To Boost or Not To Boost?

The progress and studies on COVID booster shots have been front page news for many months now, and the CDC and FDA have given recommendations on booster shots for all 3 approved COVID vaccines as of last week.

Here’s the summary:

1. For those who received an initial Johnson & Johnson (J&J) vaccine, everyone 18 and older is recommended to get a booster shot 2 months or later.

2. For people who received either Pfizer and Moderna initial vaccines, a booster shot is recommended 6 months after the 2^nd dose for:
   1. All people 65 years and older
   2. All people 18-64 with certain chronic conditions (this is a long list!):
      1. Cancer
      2. Chronic Kidney Disease
      3. Chronic Liver Disease
      4. Chronic Lung Disease
      5. Dementia
      6. Diabetes
      7. HIV
      8. Immunocompromised state
      9. Mental Health conditions (depression, schizophrenia, autism)
      10. Overweight and obesity
      11. Pregnancy
      12. Sickle cell
      13. Current or Former Smokers
      14. Stroke or cerebrovascular disease
      15. Substance use (alcohol, opioid dependency, cocaine use)
      16. Tuberculosis
   3. Those who work in high-risk occupations:
      1. Healthcare workers
      2. Teachers
      3. Grocery store workers
   4. Those who live in high exposure settings:
      1. Nursing home residents
      2. Prisoners

If you have any questions on whether you qualify, ask your physician!

Further details:

1. Those who are immunocompromised with cancer, organ transplant, stem cell transplant, are on chronic drugs that suppress the immune system, have primary immunodeficiency syndromes or have severe HIV or untreated HIV are suggested to get a 3^rd shot at least 28 days after their 2^nd mRNA vaccine.  
2. Therefore, the timing, and the dosage (only in case of the Moderna vaccine), of the 3^rd shot are different from the booster shots.  An excellent article on this was written by Marsha Seidelman, M.D. on Lady Docs.
3. The FDA/CDC have supported using the mix and match approach to the boosters, so you can receive any of the vaccines as your booster.  I have been recommending the Moderna booster recently as data pointed to the higher antibody levels for those who received Moderna as their booster.

Here is a great interactive article from the Washington Post on figuring out if you should get a booster.

To locate a place giving COVID vaccines and boosters, go to this page.

Even more important than boosters is getting the initial vaccine.   If you haven’t received your first shots, please do it now!  Protect yourself and protect those around you.  The sooner the virus has no more new susceptible hosts, the less likely we have new, stronger variants that can harm us all.

Boosters are not recommended for the general population as studies show that healthy people under the age of 65 have very good protection at this point, but it may be recommended in the future.  Why wait?  This article summarizes some of the reasons.

The situation is complex and fluid.  Check with your physician if you are uncertain as to how this information pertains to you.  And while you’re figuring all this out, please be sure to get your flu shot as well!