COVID-19 vaccine booster shots: What you need to know

·8 min read

This week, the Biden administration announced it was recommending booster shots of the Moderna and Pfizer vaccines for many Americans as early as Sept. 20. The nation’s top health officials made the announcement Wednesday, citing increased concerns over the hypercontagious Delta variant, as well as new data indicating that the effectiveness of these vaccines against COVID-19 may decline over time.

The booster plan still needs to be evaluated and approved by the FDA, which will look at the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines, and also by the CDC’s Advisory Committee on Immunization Practices.

But at Wednesday’s press briefing, Surgeon General Vivek Murthy said the decision to recommend boosters was not made lightly.

“It was made with careful consideration by the top medical and public health experts and the Department of Health and Human Services. It was informed by data, thoughtful analysis and by our collective years of experience addressing illness and epidemics,” Murthy said.

Dr. Leana Wen, an emergency physician and author of “Lifelines: A Doctor’s Journey in the Fight for Public Health,” told Yahoo News that the decision to recommend boosters is the right one.

“This entire pandemic we have been behind, we have been playing catch-up. We have been waiting for something bad to happen and then respond to it,” Wen said.

“The Biden administration is saying we don’t want to wait until we find that the vaccines are not protecting against severe disease, we want to get ahead of it and prepare for if that were to happen. That’s really smart. They’re not saying that people should rush out and get a booster because the vaccines are not working. They’re saying we may need to get a booster at some point soon, so let’s prepare for that.”

At the same time, Wen cautioned against trying to get a booster shot before they’ve been approved. Instead, she recommended beginning a conversation with your physician to discuss the pros and cons of receiving a third dose. “Have a plan together that’s going to be tailored to your individual medical circumstances,” she added.

Here are some things to know about booster shots.

Why are booster shots recommended?

At the White House press briefing on Wednesday, public health officials presented data from recent studies on breakthrough infections from institutions like the New York State Department of Health, the Mayo Clinic and the CDC’s National Healthcare Safety Network.

These studies, CDC Director Rochelle Walensky said, looked at numerous data sets through the end of July and early August. Health officials involved in the decision also looked at international data –– particularly from Israel, where the Delta surge arrived earlier than it did in the U.S. and which has vaccinated a greater percentage of its population.

It’s important to note that the studies did not show any major increases in severe COVID-19, hospitalization or death among those who are fully vaccinated. So if you are fully vaccinated, you are still protected from getting seriously ill from the disease.

However, Walensky noted that vaccine protection could decrease in the months ahead, based on the recent data reviewed from Israel and elsewhere.

Dr. Anthony Fauci, President Biden’s chief medical adviser, also weighed in. A third vaccine dose, he said, greatly increases antibodies against the virus that causes COVID-19.

“Higher levels of antibody are associated with a higher level of efficacy; higher levels of antibody may be required to protect against Delta,” Fauci said.

Wen said it is important for people to understand that this recommendation is not surprising, because boosters are not unusual.

“You look at the other common vaccines," she said. "Hepatitis vaccine requires three doses. Polio vaccine requires four doses to complete the series. Tetanus requires a booster every 10 years. We’re used to getting a flu shot every year. The fact that you may need to get a booster at some point, it does not mean that the vaccine doesn’t work. It means the vaccine is protecting you now, and in order to protect you better in the future, you may need to get a booster.”

Who will get boosters first? Where can I get my booster shot?

Assuming that the new shots are approved by the FDA and CDC, fully vaccinated adults 18 years and older will be eligible for a booster shot eight months after they received their second dose of the Pfizer or Moderna mRNA vaccine.

According to the Biden administration, boosters are expected to be available starting Sept. 20. The president said on Wednesday that these boosters will be free, regardless of health insurance or immigration status. No ID will be required from those who are eligible and want to get these shots.

Murthy said priority will be given to those who were “fully vaccinated earliest in the vaccination rollout.” This will include the most vulnerable populations, such as health care providers, nursing home residents and other seniors.

He added that the U.S. government has enough vaccines for every American and that the boosters will be available at roughly 80,000 places across the country, including doctors’ offices, grocery stores and over 40,000 local pharmacies. They will also be directly delivered to residents of long-term-care facilities.

Are these booster shots different from the original doses of the vaccines? Can you mix and match the vaccines?

Wen told Yahoo News that, as of now, the booster shots are the same vaccines that have been administered all year. They’re just an additional dose of what fully vaccinated people have already had.

The CDC, which first made the booster shot recommendation for immunocompromised patients, says vaccines should not be mixed. So if you received a Pfizer vaccine, you should stick with Pfizer, and if you got Moderna, you should get a Moderna booster.

However, the agency adds that “if the mRNA vaccine product given for the first two doses is not available or is unknown, either mRNA COVID-19 vaccine product may be administered.”

Are there any risks or side effects associated with a third shot?

According to the CDC, there is “limited information about the risks of receiving an additional dose of vaccine.” The safety, efficacy and benefit of additional doses of COVID-19 vaccine in immunocompromised people are still being evaluated, according to the agency.

However, Wen said that if we look at the evidence from Israel, the U.K. and Germany, where a third dose of these vaccines has already been approved for use, there has been no cause for alarm.

The CDC notes that side effects reported after the third shot “were similar to that of the two-dose series.” The most common symptoms, the agency says, include fatigue and pain at the injection site, but “most symptoms were mild to moderate.”

What does this mean for Americans who received the one-dose Johnson & Johnson vaccine?

More than 13 million Americans received the single-dose Johnson & Johnson vaccine, and many are wondering what this means for them.

At the moment, the upcoming boosters will be for those who received the Pfizer and Moderna vaccines only. Officials say, though, that they anticipate that for people who got the Johnson & Johnson vaccine, boosters will be needed too.

The J&J vaccine began to be administered in March, a few months after the mRNA Pfizer and Moderna vaccines. If federal health officials recommend the same eight-month timeline between vaccination and booster shots, the first Johnson & Johnson boosters would most likely start in November.

The Biden administration said it expects more data on the effectiveness of that vaccine in a few weeks.

“With that data in hand, we will keep the public informed with a timely plan for J&J booster shots,” said Murthy at the briefing on Wednesday.

How long will protection from a third dose last?

This remains unclear. Wen said that, since this is playing out in real time, it is hard to predict.

Other experts, however, believe that a third dose may offer protection for a longer period. On Thursday, in an interview with NBC News, Dr. Peter Hotez of the Texas Children’s Hospital Center for Vaccine Development said it should have been noted that this was probably going to be a three-dose vaccine from the beginning.

“When we made that commitment early on to space the first two doses only three or four weeks apart, we did that because we needed to aggressively vaccinate the American people, when we were losing 3,000 American lives every day in December and January, and that was a wise decision,” Hotez said.

“The problem is when you bring those first two doses together like that, it stacks the deck against you giving a long-term durable response, and that’s why we knew a third immunization was necessary,” he added.

Finally, he said, a third dose is likely to give a big boost for longer-term protection. “That’s why I don’t think this is going to be an annual event like the flu vaccine, for a lot of reasons. I’m hoping it will be not one and done, two and done, but three and done — at least for a while — and I think all those points have to be better communicated.”


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