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Get the Latest Information on COVID-19 Vaccine Booster Doses + Third Doses

October 28, 2021

On Monday, October 25, 2021 the CDC published an update to the Interim Clinical Considerations for Use of COVID-19 Vaccines with a focus on Booster Dose. Below are answers to commonly asked questions.

Oct 2021 Vaccine Booster and Third Dose

Vaccine Boosters and Third Doses

Are children eligible for COVID-19 vaccine boosters?

Yes. The CDC now recommends that adolescents age 12 to 17 years old should receive a booster shot 5 months after their initial Pfizer-BioNTech vaccination series. Learn more: CDC Expands Booster Shot Eligibility and Strengthens Recommendations for 12-17 Year Olds.

For everyone 18 and older, the CDC says they “should” be boosted. 

Are children aged 5-11 who are immunocompromised eligible for a third dose?

No. Third doses are not permitted for people under 12 years of age.

Which vaccine recipients are eligible for a COVID-19 booster dose?

For individuals who received a Pfizer-BioNTech, Moderna or Johnson & Johnson's Janssen COVID-19 vaccine, the following groups are eligible for a booster shot after their initial vaccine series:

  • Anyone 18 and older may get a booter. Depending on which vaccine you got originally, there are different waiting periods for boosters. See the CDC chart: COVID-19 Vaccine Booster Shots.
  • Adolescents age 12-17 who are 5 months past their second dose of Pfizer may only get a Pfizer booster.

For the nearly 15 million people who got the Johnson & Johnson COVID-19 vaccine, booster shots are also recommended for those who are 18 and older and who were vaccinated two or more months ago.

Read more about the CDC Expands Eligibility of COVID-19 Booster Shots.

Why was an additional booster dose recommended?

All currently available COVID-19 vaccine series (one shot of J&J/Janssen or two shots of Pfizer or Moderna) continue to offer strong protection against severe COVID-19 disease. Recent studies have shown that protection against the virus may decrease over time. In order to increase protection a booster dose was recommended.

Read: CDC - COVID-19 Vaccine Booster Shots

What is the difference between “additional dose” vs. “booster dose”?

  • Additional dose after a primary series: An additional dose of vaccine is administered when the immune response following a primary vaccine series is likely to be insufficient. For example, a third dose of COVID-19 mRNA vaccine for certain immunocompromised patients.
  • Booster dose: Initial immune response to a primary vaccine series is thought to be adequate (for example, in immunocompetent individuals). But an additional dose of vaccine is administered when the initial immune response to a primary series is likely to have waned over time.

Are the side effects similar for the booster dose?

Yes. To date, the side effects reported after a booster dose for all US-authorized COVID-19 vaccines seem to be similar to what people experienced after receiving doses 1 and/or 2. Pain at the injection site was the most commonly reported side effect. Most symptoms were mild to moderate and resolved within 3 days.

I am immunocompromised and received a third dose of Pfizer vaccine already. Do I get an additional booster dose?

No. Pfizer or Moderna recipients who are severely immunocompromised should have already received a third dose of Pfizer or Moderna COVID-19 vaccine at least 28 days or more from their second dose of Pfizer COVID-19 Vaccine. If you have not done so, you should do so now. An additional booster dose after that third will not be due until 6 months after your third dose.

I am immunocompromised and have not received an additional dose of vaccine. Do I get a booster dose?

If you received Pfizer as your initial series, you should get a third dose of the same dosage at least 28 days after your second dose. If you received Moderna as your initial series, you should get a third dose of the same dosage (not the booster half-dose) at least 29 days after your second dose. If you received the J&J/Janssen vaccine initially, you should get your booster dose at least 2 months after your first shot.

Can I stop wearing masks and social distancing if I get the booster dose?

While the booster dose of the vaccine may provide added protection, it is still recommended that you continue to follow state and local guidance as it relates to wearing a mask, maintaining social distance, hand hygiene, etc.

Where can I get the COVID-19 vaccine and/or booster?

We are no longer scheduling COVID-19 vaccine appointments for the general public and are unable to accommodate walk-ins at this time. Please visit vaccines.gov to find a vaccine or booster appointment near you.

Do I need a note from my doctor to get a booster?

No. You do not need a doctor’s note to receive a booster dose. You may be required to attest that you meet eligibility criteria to receive a booster.

Do I need to bring my COVID-19 vaccine documentation when I get the booster shot?

We encourage you to bring your original vaccine card or documentation but it is not a requirement.

Is it okay to get the flu vaccine and the COVID-19 vaccine at the same time?

Yes. It is okay to get the influenza vaccine with any other recommended vaccines, including the COVID-19 vaccine.

I have been fully vaccinated with the Pfizer primary series and later had a COVID-19 breakthrough infection. Since COVID-19 infections often offer additional immunity, do I still need a Pfizer COVID-19 vaccine booster?

At this time, the CDC has no specific recommendations for this particular clinical scenario due to lack of data. But they are collecting data as quickly as possible to be able to answer this question with more certainty. That being said, we know that overall the likelihood of re-infection after being infected with COVID-19 is low and it becomes even lower if you were fully vaccinated prior to being infected. This is because it is likely that the infection acts as a natural “booster” of your immune system, hence further prolonging protection against re-infection. We also know that to date there has been no reports of re-infections in individuals who were fully vaccinated and then developed breakthrough COVID-19 infection. Based on this it is reasonable to wait at least 90 days after COVID-19 breakthrough infection and/or until more data becomes available.

Should I get a COVID-19 booster dose from the same vaccine brand as my primary series?

The FDA and CDC now allow for the receipt of any brand of vaccine as a booster for those who are eligible, regardless of the brand of the primary series. There are no clinical trial data to inform which combination is most effective.

Are there any populations in which specific mix-and-match combinations would be preferred?

  • Women under 50 requesting a booster dose of J&J/Janssen should be counseled about the risk of TTS and offered mRNA vaccine. They may choose to proceed with J&J/Janssen.
  • Men under 30 requesting a booster dose of mRNA vaccine should be counseled about the risk of myocarditis and offered J&J/Janssen vaccine. They may choose to proceed with mRNA vaccine.

Is a mix-and-match approach acceptable for the 2nd or 3rd doses or only for the booster?

A mix-and-match approach is only approved for the booster dose. Second doses of mRNA vaccine should be the same brand as the first. Third doses for the immunocompromised should be the same dose as the first.

Press Releases
Third Dose of COVID-19 Vaccine Now Authorized
On August 13, 2021 the Centers for Disease Control and Prevention (CDC) provided new recommendations for the mRNA (Pfizer and Moderna) COVID-19 vaccines for moderately to severely immunocompromised people. The CDC now recommends a third dose of the Pfizer or Moderna COVID-19 vaccine for these individuals.
Articles
What You Need To Know about COVID-19 Third Doses + Boosters
Dr. Adam Weston, an infectious disease specialist at Lowell General Hospital and a clinical leader in the hospitals’ pandemic response discusses the latest updates on 3rd dose and booster shots as well as the outlook for COVID-19 this fall.
News
Employee Vaccinations Required by October 1, 2021
Every day we have the privilege of helping people heal and become their best, healthiest selves. These individuals turn to us when they are most vulnerable and trust that we will care for them safely. To serve them well, we also must be our healthiest and best selves and the best way to be healthy amidst this ongoing pandemic is vaccination.

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