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Digging into Common COVID-19 Booster Shot Questions

Almost a year after COVID-19 vaccines were first released, we’re now reaching the point where many people could benefit from an additional dose – also known as a booster shot. Over the last few weeks, the FDA and CDC finalized recommendations for Pfizer, Moderna and Johnson & Johnson boosters.

LIUNA General
and LHSFNA Labor
Armand E. Sabitoni

“It’s reassuring to see that rates for people getting booster shots are higher than when the vaccines were first released,” says LIUNA General-Secretary Treasurer and LHSFNA Labor Co-Chairman Armand E. Sabitoni. “We’ve all seen what this virus can do and we all need to continue taking the steps to protect ourselves and others.”

Who is eligible for a COVID-19 booster shot?

Booster shot eligibility varies based on a few different factors, including age, risk and which vaccine you received initially.

Pfizer or Moderna Vaccine Recipients

For people who received a Pfizer or Moderna vaccine at least six months ago, the CDC recommends a booster shot for the following groups:

  • Adults age 65+ or adults living in long-term care facilities
  • Adults age 50-64 with an underlying medical condition that increases risk for severe COVID-19

Additionally, these two groups are eligible for a Pfizer of Moderna booster if they want one:

  • Adults 18 or older with an underlying medical condition that increases risk for severe COVID-19
  • Adults 18 or older who work in a setting that puts them at high risk of exposure and transmission

CDC Director Dr. Rochelle Walensky expanded the initial recommendation to include occupational risk as a factor in booster shot eligibility for Pfizer and Moderna recipients. “It is my job to recognize where our actions can have the greatest impact,” said Dr. Walensky. “At CDC, we are tasked with analyzing complex, often imperfect data to make concrete recommendations that optimize health. In a pandemic, even with uncertainty, we must take actions that we anticipate will do the greatest good.”

Johnson & Johnson (J&J) Vaccine Recipients

More recently, the CDC also recommended that the 15 million Americans who are 18 or older and initially received the J&J one-shot vaccine also get a booster if they were vaccinated at least two months ago. Unlike the Pfizer or Moderna vaccines, there are no other medical or occupational eligibility requirements for getting a J&J booster.

Taken together with the Pfizer and Moderna booster recommendations above, these broad eligibility groups will make about 120 million Americans – two out of three vaccinated people – eligible for a booster in the coming weeks.

Why do I need a booster shot if I’m already vaccinated?

For some viruses, the protection you get from a vaccine wears off over time (e.g., the annual flu shot). Boosters are common for other vaccines as well, such as Tdap, which protects against tetanus. While COVID-19 vaccines continue to be effective at preventing severe disease, their ability to prevent infection and milder symptoms decreases over time.

Overall effectiveness of the Pfizer vaccine (which includes preventing hospitalization and death) fell from 96 percent to 84 percent after four months; the vaccine’s effectiveness at preventing transmission alone fell from 88 percent to 47 percent after five months.

People who received the Johnson & Johnson vaccine initially will see a big boost in immunity compared to the original one-shot dose. The company reports two doses boosts effectiveness against mild and severe COVID-19 from 74 percent to 94 percent.

Vaccines continue to be our best defense against serious COVID-19 complications. A recent report found that unvaccinated people are 11 times more likely to die of COVID-19 than those who are fully vaccinated.

Does my booster shot have to be the same type of vaccine I got initially?

No. After reviewing data, the CDC has approved a “mix and match” approach and says those eligible can choose any of the three vaccines authorized in the U.S. for their booster shot. This additional flexibility should help speed the rollout of booster shots because people won’t have to track down a particular shot. It should also help encourage people who had side effects with one brand or are concerned about a specific shot to get a booster shot of a different brand rather than skipping a booster shot altogether.

Will Pfizer and Moderna booster shots become available to everyone?

The Biden administration has supported booster shots for all Americans who are at least eight months post-vaccination, but scientists at the FDA and CDC haven’t made a recommendation yet. Instead, booster shots are being treated similarly to the initial COVID-19 vaccine rollout, when they were reserved for people at greater risk for severe illness, hospitalization and death.

What are the possible side effects for booster shots?

Because booster shots are still rolling out in the U.S., we don’t have large-scale results here yet. In other countries where booster shots have been available for longer, about a third of people had some side effects, with fatigue and pain at the injection site being the most common. Almost 90 percent of people said the Pfizer booster caused side effects that were similar or less severe than their second shot.

How do I get a booster shot if I’m eligible for one?

State and local health departments, pharmacies and doctors’ offices will administer booster shots, similar to the initial vaccine rollout. It’s recommended you bring your vaccination card and call ahead to find out about scheduling or other requirements.

For the latest information on COVID-19, including vaccines and other booster information, download the LHSFNA’s COVID-19 Vaccines: Key Facts & Benefits fact sheet, which is available on our COVID-19 Resources page.

[Nick Fox]

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