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Booster shots: Second booster approved for those over 50

Our expert explains why boosters are important for adults and kids.

Older woman getting vaccinated Photo: Getty Images

Updated April 13, 2022, to reflect FDA authorization of a second booster for people 50 and over plus some immunocompromised individuals. 

The Food and Drug Administration has authorized for emergency use a second COVID-19 booster for those age 50 and older. Why are booster shots so important? When and where should you get your booster? Here, VCU Health infectious disease expert Dr. Gonzalo Bearman discusses the need for COVID-19 booster shots.

Dr. Gonzalo BearmanFirst off, why would anyone need a booster shot for COVID-19?

For many diseases, booster shots aren’t necessary once you complete the primary vaccine series. But for others, you may need a booster to maintain optimal protection.

Although our current vaccines continue to offer tremendous protection against severe COVID-19, studies show that the strength of these vaccines does decline over time. This is the case with all three of the vaccines offered in the United States — the Pfizer, Moderna and Johnson & Johnson (J&J) vaccines. A booster will re-prime an immune system that has lost some of its ability to fight off infection.

Does this mean my vaccination is no longer protecting me?

Not at all. We know that the available COVID-19 vaccines are wildly effective at preventing severe illness and death in people with healthy immune systems. However, especially 5 months or longer after completing vaccination, some fully vaccinated people still can get infected.

Although some people with these breakthrough” infections” get quite ill for a short period of time, most develop only mild symptoms, if any symptoms at all. However, even a minimally symptomatic person may transmit the infection on to someone who could then become extremely ill.

Can everyone get a booster shot? 

The CDC recommends that everyone ages 12 and older get a booster shot, and that children 5-11 get a booster if they are moderately to severely immunocompromised. The Food and Drug Administration has approved a second booster for individuals 50 years of age and older, as well as certain immunocompromised individuals.

When should I get my booster?

If your primary vaccination series was with Pfizer:
For those 12 or older, you are eligible for a booster shot 5 months after completion of your two-dose vaccine series.

If your primary vaccination series was with Moderna:
For those 18 or older, you are eligible for a booster shot 6 months after completion of your two-dose vaccine series.

If your primary vaccination was with Johnson & Johnson (J&J):
You are eligible for a booster shot two months after receiving your single-dose vaccination.

If you are immunocompromised: 
If you have an immunocompromising condition, you are eligible for a third dose of vaccine 28 days after your vaccination if you received the Pfizer or Moderna vaccines. This is not really a booster per se — it’s more a completion of your primary vaccine series. Six months after completing your three-dose series you are eligible for a fourth “booster” dose of vaccine.

If you are getting your second booster:
You are eligible four months after your first booster. 

What about children who aren’t yet 12 years old?

Scientists are studying whether boosters will be necessary for children younger than 12. At the current time, boosters are not recommended for these children.

Do I have to get the same vaccine I received the first time, or can I “mix and match”? 

Mixing vaccines, such as receiving a Pfizer booster after receiving Moderna or J&J the first time, is allowed for people 18 years of age and older. However, if you received the Pfizer or Moderna vaccine for your initial series, it’s recommended you stick with the same vaccine if it’s available.

If you received the J&J vaccine, you will likely be offered the Pfizer or Moderna booster due to the risk of serious adverse events with the J&J booster.

When will my “bump” in immunity kick in?

For people who have been previously vaccinated and have a healthy immune system, you will likely benefit very quickly. Your full immune benefits will likely be present two weeks after receiving your booster shot.

Is this it, or will I need another booster shot down the road?

We don’t know yet. A lot of this depends on what happens with the pandemic and scientific data on what happens with immunity over time after receiving the booster.

Where do I get my booster shot?

Most pharmacies — including those in the larger grocery stores — offer booster shots. It’s easy to schedule an appointment online. Check vaccinate.virginia.gov for a location near you.

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