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Public Health Weekly Report 2025; 18(2): 90-102

Published online December 6, 2024

https://doi.org/10.56786/PHWR.2025.18.2.3

© The Korea Disease Control and Prevention Agency

Implementation Plan for the Coronavirus Disease 2019 Vaccination for the 2024–2025 Season: Recommendations of the 6th Expert Committee on Immunization Practices

Hyewook Hwang 1, Wookeon Lee 1, Seohyeon Ahn 1, Young-Sook Choi 1, Seunghyun Lewis Kwon 1, Dongwoo Lee 1*, Eun Hwa Choi 2*, SokGoo Lee 3*

1Division of Immunization Services, Department of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea, 2Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea, 3Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea

*Corresponding author: Dongwoo Lee, Tel: +82-43-719-8360, E-mail: williamdongwoolee@korea.kr
Eun Hwa Choi, Tel: +82-2-2072-3624, E-mail: eunchoi@snu.ac.kr
SokGoo Lee, Tel: +82-42-580-8264, E-mail: sgoolee@cnu.ac.kr

Received: November 11, 2024; Revised: December 4, 2024; Accepted: December 5, 2024

This is an Open Access aritcle distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) which permits unrestricted distribution, and reproduction in any medium, provided the original work is properly cited.

This paper summarizes the policy deliberations and conclusions regarding coronavirus disease 2019 vaccination for the 2024–2025 season, based on outcomes from the sixth meeting of the Expert Committee on Immunization Practices held on September 13, 2024. During the meeting, government officials and experts from various fields discussed implementation plans and guidelines in detail. A key topic was the vaccination strategy for high-risk children aged <12 years. The committee decided to adjust dose schedules and intervals based on age and prior vaccination history, recommending vaccine introduction through the Ministry of Food and Drug Safety’s approval process. This decision is expected to provide a foundation for future national vaccination programs and enhance safety for high-risk groups.

Key words COVID-19; Vaccination; Implementation plan; Guidelines

Key messages

① What is known previously?

Coronavirus disease 2019 variants continue to emerge, necessitating vaccinations for high-risk groups, including individuals aged ≥65 years, immunocompromised individuals, and residents of high-risk facilities.

② What new information is presented?

In the 2024–2025 season, high-risk groups will receive the JN.1 monovalent vaccine, with criteria varying based on age and prior vaccination history.

③ What are implications?

The committee’s strategic decisions regarding epidemic prediction, vaccine selection, and expected outcomes are expected to provide crucial evidence for future national vaccination programs and improvements in the safety of high-risk groups.

Coronavirus disease 2019 (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, leads to a wide range of clinical outcomes, from asymptomatic infection to death due to pneumonia. If infected, the elderly, in particular, are at higher risk of severe illness and death [1].

COVID-19 variants that evade existing immunity continue to emerge over time. The Omicron subvariants of the virus, first detected in South Africa in November 2021, are still circulating globally as of 2024. Among the Omicron subvariants, the BA.1 variant was prevalent in 2022, while the XBB and JN.1 variants circulated in 2023 and 2024, respectively [2]. In response to the prevalence of these COVID-19 variants, new vaccines have been developed. In the Republic of Korea (ROK), COVID-19 vaccination was carried out using the BA.1 and BA.4/5 bivalent vaccines (Pfizer-BioNTech, Morderna) in 2022 and the XBB.1.5 monovalent vaccine (Pfizer-BioNTech, Morderna, and Novavax) against the XBB variant in 2023.

In April 2024, the World Health Organization (WHO) and the European Medicines Agency, and in June, the Vaccines and Related Biological Products Advisory Committee of the U.S. Food and Drug Administration, recommended the JN.1 series monovalent vaccine as the formula and antigen for the 2024–2025 seasonal vaccination [3-5].

ROK decided to introduce the JN.1 monovalent vaccine for the 2024–2025 seasonal vaccination after two expert advisory meetings in the field of COVID-19 vaccines held on June 10 and 21, 2024, and two deliberations (the 3rd and 4th) in the Advisory Committee on Vaccination on June 11 and 27, 2024 [6]. The JN.1 monovalent vaccine will be used for the 2024–2025 seasonal vaccination in most countries, including ROK, the United Kingdom, Europe, and Japan.

On September 13, 2024, the 6th meeting of the Advisory Committee on Vaccination (hereafter referred to as the committee) deliberated on the implementation plan for the 2024–2025 seasonal COVID-19 vaccination (national implementation) and decided on detailed plans, implementation standards, and response strategies for each vaccination situation. This article describes the decisions made by the committee and is intended to serve as a basis for the proper operation of the COVID-19 vaccination program in the future.

1. Implementation Plan for the 2024–2025 Seasonal Coronavirus Disease 2019 Vaccination (National Implementation)

Considering the decisions made by the 5th meeting of the Advisory Committee on Vaccination in 2023, the committee decided on the following detailed implementation plan for the COVID-19 vaccination (national implementation) support program for the 2024–2025 season.

The 2024–2025 seasonal COVID-19 vaccination aims to prevent severe illness, hospitalization, and death in high-risk groups. This takes into account the fact that the effectiveness of vaccination in preventing severe illness, hospitalization, and death lasts for a relatively long period of time, but its effectiveness in preventing infection is limited due to the emergence of new variants. Therefore, it was decided to focus vaccination efforts on high-risk groups, considering this purpose.

As for those targeted for vaccination, the elderly aged 65 years and older, the immunocompromised aged over 6 months, and those hospitalized or residing in infection-prone facilities are to be recommended and subsidized. For the elderly and immunocompromised, it was decided to comprehensively consider the results of Korean and international studies, the degree of disease burden in the event of infection, and the duration of immunity. For the immunocompromised, in particular, it was decided to accept a broader range of individuals, including those deemed eligible by the judgment of healthcare workers (Supplementary Table 1; available online). To protect high-risk groups in hospitals from outbreaks, individuals hospitalized and living in high-risk facilities were also included (Supplementary Table 2; available online). Although support for vaccination of healthcare workers and workers in high-risk facilities was also considered, it was determined that this secondary target would be expanded depending on the vaccination situation, considering the goal of preventing severe illness, hospitalization, and death in high-risk groups.

The committee decided to introduce vaccines from Pfizer-BioNTech, Moderna, and Novavax for the 2024–2025 seasonal vaccination. Unlike the Pfizer-BioNTech and Moderna vaccines, which are introduced through the approval process, the Novavax vaccine is being introduced through the Emergency Use Authorization procedure. Therefore, the committee considered supporting the Novavax vaccine, with cost for vaccination as an exception for those who are contraindicated or deferred from mRNA vaccines. As a result, the Novavax vaccine will be introduced through the Korea Ministry of Food and Drug Safety (MFDS)’s approval process for the 2025–2026 season, and those who are contraindicated or deferred from mRNA vaccines will be supported only for this season.

In addition, the committee decided to align the vaccination schedule with the timing of the National Influenza Vaccination Support Program to improve the convenience of vaccination in line with recommendations for co-administration with influenza vaccine. Accordingly, the 2024–2025 seasonal vaccination will be administered sequentially by age group, starting with the elderly aged 75 years and older as of October 11, followed by the immunocompromised and residents of infectious disease-vulnerable facilities. They will receive the vaccine at community health centers and about 16,000 healthcare facilities nationwide, regardless of the recipient’s address (Table 1). Furthermore, the committee decided to operate a vaccine adverse event reporting system and deliberate on an active surveillance plan by sending text messages to the first 10,000 recipients to ensure the vaccine is safely administered.

Table 1. Eligible group and period of coronavirus disease 2019 vaccination (national implementation) for the 2024–2025 season
Eligible group (yr)Vaccination period
Elderly people (born before 1959. 12. 31.)≥752024. 10. 11.–2025. 4. 30.
70–742024. 10. 15.–2025. 4. 30.
65–692024. 10. 18.–2025. 4. 30.
Immunocompromised individuals and residents of high-risk facilities (all individuals aged 6 months and older, regardless of age)2024. 10. 11.–2025. 4. 30.


2. Guidelines for Implementing Coronavirus Disease 2019 Vaccination for the 2024–2025 Season (National Implementation)

The committee deliberated on the implementation guidelines for the COVID-19 vaccination support program for the 2024–2025 season, reviewing the interval, number, and method of vaccination, which resulted in the following decisions. As vaccination of high-risk groups aged under 12 years was not included in the license or approval criteria of the MFDS for this season’s new vaccines, the committee focused its deliberations on the vaccination plan and criteria for this group.

First, the committee decided to utilize a half dose of the Moderna vaccine for high-risk groups aged under 12 years, similar to how the vaccine was administered to infants and children aged under 12 years in the previous season when it was approved for those aged 12 years and older [7]. This decision was based on the fact that the Moderna vaccine for each age group has the same composition, with only a difference in the dose, and on approval of the Moderna vaccine by the Japanese Pharmaceuticals and Medical Devices Agency [8].

The committee also decided to introduce the Pfizer-BioNTech vaccine for infants and young children under the emergency use authorization process of the MFDS to provide high-risk infants and young children, who needed to receive a vaccine from the same manufacturer as the one previously administered, with the opportunity to receive a vaccine from the same manufacturer. The committee also recommended introducing vaccines for infants and children through the approval process for the next season.

The committee reviewed the number and interval of vaccinations by age for the 2024–2025 season and determined that one dose of the vaccine would be required for those aged 12 years and older, regardless of prior dosing. For high-risk groups aged under 12 years, the committee decided on up to two doses for those who previously received the Moderna vaccine, and up to three doses for those who received the Pfizer-BioNTech vaccine designed for infants and young children (Figure 1). This decision was based on a comprehensive consideration of the approval by the MFDS, the previous COVID-19 vaccination implementation guidelines for the 2023–2024 season in ROK, and international vaccination guidelines. For at least one dose of the JN.1 monovalent vaccine, fully vaccinated person aged under 12 years and those aged 12 years and older will receive one dose of the JN.1 monovalent vaccine, with a gap of at least 3 months between doses. Unvaccinated individuals aged under 12 years will receive two doses of the Moderna vaccine at least 4 weeks apart, while those who received one dose in the past will receive only one dose of the JN.1 monovalent vaccine. Of the unvaccinated individuals aged under 12 years, those who received the Pfizer-BioNTech vaccine for infants and young children will be given three doses, with the first and second doses administered at least 3 weeks apart and the second and third doses at least 8 weeks apart. Those who had two doses in the past will receive one dose of the JN.1 vaccine, and those who received one dose in the past will be given two doses of the JN.1 vaccine (Table 2).

Figure 1. Number of vaccinations for high-risk individuals under 12 years old for the 2024–2025 season

Table 2. Recommended interval between next doses for high-risk individuals under 12 years old for the 2024–2025 season
VaccineInterval between doses
Dose 2Dose 3More
Moderna (JN.1)4–8 weeks after dose 1 (minimum: 24 days)At least 3 months after last dose
Pfizer-BioNTech (JN.1) (ages 6 months to 4 years)3–8 weeks after dose 1 (minimum: 17 days)8 weeks after dose 2 (minimum: 52 days)At least 3 months after last dose


The committee strongly recommended that the influenza vaccine and COVID-19 vaccine be administered at the same time this season, as in previous seasons. This recommendation was based on the fact that there are no safety or efficacy concerns with co-administration with the influenza vaccine, and on international vaccination guidelines from the United States, the United Kingdom, and the WHO. Last season, the Korea Disease Control and Prevention Agency surveyed 20,000 COVID-19 vaccine recipients via text message about whether they experienced any health problems after receiving the vaccine. The results showed that the reporting rate was similar regardless of whether they were co-administrated or not: 27.8% of those who were co-administrated and 27.9% of those who were not.

3. Response Strategies for the 2024–2025 Seasonal Vaccination by Situation

The committee reviewed the response strategies for vaccine shortages and surpluses to ensure a stable vaccine supply and demand based on this year’s vaccination progress. Considering the full alignment of this year’s influenza and COVID-19 vaccination schedules and the increased interest in vaccination due to the COVID-19 resurgence in the summer, the committee considered two scenarios: a shortage due to high vaccination rates and a surplus due to low vaccination rates.

To begin with, in the case that the initial vaccination rate is higher than expected, leading to a shortage of vaccines, the government will procure additional vaccines in a step-by-step manner through prior consultation with pharmaceutical companies. The plan was designed to quickly secure vaccines.

Meanwhile, if the initial vaccination rate is lower than expected, the priority for vaccination will be established to expand the free vaccination support and minimize vaccine wastage (Table 3). Referring to the prioritization of COVID-19 winter supplemental vaccination in 2022, the priority of vaccination was determined by prioritizing healthcare workers, including those who have frequent contact with high-risk groups, and workers in high-risk facilities as the second priority [9].

Table 3. Response strategies based on vaccination scenarios for the 2024–2025 season
Vaccination scenarioResponse strategy
Vaccine shortagePromote phased additional procurement based on vaccine shortage situations through prior consultations with pharmaceutical companies
Vaccine surplusExpand free vaccination targets based on vaccination priority

Priority 1 (from October 11)

Immunocompromised individuals

Residents of high-risk facilities

Over 65 years old

Priority 2 (from November)

Healthcare workers including medical personnel

Workers in high-risk facilities, etc.


Since 2021, COVID-19 vaccination has been implemented as a temporary vaccination under Article 25 of the Infectious Disease Control and Prevention Act. As the COVID-19 pandemic subsided, the WHO declared the Public Health Emergency of International Concern to be lifted in May 2023. Accordingly, in June 2023, ROK classified COVID-19 as a Level 4 infectious disease, and in May 2024, the COVID-19 crisis was downgraded to a lower level of concern.

The need to consider the transition of COVID-19 vaccination to routine vaccination was also proposed. The 5th meeting of the Advisory Committee on Vaccination, held on June 28, 2023, deliberated on the plan to introduce the COVID-19 vaccine into the national vaccination program. Based on this, the “Study to evaluate the validity of introducing a new national COVID-19 vaccine” was initiated in April 2024, and two COVID-19 vaccines (Pfizer-BioNTech and Moderna) were introduced this season through the approval of the MFDS.

The committee deliberated on the implementation plan for COVID-19 vaccination (national implementation) for the 2024–2025 season during the 6th meeting held on September 13, 2024. The committee also further reviewed the progress of introducing the COVID-19 vaccine into the national vaccination program. Based on this, the committee urged the government to again convert COVID-19 vaccination to the national vaccination program for the 2025–2026 season through legislative amendments and recommended that the MFDS proceed with the approval process for vaccines for children aged under 12 years as part of the shift to the national vaccination program.

It is expected that the outcome of the meeting will be used as a basis for preparing a vaccination strategy for high-risk groups and introducing it into the national vaccination program in the future, helping to prepare a systematic and long-term response to the seasonal program in preparation for a COVID-19 resurgence.

Ethics Statement: None.

Funding Source: None.

Acknowledgments: None.

Conflict of Interest: The authors have no conflicts of interest to declare.

Author Contributions: Conceptualization: HWH, WKL, DWL, EHC, SGL. Investigation: HWH, WKL, SHA. Methodology: HWH, WKL, DWL, EHC, SGL. Project administration: WKL, DWL. Supervision: DWL, EHC, SGL. Validation: SLK, DWL, EHC, SGL. Visualization: HWH, WKL. Writing – original draft: HWH, WKL. Writing – review & editing: HWH, WKL, SHA, YSC, SLK, DWL, EHC, SGL.

Supplementary data are available online.

  1. Choi SY, Ryu B, Jeong SJ, et al. Characteristics and trends of COVID-19 deaths in the Republic of Korea (January 20, 2020-August 30, 2023). Public Health Wkly Rep 2024;17:802-22.
    CrossRef
  2. Korea Disease Control and Prevention Agency (KDCA). KDCA, checks response efforts of relevant ministries for the COVID-19 wave [Internet]. KDCA; 2024 [cited 2024 Sep 30].
    Available from: https://www.kdca.go.kr/board/board.es?mid=a20501010000&bid=0015&list_no=725962&cg_code=&act=view&nPage=1&newsField=202408
  3. World Health Organization (WHO). Statement on the antigen composition of COVID-19 vaccines [Internet]. WHO; 2024 [cited 2024 Sep 24].
    Available from: https://www.who.int/news/item/26-04-2024-statement-on-the-antigen-composition-of-covid-19-vaccines
  4. European Medicines Agency (EMA). ETF recommends updating COVID-19 vaccines to target new JN.1 variant [Internet]. EMA; 2024 [cited 2024 Sep 24].
    Available from: https://www.ema.europa.eu/en/news/etf-recommends-updating-covid-19-vaccines-target-new-jn1-variant
  5. U.S. Food and Drug Administration (FDA). Updated COVID-19 vaccines for use in the United States beginning in fall 2024 [Internet]. FDA; 2024 [cited 2024 Sep 24].
    Available from: https://www.fda.gov/vaccines-blood-biologics/updated-covid-19-vaccines-use-united-states-beginning-fall-2024
  6. Korea Disease Control and Prevention Agency (KDCA). '24-'25 season COVID-19 vaccination plan announced [Internet]. KDCA; 2024 [cited 2024 Sep 24].
    Available from: https://www.kdca.go.kr/board/board.es?mid=a20501010000&bid=0015&list_no=725449&cg_code=&act=view&nPage=3&newsField=202406
  7. Korea Disease Control and Prevention Agency (KDCA). Notice of changes to COVID-19 vaccination guidelines [Internet]. KDCA; 2023 [cited 2024 Sep 24].
    Available from: https://www.kdca.go.kr/filepath/boardSyview.es?bid=0019&list_no=723744&seq=1
  8. Pharmaceuticals and Medical Devices Agency (PMDA). Medical drugs detailed display - Spikevax intramuscular injection [Internet]. PMDA; 2024 [cited 2024 Sep 25].
    Available from: https://www.pmda.go.jp/PmdaSearch/iyakuDetail/790314_631341EA3022_1_01#HDR_ContraIndications
  9. Korea Disease Control and Prevention Agency (KDCA). '22-'23 winter COVID-19 vaccination plan: guiding principles announced [Internet]. KDCA; 2022 [cited 2024 Sep 25].
    Available from: https://www.kdca.go.kr/board/board.es?mid=a20501010000&bid=0015&list_no=720600&cg_code=&act=view&nPage=1&newsField=202209

Policy Notes

Public Health Weekly Report 2025; 18(2): 90-102

Published online January 9, 2025 https://doi.org/10.56786/PHWR.2025.18.2.3

Copyright © The Korea Disease Control and Prevention Agency.

Implementation Plan for the Coronavirus Disease 2019 Vaccination for the 2024–2025 Season: Recommendations of the 6th Expert Committee on Immunization Practices

Hyewook Hwang 1, Wookeon Lee 1, Seohyeon Ahn 1, Young-Sook Choi 1, Seunghyun Lewis Kwon 1, Dongwoo Lee 1*, Eun Hwa Choi 2*, SokGoo Lee 3*

1Division of Immunization Services, Department of Healthcare Safety and Immunization, Korea Disease Control and Prevention Agency, Cheongju, Korea, 2Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea, 3Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea

Correspondence to:*Corresponding author: Dongwoo Lee, Tel: +82-43-719-8360, E-mail: williamdongwoolee@korea.kr
Eun Hwa Choi, Tel: +82-2-2072-3624, E-mail: eunchoi@snu.ac.kr
SokGoo Lee, Tel: +82-42-580-8264, E-mail: sgoolee@cnu.ac.kr

Received: November 11, 2024; Revised: December 4, 2024; Accepted: December 5, 2024

This is an Open Access aritcle distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) which permits unrestricted distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This paper summarizes the policy deliberations and conclusions regarding coronavirus disease 2019 vaccination for the 2024–2025 season, based on outcomes from the sixth meeting of the Expert Committee on Immunization Practices held on September 13, 2024. During the meeting, government officials and experts from various fields discussed implementation plans and guidelines in detail. A key topic was the vaccination strategy for high-risk children aged <12 years. The committee decided to adjust dose schedules and intervals based on age and prior vaccination history, recommending vaccine introduction through the Ministry of Food and Drug Safety’s approval process. This decision is expected to provide a foundation for future national vaccination programs and enhance safety for high-risk groups.

Keywords: COVID-19, Vaccination, Implementation plan, Guidelines

Body

Key messages

① What is known previously?

Coronavirus disease 2019 variants continue to emerge, necessitating vaccinations for high-risk groups, including individuals aged ≥65 years, immunocompromised individuals, and residents of high-risk facilities.

② What new information is presented?

In the 2024–2025 season, high-risk groups will receive the JN.1 monovalent vaccine, with criteria varying based on age and prior vaccination history.

③ What are implications?

The committee’s strategic decisions regarding epidemic prediction, vaccine selection, and expected outcomes are expected to provide crucial evidence for future national vaccination programs and improvements in the safety of high-risk groups.

Introduction

Coronavirus disease 2019 (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, leads to a wide range of clinical outcomes, from asymptomatic infection to death due to pneumonia. If infected, the elderly, in particular, are at higher risk of severe illness and death [1].

COVID-19 variants that evade existing immunity continue to emerge over time. The Omicron subvariants of the virus, first detected in South Africa in November 2021, are still circulating globally as of 2024. Among the Omicron subvariants, the BA.1 variant was prevalent in 2022, while the XBB and JN.1 variants circulated in 2023 and 2024, respectively [2]. In response to the prevalence of these COVID-19 variants, new vaccines have been developed. In the Republic of Korea (ROK), COVID-19 vaccination was carried out using the BA.1 and BA.4/5 bivalent vaccines (Pfizer-BioNTech, Morderna) in 2022 and the XBB.1.5 monovalent vaccine (Pfizer-BioNTech, Morderna, and Novavax) against the XBB variant in 2023.

In April 2024, the World Health Organization (WHO) and the European Medicines Agency, and in June, the Vaccines and Related Biological Products Advisory Committee of the U.S. Food and Drug Administration, recommended the JN.1 series monovalent vaccine as the formula and antigen for the 2024–2025 seasonal vaccination [3,-5].

ROK decided to introduce the JN.1 monovalent vaccine for the 2024–2025 seasonal vaccination after two expert advisory meetings in the field of COVID-19 vaccines held on June 10 and 21, 2024, and two deliberations (the 3rd and 4th) in the Advisory Committee on Vaccination on June 11 and 27, 2024 [6]. The JN.1 monovalent vaccine will be used for the 2024–2025 seasonal vaccination in most countries, including ROK, the United Kingdom, Europe, and Japan.

On September 13, 2024, the 6th meeting of the Advisory Committee on Vaccination (hereafter referred to as the committee) deliberated on the implementation plan for the 2024–2025 seasonal COVID-19 vaccination (national implementation) and decided on detailed plans, implementation standards, and response strategies for each vaccination situation. This article describes the decisions made by the committee and is intended to serve as a basis for the proper operation of the COVID-19 vaccination program in the future.

Results

1. Implementation Plan for the 2024–2025 Seasonal Coronavirus Disease 2019 Vaccination (National Implementation)

Considering the decisions made by the 5th meeting of the Advisory Committee on Vaccination in 2023, the committee decided on the following detailed implementation plan for the COVID-19 vaccination (national implementation) support program for the 2024–2025 season.

The 2024–2025 seasonal COVID-19 vaccination aims to prevent severe illness, hospitalization, and death in high-risk groups. This takes into account the fact that the effectiveness of vaccination in preventing severe illness, hospitalization, and death lasts for a relatively long period of time, but its effectiveness in preventing infection is limited due to the emergence of new variants. Therefore, it was decided to focus vaccination efforts on high-risk groups, considering this purpose.

As for those targeted for vaccination, the elderly aged 65 years and older, the immunocompromised aged over 6 months, and those hospitalized or residing in infection-prone facilities are to be recommended and subsidized. For the elderly and immunocompromised, it was decided to comprehensively consider the results of Korean and international studies, the degree of disease burden in the event of infection, and the duration of immunity. For the immunocompromised, in particular, it was decided to accept a broader range of individuals, including those deemed eligible by the judgment of healthcare workers (Supplementary Table 1; available online). To protect high-risk groups in hospitals from outbreaks, individuals hospitalized and living in high-risk facilities were also included (Supplementary Table 2; available online). Although support for vaccination of healthcare workers and workers in high-risk facilities was also considered, it was determined that this secondary target would be expanded depending on the vaccination situation, considering the goal of preventing severe illness, hospitalization, and death in high-risk groups.

The committee decided to introduce vaccines from Pfizer-BioNTech, Moderna, and Novavax for the 2024–2025 seasonal vaccination. Unlike the Pfizer-BioNTech and Moderna vaccines, which are introduced through the approval process, the Novavax vaccine is being introduced through the Emergency Use Authorization procedure. Therefore, the committee considered supporting the Novavax vaccine, with cost for vaccination as an exception for those who are contraindicated or deferred from mRNA vaccines. As a result, the Novavax vaccine will be introduced through the Korea Ministry of Food and Drug Safety (MFDS)’s approval process for the 2025–2026 season, and those who are contraindicated or deferred from mRNA vaccines will be supported only for this season.

In addition, the committee decided to align the vaccination schedule with the timing of the National Influenza Vaccination Support Program to improve the convenience of vaccination in line with recommendations for co-administration with influenza vaccine. Accordingly, the 2024–2025 seasonal vaccination will be administered sequentially by age group, starting with the elderly aged 75 years and older as of October 11, followed by the immunocompromised and residents of infectious disease-vulnerable facilities. They will receive the vaccine at community health centers and about 16,000 healthcare facilities nationwide, regardless of the recipient’s address (Table 1). Furthermore, the committee decided to operate a vaccine adverse event reporting system and deliberate on an active surveillance plan by sending text messages to the first 10,000 recipients to ensure the vaccine is safely administered.

Eligible group and period of coronavirus disease 2019 vaccination (national implementation) for the 2024–2025 season
Eligible group (yr)Vaccination period
Elderly people (born before 1959. 12. 31.)≥752024. 10. 11.–2025. 4. 30.
70–742024. 10. 15.–2025. 4. 30.
65–692024. 10. 18.–2025. 4. 30.
Immunocompromised individuals and residents of high-risk facilities (all individuals aged 6 months and older, regardless of age)2024. 10. 11.–2025. 4. 30.


2. Guidelines for Implementing Coronavirus Disease 2019 Vaccination for the 2024–2025 Season (National Implementation)

The committee deliberated on the implementation guidelines for the COVID-19 vaccination support program for the 2024–2025 season, reviewing the interval, number, and method of vaccination, which resulted in the following decisions. As vaccination of high-risk groups aged under 12 years was not included in the license or approval criteria of the MFDS for this season’s new vaccines, the committee focused its deliberations on the vaccination plan and criteria for this group.

First, the committee decided to utilize a half dose of the Moderna vaccine for high-risk groups aged under 12 years, similar to how the vaccine was administered to infants and children aged under 12 years in the previous season when it was approved for those aged 12 years and older [7]. This decision was based on the fact that the Moderna vaccine for each age group has the same composition, with only a difference in the dose, and on approval of the Moderna vaccine by the Japanese Pharmaceuticals and Medical Devices Agency [8].

The committee also decided to introduce the Pfizer-BioNTech vaccine for infants and young children under the emergency use authorization process of the MFDS to provide high-risk infants and young children, who needed to receive a vaccine from the same manufacturer as the one previously administered, with the opportunity to receive a vaccine from the same manufacturer. The committee also recommended introducing vaccines for infants and children through the approval process for the next season.

The committee reviewed the number and interval of vaccinations by age for the 2024–2025 season and determined that one dose of the vaccine would be required for those aged 12 years and older, regardless of prior dosing. For high-risk groups aged under 12 years, the committee decided on up to two doses for those who previously received the Moderna vaccine, and up to three doses for those who received the Pfizer-BioNTech vaccine designed for infants and young children (Figure 1). This decision was based on a comprehensive consideration of the approval by the MFDS, the previous COVID-19 vaccination implementation guidelines for the 2023–2024 season in ROK, and international vaccination guidelines. For at least one dose of the JN.1 monovalent vaccine, fully vaccinated person aged under 12 years and those aged 12 years and older will receive one dose of the JN.1 monovalent vaccine, with a gap of at least 3 months between doses. Unvaccinated individuals aged under 12 years will receive two doses of the Moderna vaccine at least 4 weeks apart, while those who received one dose in the past will receive only one dose of the JN.1 monovalent vaccine. Of the unvaccinated individuals aged under 12 years, those who received the Pfizer-BioNTech vaccine for infants and young children will be given three doses, with the first and second doses administered at least 3 weeks apart and the second and third doses at least 8 weeks apart. Those who had two doses in the past will receive one dose of the JN.1 vaccine, and those who received one dose in the past will be given two doses of the JN.1 vaccine (Table 2).

Figure 1. Number of vaccinations for high-risk individuals under 12 years old for the 2024–2025 season

Recommended interval between next doses for high-risk individuals under 12 years old for the 2024–2025 season
VaccineInterval between doses
Dose 2Dose 3More
Moderna (JN.1)4–8 weeks after dose 1 (minimum: 24 days)At least 3 months after last dose
Pfizer-BioNTech (JN.1) (ages 6 months to 4 years)3–8 weeks after dose 1 (minimum: 17 days)8 weeks after dose 2 (minimum: 52 days)At least 3 months after last dose


The committee strongly recommended that the influenza vaccine and COVID-19 vaccine be administered at the same time this season, as in previous seasons. This recommendation was based on the fact that there are no safety or efficacy concerns with co-administration with the influenza vaccine, and on international vaccination guidelines from the United States, the United Kingdom, and the WHO. Last season, the Korea Disease Control and Prevention Agency surveyed 20,000 COVID-19 vaccine recipients via text message about whether they experienced any health problems after receiving the vaccine. The results showed that the reporting rate was similar regardless of whether they were co-administrated or not: 27.8% of those who were co-administrated and 27.9% of those who were not.

3. Response Strategies for the 2024–2025 Seasonal Vaccination by Situation

The committee reviewed the response strategies for vaccine shortages and surpluses to ensure a stable vaccine supply and demand based on this year’s vaccination progress. Considering the full alignment of this year’s influenza and COVID-19 vaccination schedules and the increased interest in vaccination due to the COVID-19 resurgence in the summer, the committee considered two scenarios: a shortage due to high vaccination rates and a surplus due to low vaccination rates.

To begin with, in the case that the initial vaccination rate is higher than expected, leading to a shortage of vaccines, the government will procure additional vaccines in a step-by-step manner through prior consultation with pharmaceutical companies. The plan was designed to quickly secure vaccines.

Meanwhile, if the initial vaccination rate is lower than expected, the priority for vaccination will be established to expand the free vaccination support and minimize vaccine wastage (Table 3). Referring to the prioritization of COVID-19 winter supplemental vaccination in 2022, the priority of vaccination was determined by prioritizing healthcare workers, including those who have frequent contact with high-risk groups, and workers in high-risk facilities as the second priority [9].

Response strategies based on vaccination scenarios for the 2024–2025 season
Vaccination scenarioResponse strategy
Vaccine shortagePromote phased additional procurement based on vaccine shortage situations through prior consultations with pharmaceutical companies
Vaccine surplusExpand free vaccination targets based on vaccination priority

Priority 1 (from October 11).

Immunocompromised individuals.

Residents of high-risk facilities.

Over 65 years old.

Priority 2 (from November).

Healthcare workers including medical personnel.

Workers in high-risk facilities, etc..


Conclusion

Since 2021, COVID-19 vaccination has been implemented as a temporary vaccination under Article 25 of the Infectious Disease Control and Prevention Act. As the COVID-19 pandemic subsided, the WHO declared the Public Health Emergency of International Concern to be lifted in May 2023. Accordingly, in June 2023, ROK classified COVID-19 as a Level 4 infectious disease, and in May 2024, the COVID-19 crisis was downgraded to a lower level of concern.

The need to consider the transition of COVID-19 vaccination to routine vaccination was also proposed. The 5th meeting of the Advisory Committee on Vaccination, held on June 28, 2023, deliberated on the plan to introduce the COVID-19 vaccine into the national vaccination program. Based on this, the “Study to evaluate the validity of introducing a new national COVID-19 vaccine” was initiated in April 2024, and two COVID-19 vaccines (Pfizer-BioNTech and Moderna) were introduced this season through the approval of the MFDS.

The committee deliberated on the implementation plan for COVID-19 vaccination (national implementation) for the 2024–2025 season during the 6th meeting held on September 13, 2024. The committee also further reviewed the progress of introducing the COVID-19 vaccine into the national vaccination program. Based on this, the committee urged the government to again convert COVID-19 vaccination to the national vaccination program for the 2025–2026 season through legislative amendments and recommended that the MFDS proceed with the approval process for vaccines for children aged under 12 years as part of the shift to the national vaccination program.

It is expected that the outcome of the meeting will be used as a basis for preparing a vaccination strategy for high-risk groups and introducing it into the national vaccination program in the future, helping to prepare a systematic and long-term response to the seasonal program in preparation for a COVID-19 resurgence.

Declarations

Ethics Statement: None.

Funding Source: None.

Acknowledgments: None.

Conflict of Interest: The authors have no conflicts of interest to declare.

Author Contributions: Conceptualization: HWH, WKL, DWL, EHC, SGL. Investigation: HWH, WKL, SHA. Methodology: HWH, WKL, DWL, EHC, SGL. Project administration: WKL, DWL. Supervision: DWL, EHC, SGL. Validation: SLK, DWL, EHC, SGL. Visualization: HWH, WKL. Writing – original draft: HWH, WKL. Writing – review & editing: HWH, WKL, SHA, YSC, SLK, DWL, EHC, SGL.

Supplementary Materials

Supplementary data are available online.

Fig 1.

Figure 1.Number of vaccinations for high-risk individuals under 12 years old for the 2024–2025 season
Public Health Weekly Report 2025; 18: 90-102https://doi.org/10.56786/PHWR.2025.18.2.3
Eligible group and period of coronavirus disease 2019 vaccination (national implementation) for the 2024–2025 season
Eligible group (yr)Vaccination period
Elderly people (born before 1959. 12. 31.)≥752024. 10. 11.–2025. 4. 30.
70–742024. 10. 15.–2025. 4. 30.
65–692024. 10. 18.–2025. 4. 30.
Immunocompromised individuals and residents of high-risk facilities (all individuals aged 6 months and older, regardless of age)2024. 10. 11.–2025. 4. 30.

Recommended interval between next doses for high-risk individuals under 12 years old for the 2024–2025 season
VaccineInterval between doses
Dose 2Dose 3More
Moderna (JN.1)4–8 weeks after dose 1 (minimum: 24 days)At least 3 months after last dose
Pfizer-BioNTech (JN.1) (ages 6 months to 4 years)3–8 weeks after dose 1 (minimum: 17 days)8 weeks after dose 2 (minimum: 52 days)At least 3 months after last dose

Response strategies based on vaccination scenarios for the 2024–2025 season
Vaccination scenarioResponse strategy
Vaccine shortagePromote phased additional procurement based on vaccine shortage situations through prior consultations with pharmaceutical companies
Vaccine surplusExpand free vaccination targets based on vaccination priority

Priority 1 (from October 11).

Immunocompromised individuals.

Residents of high-risk facilities.

Over 65 years old.

Priority 2 (from November).

Healthcare workers including medical personnel.

Workers in high-risk facilities, etc..


References

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