Booster Shot Questions and Answers: What You Need to Know

Booster Shot Questions and Answers: What You Need to Know 1

Certain Pfizer recipients already are eligible, and now health officials are considering boosters of Moderna and Johnson & Johnson.

The Food and Drug Administration is considering expanding booster shots to certain people who received the Moderna and Johnson & Johnson vaccines and who may be more vulnerable to complications from Covid-19. Here are answers to some common questions.

The F.D.A. has authorized booster shots for a select group of people who received their second dose of the Pfizer-BioNTech vaccine at least six months ago. Eligible people include Pfizer recipients who are 65 and older or who live in long-term care facilities. The agency also authorized boosters for adults who were at high risk of severe Covid-19 because of an underlying medical condition as well as for health care workers and others whose jobs put them at risk.

People with weakened immune systems who received the Pfizer or Moderna vaccines also are eligible for a third shot, at least four weeks after their second dose. For these patients, the third shot is not a booster dose but is now recommended because some people with compromised immune systems don’t generate a robust response after just two shots. About 3 percent of Americans are in this group for a variety of reasons, including those who received an organ transplant.

This week, an F.D.A. advisory panel voted in favor of emergency authorization of a half-dose booster of Moderna vaccine, at least six months after the second dose. Those eligible would include Moderna recipients over 65 and other adults considered at high risk — the same groups eligible for a Pfizer-BioNTech booster.

The F.D.A. typically follows the panel’s advice, and it should rule within days. Next week, a committee advising the Centers for Disease Control and Prevention will make its own recommendations. The C.D.C. is expected to rule quickly, and people in the eligible groups could begin seeking the shots soon afterward.

On Friday, the same expert committee will recommend whether the roughly 15 million people who received the single-dose Johnson & Johnson vaccine should also be eligible for booster doses. Its members are also supposed to discuss a federal study that suggested that those Americans might be better off with a Moderna or Pfizer-BioNTech booster.

The C.D.C. has said the risk of complications from Covid-19 is highest for people with high blood pressure, diabetes, obesity, cancer, chronic lung or kidney disease, heart disease, dementia and certain disabilities. You can find a complete list here; the agency may offer additional guidance in the coming days.

A C.D.C. scientific committee said that people over 50 with underlying medical concerns should receive boosters, but it advised people 18 to 49 with the conditions to make decisions based on their individual risk.

The category of immunocompromised people who are eligible for a third Pfizer or Moderna shot (technically not a booster dose) includes people who are undergoing cancer treatment; those who have received an organ or stem cell transplant and are taking medicine to suppress the immune system; people with primary immunodeficiency, or advanced or untreated H.I.V. infection; and people taking high-dose corticosteroids or other drugs that suppress the immune response.

The F.D.A. authorized booster doses for workers whose jobs put them at high risk of exposure to potentially infectious people. So far, that includes health care workers, teachers and day care staff, grocery workers, transit and postal workers and people who work in homeless shelters or prisons

Health departments, pharmacies and doctors’ offices will dispense boosters in much the same way as they administered the first and second doses. Call ahead to find out about scheduling, and bring your vaccine card. Proof of an underlying medical condition won’t be required, but you may want to discuss the risks and benefits with your doctor.

You can find more information on your state’s health department website or pharmacy websites. People who are immunocompromised also can talk to their physicians about the best way to get a third shot. Since the F.D.A. fully approved the Pfizer-BioNTech vaccine as a two-dose regimen last month, physicians have had broad latitude to prescribe a third dose to people they deem in need of one.

While people who are severely immunocompromised can receive a third shot sooner, everyone else who qualifies should wait until at least six months after their second shot. In addition to a lack of safety data, getting a booster too soon is probably a waste of a dose and may not increase your antibodies in a meaningful way.

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What to Know About Covid-19 Booster Shots

The F.D.A. authorized booster shots for a select group of people who received their second doses of the Pfizer-BioNTech vaccine at least six months before. That group includes: vaccine recipients who are 65 or older or who live in long-term care facilities; adults who are at high risk of severe Covid-19 because of an underlying medical condition; health care workers and others whose jobs put them at risk. People with weakened immune systems are eligible for a third dose of either Pfizer or Moderna four weeks after the second shot.

Regulators have not authorized booster shots for recipients of Moderna and Johnson & Johnson vaccines yet. A key advisory committee to the F.D.A. voted unanimously on Oct. 14 to recommend a third dose of the Moderna coronavirus vaccine for many of its recipients. The same panel voted unanimously on Oct. 15 to recommend booster shots of Johnson & Johnson’s one-dose vaccine for all adult recipients. The F.D.A. typically follows the panel’s advice, and should rule within days.

The C.D.C. has said the conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney or liver disease; dementia and certain disabilities. Pregnant women and current and former smokers are also eligible.

The F.D.A. authorized boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The C.D.C. says that group includes: emergency medical workers; education workers; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit workers; grocery store workers.

It is not recommended. For now, Pfizer vaccine recipients are advised to get a Pfizer booster shot, and Moderna and Johnson & Johnson recipients should wait until booster doses from those manufacturers are approved.

Yes. The C.D.C. says the Covid vaccine may be administered without regard to the timing of other vaccines, and many pharmacy sites are allowing people to schedule a flu shot at the same time as a booster dose.

While the Biden administration has said it supports booster shots for everyone who is eight months post-vaccination, F.D.A. scientists have rejected the plan. But the recommendation could change in the coming weeks or months as more data becomes available on the durability of vaccine antibodies over time. The good news is that the consensus in the scientific community is that all the vaccines continue to provide strong protection against severe illness, hospitalization and death from Covid-19.

While data are limited, so far reactions reported after the third mRNA dose from Pfizer or Moderna were similar to those of the two-dose series. Fatigue and pain at the injection site were the most commonly reported side effects, and overall, most symptoms were mild to moderate, the C.D.C. said. A survey from Israel, where booster shots are being given, found that 88 percent of Pfizer vaccine recipients said that in the days after the third dose, they felt “similar or better” to how they felt after the second shot. About a third of respondents reported some side effects, with the most common being soreness at the injection site, and 1 percent said they sought medical treatment because of one or more side effects.

The F.D.A. panel is reviewing new research on mixing vaccine booster shots, but the practice is not yet recommended. For now, Pfizer vaccine recipients are advised to get a Pfizer booster shot, and Moderna and Johnson & Johnson recipients should wait until booster doses are approved for their manufacturer’s vaccine or the C. D.C gives additional guidance.

Some people who have received the Johnson & Johnson vaccine are seeking a Pfizer booster shot on their own. San Francisco health officials have said that they will accommodate these requests as long as people consult their doctors first.

Sharon LaFraniere and Noah Weiland contributed reporting.

Read more:
A C.D.C. Panel Recommends Booster Shots for Many Americans

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