formulation requires dilution |
5 years to 11 years | 1 or more doses of any mRNA vaccine | 1 dose Moderna (dark blue/green), 0.25 mL, OR 1 dose Pfizer (blue/blue), 0.3 mL, at least 8 weeks after last dose | |
12 years or older | 1 or more doses of any vaccine | 1 dose Moderna (dark blue/blue), 0.5 mL, OR 1 dose Pfizer (gray/gray), 0.3 mL, at least 8 weeks after last dose | |
Schedule for individuals who ARE moderately to severely immunocompromised | |||
6 months to 4 years | 1 dose Moderna | 2 doses Moderna (dark blue/green), 0.25 mL: first dose 4 weeks after prior dose, second dose at least 4 weeks after first 2023-2024 formula dose | At clinician's discretion, additional dose(s) of Moderna only at an interval of at least 2 months |
6 months to 4 years | 2 doses Moderna | 1 dose Moderna (dark blue/green), 0.25 mL, at least 4 weeks after last dose | At clinician's discretion, additional dose(s) of Moderna only at an interval of at least 2 months |
6 months to 4 years | 3 or more doses Moderna | 1 dose Moderna (dark blue/green), 0.25 mL, at least 8 weeks after last dose | At clinician's discretion, additional dose(s) of Moderna only at an interval of at least 2 months |
6 months to 4 years | 1 dose Pfizer | 2 doses Pfizer (yellow/yellow), 0.3 mL: first dose 3 weeks after prior dose, second dose at least 8 weeks after first 2023-2024 formula dose | Yellow formulation requires dilution; at clinician's discretion, additional dose(s) of Pfizer only at an interval of at least 2 months |
6 months to 4 years | 2 or more doses Pfizer | 1 dose Pfizer (yellow/yellow), 0.3 mL at least 8 weeks after last dose | Yellow formulation requires dilution; at clinician's discretion, additional dose(s) of Pfizer only at an interval of at least 2 months |
5 years to 11 years | 1 dose Moderna | 2 doses Moderna (dark blue/green), 0.25 mL: first dose 4 weeks after prior dose, second dose at least 4 weeks after first 2023-2024 formula dose | At clinician's discretion, additional dose(s) of Moderna or Pfizer at an interval of at least 2 months |
5 years to 11 years | 2 doses Moderna | 1 dose Moderna (dark blue/green), 0.25 mL, at least 4 weeks after last dose | At clinician's discretion, additional dose(s) of Moderna or Pfizer at an interval of at least 2 months |
5 years to 11 years | 1 dose Pfizer | 2 doses Pfizer (blue/blue), 0.3 mL: first dose 3 weeks after prior dose, second at least 4 weeks after first 2023-2024 formula dose | At clinician's discretion, additional dose(s) of Pfizer or Moderna at an interval of at least 2 months |
5 years to 11 years | 2 doses Pfizer | 1 dose Pfizer (blue/blue), 0.3 mL at least 4 weeks after last dose | At clinician's discretion, additional dose(s) of Pfizer or Moderna at an interval of at least 2 months |
5 years to 11 years | 3 doses of any mRNA vaccine | 1 dose Moderna (dark blue/green), 0.25 mL, OR 1 dose Pfizer (blue/blue), 0.3 mL, at least 8 weeks after last dose | At clinician's discretion, additional dose(s) of Moderna or Pfizer at an interval of at least 2 months |
12 years or older | 1 dose Moderna | 2 doses Moderna (dark blue/blue), 0.5 mL: first dose 4 weeks after prior dose, second dose at least 4 weeks after first 2023-2024 formula dose | At clinician's discretion, additional dose(s) of Moderna or Pfizer at an interval of at least 2 months |
12 years or older | 2 doses Moderna | 1 dose Moderna (dark blue/blue), 0.5 mL at least 4 weeks after last dose | At clinician's discretion, additional dose(s) of Moderna or Pfizer at an interval of at least 2 months |
12 years or older | 1 dose Pfizer | 2 doses Pfizer (gray/gray), 0.3 mL: first dose 3 weeks after prior dose, second dose at least 4 weeks after first 2023-2024 formula dose | At clinician's discretion, additional dose(s) of Pfizer or Moderna at an interval of at least 2 months |
12 years or older | 2 doses Pfizer | 1 dose Pfizer (gray/gray), 0.3 mL, at least 4 weeks after last dose | At clinician's discretion, additional dose(s) of Pfizer or Moderna at an interval of at least 2 months |
12 years or older | 3 doses of any mRNA vaccine | 1 dose Moderna (dark blue/blue), 0.5 mL, OR 1 dose Pfizer (gray/gray), 0.3 mL, at least 8 weeks after last dose | At clinician's discretion, additional dose(s) of Moderna or Pfizer at an interval of at least 2 months |
12 years or older | 1 or more doses Novavax or Janssen, with or without subsequent doses of mRNA vaccine | 1 dose Moderna (dark blue/blue), 0.5 mL, OR 1 dose Pfizer (gray/gray), 0.3 mL, at least 8 weeks after last dose | At clinician's discretion, additional dose(s) of Moderna or Pfizer at an interval of at least 2 months |