COVID-19 Booster FAQs as of 10/14/2021
Confused about all the news on boosters? You are not alone. Here are some answers to your questions.
I received the Pfizer vaccine (Comirnaty). Do I need a booster and if so, when?
The FDA and CDC approved a booster six months or more after dose 2 if:
- You are over 65, or over 50 with a chronic medical condition, you should receive a booster.
- You are over 18, have a chronic medical condition or either work or live in a high risk environment you may receive a booster but you are still VERY well protected without a booster. FYI – Healthcare is considered a high-risk environment.
I received the Moderna vaccine (Spikevax). Do I need a booster and if so, when?
The FDA and CDC approved a half-dose Moderna booster six months or more after dose 2 if:
- You are over 65, or over 50 with a chronic medical condition, you should receive a booster.
- You are over 18, have a chronic medical condition or either work or live in a high risk environment you may receive a booster but you are still VERY well protected without a booster. FYI – Healthcare is considered a high-risk environment.
I received the Johnson and Johnson vaccine. Do I need a booster and if so, when?
One dose of J&J is not as effective against symptomatic infection as the mRNA vaccines, even as mRNA vaccine immunity has waned over time. The FDA and CDC have recommended a J&J booster to be given two months or more after the original dose. This results in immunity similar to boosted mRNA vaccines.
I am eligible for a booster. Where can I get it?
Go to the federal website Find COVID-19 vaccines. This will show the many pharmacies and local health departments, which vaccines they have and how to schedule. As a CVPH or AHMC employee eligible for a booster, you can take advantage of Booster PODs planned for later this month and into November. Our capacity is somewhat limited and if you are able to get the booster from a local pharmacy or health department, be sure to let Occupational Health know for your records. Boosters are not required now, but that may not always be the case.
I am fully vaccinated but had a breakthrough infection. Do I need a booster?
There is no data on this yet. It is very likely that a symptomatic breakthrough infection works like a booster. It is probably not necessary to get a booster in that situation but if you have questions, discuss with your physician.
Do I have to get the same vaccine for my booster as I got originally?
The FDA has approved a “Mix and Match” strategy for boosters. This means that a booster dose can be either of the three approved vaccines, regardless of the original vaccine received. This is designed to simplify and streamline boosting – vaccinating providers don’t need to stock all three vaccines for purposes of boosting. This is more in line with all other vaccines where the “brand” of the vaccine is not something to which any of us pay attention.
Even though we can “Mix and match” is there any reason to prefer one over the other for my booster?
All the vaccines are considered safe and effective. But, to truly minimize the risk of some rare known side effects or truly maximize immunity, there are a few things you might consider.
- Younger women are at the most risk of the rare bleeding complications of the J&J, so they may prefer an mRNA vaccine (Pfizer, Moderna).
- Older teens and young adult men are at the most risk for the rare heart inflammation from mRNA vaccines so might prefer a J&J booster.
- Boosting a J&J vaccine with an mRNA vaccine seems to give stronger immunity than two J&J vaccines.
Can we make it simple and just say everyone should get a booster at a certain time, regardless of vaccine?
We are getting there. Pfizer and Moderna boosters are at 6 months but not for everyone yet. J&J is at 2 months for everyone. It is really more like a 2 shot vaccine.
Why is it so confusing?
There are 3 vaccines that either work differently or are dosed differently. As a strategy to develop vaccines rapidly, this made perfect sense by increasing the chance that at least some vaccines would work. It does add to confusion now as they all have differences in how well and long they protect after “full vaccination.”
Written by: Wouter J. Rietsema MD
