With all the talk in the past couple of years about COVID vaccines and boosters, it may be confusing to know just when you should get a COVID-19 booster. A lot of that confusion has to do with the new COVID strains that have emerged, as well as the continuously changing vaccination guidelines. Still, getting any recommended COVID boosters can help you protect yourself and others against more severe infection from the virus.
“They’re designed to remind the immune system that this condition is still something we need to be prepared to encounter,” says Dr. Del DeHart, an infectious disease specialist with University of Michigan Health-West in Wyoming, Michigan.
How Often Do You Need a COVID Booster?
To figure out how often you need a COVID booster, you first need to consider your age group and what manufacturer made your primary COVID vaccine, which is the first shot or shots you received to protect against COVID. In the U.S., the current approved manufacturers for COVID vaccines and boosters are:
— Johnson & Johnson’s Janssen.
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If you’re a healthy adult, here is when you should get a COVID booster, according to the Centers for Disease Control and Prevention:
— Pfizer-BioNTech: Get the updated booster made by Pfizer-BioNTech or Moderna at least two months after your second primary vaccine shot or after you received a previous booster. You may hear these boosters be referred to as a bivalent booster. That means the booster works against both the original strain of the virus and the original Omicron variant of the virus.
— Moderna: Get the updated booster made by Pfizer-BioNTech or Moderna at least two months after your second primary vaccine shot or after you received a previous booster.
— Novavax: Get the updated booster made by Pfizer-BioNTech or Moderna at least two months after your second primary vaccine shot. If needed, you can get a Novavax monovalent booster if the Pfizer or Moderna booster isn’t available, you finished your primary vaccine series more than six months ago and you haven’t received any other boosters.
— Johnson & Johnson’s Janssen: Get the updated booster made by Pfizer-BioNTech or Moderna at least two months after your primary vaccine shot.
You’re considered up-to-date with COVID vaccines if you have finished your primary COVID vaccine series and you’ve had the most recent booster dose as recommended by the CDC. The CDC’s chart provides vaccine recommendations by age group for those who are not immunocompromised.
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COVID-19 Booster Recommendations for Children
The recommendations below are for children ages 6 months to 17 years old. Infants under 6 months aren’t old enough to get the COVID vaccine.
— Ages 6 months to 4 years: The CDC doesn’t have a recommendation for an updated bivalent booster for this age group.
— Ages 5 to 11 years: Children who are five can get the updated booster made by Pfizer-BioNTech at least two months after a second primary vaccine shot or a previous booster. They shouldn’t receive the Moderna booster. However, those ages 6 to 11 can receive a Pfizer-BioNTech or Moderna booster.
— Ages 12 to 17 years: They can receive a booster at least two months after a second primary vaccine shot or a previous booster.
— Ages 6 months to 5 years: They can receive a booster at least two months after a second primary vaccine shot but should only receive a booster made by Moderna. Those age 5 may receive a Pfizer-BioNTech or Moderna updated booster.
— Ages 6 to 17 years: They can receive a Pfizer-BioNTech or Moderna booster at least two months after a second primary vaccine shot or a previous booster.
— Ages 12 to 17 years old: Teens who received a Novavax primary series vaccine can receive a booster made by Pfizer-BioNTech or Moderna at least two months after a second primary vaccine shot. Novavax doesn’t currently have an updated booster.
Johnson & Johnson’s Janssen
— Johnson & Johnson’s Janssen vaccine is approved only for those aged 18 and older.
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COVID-19 Booster Recommendations for Those Who Are Immunocompromised
If you’re immunocompromised, you have a greater chance of serious infection or death from COVID-19. For this reason, vaccine recommendations are a little different when you’re immunocompromised.
You should still get a booster at least two months after your last primary vaccine shot or after you received a previous booster if you’re immunocompromised, according to the CDC. The difference is that you’ll receive an extra dose of the primary vaccine. For those receiving the Pfizer or Moderna shot, this means getting three doses of the primary vaccine. For those receiving the Novavax or Johnson & Johnson/Janssen shot, you’ll get two doses of the primary vaccine.
The CDC’s chart provides vaccine recommendations by age group for those who are immunocompromised.
You should also check with your primary health care provider for any other booster recommendations specific to your health situation.
Where to Get a COVID-19 Booster
Many pharmacies, health clinics and doctors offices offer COVID vaccines and boosters. To find where COVID boosters are offered near you, the federal government’s site, Vaccine.gov, allows you to search by ZIP code and the type of shot that you need.
If you’re homebound, you can ask your health care provider or contact your state or local health department to find out how to get a COVID booster from the convenience of your home.
COVID-19 Boosters: How to Prepare, What to Expect
You don’t need to do anything to prepare to get a COVID-19 booster. Although not everyone will have booster side effects, you may want to schedule your booster when you have a day or two without strenuous activity or travel. That’s so you have time to rest in case you have any side effects from the booster.
Don’t take over-the-counter pain relievers like acetaminophen or ibuprofen before getting your booster, cautions Dr. Susan McLellan, a professor in the infectious diseases division and medical director of the Biocontainment Treatment Unit at The University of Texas Medical Branch at Galveston. These may lessen the effectiveness of the boosters. However, it is OK to take these medications after getting your vaccine as detailed below.
Many people will have no side effects from a COVID booster. For those who do, the CDC says that the most common effects are:
— Soreness in your arm.
Most side effects people have had are similar to any side effects they felt after getting their primary COVID-19 vaccines.
You can cope with booster side effects by:
— Applying a cool washcloth on your arm where you received the injection.
— Asking your health care provider if it’s OK to use over-the-counter pain relievers like aspirin, ibuprofen and acetaminophen.
— Getting extra rest.
How Effective Are COVID-19 Boosters?
COVID-19 vaccines and boosters are effective in preventing the virus, symptomatic infection and lowering the chance of having a severe case of the infection. A severe case means hospitalization or death.
A study focused on more than 78,000 urgent care and emergency department visits as well as 15,500 hospitalizations found those who contracted COVID-19 but received boosters were 56% less likely to seek emergency room or urgent care and 57% less likely to have to be hospitalized, according to a Morbidity and Mortality Weekly Report article from December 2022.
For those who had received their vaccines and boosters but had their most recent dose 11 months ago or longer, they were 50% less likely to seek emergency room and urgent care.
So, there still may be a risk of contracting COVID-19 even after getting the primary vaccines and boosters, but your chances are lower. If you do get the virus, your chances of developing a serious infection are lower compared to if you were unvaccinated.
Booster Shot Hesitancy and Confusion
As of February 2023, 15.8% of the U.S. population had received at least one COVID booster dose, according to the CDC. That compares with 69.2% of the U.S. population that completed the primary vaccine series. There are a few reasons why not as many people have received their boosters.
“There’s understandable confusion about new vaccines, new viral variant strains and what to do if someone has already had COVID at some point in addition to previous vaccination,” DeHart says.
“Warranted or not, many people no longer feel a sense of emergency,” says Jeffrey Townsend, the Elihu Professor of Biostatistics and professor of ecology and evolutionary biology and co-leader of the Genomics, Genetics, & Epigenetics Research Program at Yale University in New Haven, Connecticut. Townsend and colleagues have published several studies on COVID vaccines.
Misinformation also plays a big role, McLellan says. This can come in the form of people who don’t favor getting COVID vaccines or boosters at all, people who have or have had COVID, especially recently or people who may have had just the primary vaccine series and think they don’t need any other protection against COVID.
Future Booster Recommendations
The guidelines about COVID boosters will most likely continue to change in the future to respond to new strains of the virus. This is why you should ask your health care provider, local pharmacist or check with the CDC website if you’re unsure of the current guidance.
Some groups, such as the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC), said in January 2023 that they favor using an up-to-date version of the COVID vaccine each year, similar to what’s done with the flu shot now. This would simplify COVID vaccine and booster requirements, McLellan says. This isn’t yet a formal guideline.
An analysis from Townsend and fellow researchers, published in January 2023 in the Journal of Medical Virology, focused on the effectiveness of different COVID vaccine frequencies and found that three out of 10 people were likely to contract COVID over six years if they had an annual and updated booster. However, nine out of 10 were projected to get the virus if they didn’t get any boosters. Annual or biannual boosting did much better than boosters that spanned more than a year apart.
“A regular booster schedule is more likely to be viewed as sensible by the public for good reasons and is likely to result in better outcomes as well,” Townsend says.
If an annual COVID booster became a future recommendation, it may be easier to associate it with the annual flu shot many people get.
“The virus will change over the next several years, and we may need to change our strategy in response to these changes,” DeHart says. Treatments for COVID, which are available now but weren’t around when the virus first emerged, also will influence future public health recommendations regarding COVID vaccination, he adds.
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Understanding the Recommendations for COVID-19 Booster Shots originally appeared on usnews.com
Update 03/16/23: This story was previously published at an earlier date and has been updated with new information.