Which Is the Best COVID Shot: Pfizer, Moderna, or Novavax?

The first COVID-19 vaccines were authorized in December 2020. Fast forward several years later, there’s been a world of change. Four different COVID vaccines are FDA approved for use, vaccines are widely available at pharmacies across the U.S., and millions of doses have been administered.

If you want to get vaccinated this year, you can receive a Pfizer (Comirnaty), Moderna (Spikevax, mNEXSPIKE), or Novavax (Nuvaxovid) vaccine to stay up to date. These 2025-2026 COVID vaccines were updated to target specific Omicron subvariants that are currently circulating and making people sick.

Still, with new information, data, and recommendations coming from many different sources, it’s hard to know what to do for your next shot. Ever-changing guidelines can be tough to digest, too. So, you may be thinking: “Which COVID vaccine should I get?” 

Ultimately, you and a healthcare professional should make this decision together. But here we’ll break down the latest facts to help you feel more informed.

Who is eligible for a COVID shot?

Protection from COVID vaccines can lessen over time. Vaccine effectiveness can also change in response to different variants that are circulating around the world. A COVID shot can help improve your protection against current versions of SARS-CoV-2, the virus that causes COVID.

When it comes to eligibility for a COVID vaccine, wanting one is what matters most. Deciding whether to get vaccinated this year is something you and a healthcare professional can do together. This could be a physician, pharmacist, or nurse — anyone who gives vaccines. You can talk through the benefits, risks, and possible downsides before making a decision.

Generally speaking, adults and kids ages 6 months and older in the U.S. are eligible to get a 2025-2026 COVID vaccine. A CDC vaccine panel notes that the benefits of vaccination are most relevant for people who have a higher risk of developing severe COVID. Several professional organizations and coalitions, meanwhile, support broader vaccination efforts — similar to years past. These recommendations offer different perspectives to help guide your decision on what would be best for you and your family.

Known risk factors for developing severe COVID include:

• Being 65 years or older

• Chronic lung conditions, such as asthma, chronic obstructive pulmonary disease (COPD), or cystic fibrosis

• Heart disease

• Diabetes

• Chronic kidney disease

• Chronic liver disease

• Cancer

• Neurologic conditions, such as Alzheimer’s disease or Parkinson’s disease

• Mental health conditions, such as depression or schizophrenia

• Certain disabilities, including cerebral palsy, Down syndrome, or other chromosomal disorders

• Obesity

• Pregnancy

• Being physically inactive

• Smoking

• A weakened immune system due to immunosuppressant medications, various health conditions, or a prior organ or stem cell transplant

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Keep in mind that some states may still require a prescription or have specific eligibility criteria to get vaccinated at a pharmacy. It’s best to check with your state health department or local pharmacy about their requirements.

2025-2026 COVID shot options

Updated COVID vaccines for 2025-2026 are now available nationwide. Availability may vary, though, so contact your preferred pharmacy or clinic to confirm they have the vaccine you want. If you prefer Nuvaxovid, you can use this locator to find a vaccine provider near you.

There are four COVID vaccines to choose from. The FDA, CDC, and other professional organizations don’t prefer or recommend one vaccine over another.

Generally speaking, you can get a COVID vaccine if it’s been at least 2 to 3 months since your last COVID vaccine dose. However, if you’ve recently had COVID, you can delay getting an updated vaccine for up to 3 months.

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Good to know: If your immune system is considered moderately to severely immunocompromised, your primary care provider may recommend getting more than one COVID vaccine dose. Make sure to defer to their recommendations for eligibility and timing.

Kids ages 6 months through 4 years old

Spikevax is currently the only COVID vaccine that’s approved for kids ages 6 months through 4 years old. 

Children ages 6 to 23 months who have never received a COVID vaccine can generally get 2 doses, each spaced 1 month apart. If they’ve already received 1 Spikevax dose, they can get another dose a month later. Kids in this age group who’ve already had 2 or more Spikevax doses can instead get a single shot. Once children turn 2 years old, they generally only need 1 dose, no matter their vaccination history.

These recommendations can be hard to follow. Your child’s pediatrician should ultimately have the final call on how many doses they should receive, and when.

People ages 5 and older

People who are at least 5 years old can receive 1 dose of an updated Comirnaty or Spikevax vaccine. This is true no matter your COVID vaccination history. People ages 12 and older can choose from all four vaccines: Comirnaty, Spikevax, mNEXSPIKE, or Nuvaxovid.

Does your next COVID shot need to be the same as your original vaccine?

In most cases, people have flexibility with which COVID vaccine brand they receive for their next dose. You may choose a mix-and-match approach, meaning that you get a different brand than you did last time. For example, someone who got a Pfizer vaccine in the past could stick with Comirnaty this year, or they could switch to Spikevax, mNEXSPIKE, or Nuvaxovid.

There are two main exceptions: 

• Pfizer’s vaccine was previously authorized for kids as young as 6 months old, but now it’s approved only for kids ages 5 years and older. That means if your young child got Pfizer’s vaccine in the 2024-2025 season, they’ll likely need to switch to Spikevax.

• The Johnson & Johnson (J&J) COVID vaccine should not be used. It’s no longer available in the U.S. for any purpose.

Are updated COVID shots the same as the original vaccine?

No, the original vaccines targeted the original strain of SARS-CoV-2. This is the strain that was first discovered in 2019.

For the 2025-2026 season, the FDA and one of its advisory committees have recommended switching to a monovalent vaccine that targets JN.1, preferably the LP.8.1 strain, to better match what’s circulating now. JN.1 is a version of the Omicron variant, and LP.8.1 is a descendant of that.

What risks are associated with updated COVID shots?

Research has shown that updated COVID shots can help provide additional protection against COVID.

But that doesn’t mean they’re free of any risks. Risks of updated COVID shots resemble the risks of previous vaccine doses. These can include: 

• Common side effects: COVID vaccine side effects seem to be similar to side effects you may have felt from your initial dose(s). This can include tiredness, fever, and pain or swelling where you received the shot. 

• Heart concerns: The Pfizer, Moderna, and Novavax vaccines have been connected to myocarditis (heart inflammation) and pericarditis (heart lining inflammation). These side effects are rare.

Researchers will continue to study the effects of COVID vaccines.

Does it make a difference if you’re pregnant or breastfeeding?

If you’re pregnant or breastfeeding, professional organizations like the American College of Obstetricians and Gynecologists recommend receiving a COVID shot when you’re eligible. COVID may result in complications that affect both mother and baby. Getting vaccinated can also help protect your newborn, since antibodies from the mother transfer to the baby and offer some protection after birth.

Since every pregnancy is unique, your OB-GYN can tell you more about getting vaccinated during this time.

Which COVID shot should you get?

The FDA and CDC don’t recommend one updated 2025-2026 COVID vaccine over the other. The same is true of various professional organizations and coalitions.

To help narrow down your choice between the four, you should weigh your options when deciding what course of action is best for you. It’s recommended to talk to a healthcare professional for their recommendation on your individual situation.

If you don’t feel strongly about one vaccine, the best move is to get a vaccine when it’s convenient for you. Differences between the vaccines — especially when it comes to Comirnaty and Spikevax — are small and nuanced. The “best” shot is the one that you have access to. 

But there are still a few thoughts to consider when making this decision. A summarized list of considerations are detailed below.

Sticking with the same vaccine

If you want your next shot to be the same as your original vaccine, there’s logic to back up your decision.

For one, vaccine recommendations are complex and change frequently. With some exceptions, a safe move may be to stick with the same vaccine that you got originally.

Researchers are continuing to conduct studies that look at how effective the same vaccine is over time. For example, it makes sense for Pfizer to see how effective their updated vaccine is following previous dose(s) of their own vaccine. They’re less likely to research how effective the Moderna shot is following a few doses of a Pfizer vaccine. However, some researchers have conducted “mix-and-match” effectiveness studies.

Changing to a different vaccine

If you want your next shot(s) to be different from your original vaccine, that would also make sense.

If you originally received the Pfizer vaccine, switching to the Moderna vaccine has been shown to result in a good immune response. The same goes for switching to Pfizer if you originally got Moderna. Some “mix-and-match” studies have found that getting a different vaccine may even lead to a slightly better immune response than getting the same vaccine again. However, the data isn’t fully clear. There isn’t a clear advantage to switching between the Pfizer, Moderna, and Novavax vaccines.

What’s more, if you originally received the J&J vaccine, then you should switch to a different vaccine for your next dose(s). The J&J vaccine is no longer authorized for use.

Other considerations

Effectiveness data changes frequently. Based on current vaccine effectiveness data, you may be inclined to choose one vaccine over another. New studies about vaccine effectiveness tend to come out many times a month.

The most up-to-date information may be helpful when deciding if you want to get a different vaccine from what you got originally. When it’s time to get your vaccine dose, try to look around and see what vaccine is best supported at the time. If you aren’t sure, ask a healthcare professional.

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Written by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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