COVID-19 Vaccine Boosters vs. Third Doses: Frequently Asked Questions

Last updated: May 23, 2022

What is a Booster Shot?

For some viruses, the protection we get from a vaccine starts to wear off over time. An additional dose of the vaccine may be needed to boost your immune response and make sure you are protected from the virus. Boosters are common for many vaccines, like the Tdap vaccine (tetanus, diphtheria and pertussis).

 

What is a Third Dose?

People with moderately to severely compromised immune systems are especially vulnerable to COVID-19, and may not build the same level of immunity to the two-dose vaccine series compared to people who are not immunocompromised.

This additional dose is intended to improve immunocompromised people’s response to their initial vaccine series.

 

Has one Booster Shot for COVID-19 vaccine been recommended by the CDC?

Yes. The Centers for Disease Control and Prevention (CDC) recommends that anyone 18 and older who completed their Moderna primary series at least five months ago, get a first booster shot.  

The Centers for Disease Control and Prevention (CDC) also recommends that anyone 5 and older who completed their Pfizer primary series at least five months ago, get a first booster shot.

For individuals who received a Johnson & Johnson vaccine, a first booster shot is also recommended for those who are 18 and older and were vaccinated two or more months ago.  

Moderately to severely immunocompromised people ages 5 years and older who received an mRNA COVID-19 vaccine primary series (Pfizer BioNTech or Moderna) and a third dose are eligible to receive a first booster shot at least 3 months after the primary series.

Individuals 18 and older may choose which vaccine they receive as a first booster shot. You may get the same vaccine type that you originally received or you can get a different vaccine type for your booster.  Individuals 5 to 17 years of age are only eligible to receive the Pfizer vaccine as their booster.

 

Why are we allowed to mix and match vaccines for Booster Shots, but not in the primary series?

Data show that mixing and matching all three of the FDA-approved or FDA-authorized vaccine booster doses led to a strong response. In groups that mixed and matched their booster dose a similar or higher immune response was created as compared to getting the same vaccine as the booster dose. Individuals 18 years of age and older are only able to mix and match vaccines for booster shots. Please talk with your medical provider if you have any questions about your booster shot.

 

What is the recommendation for a Third Dose of COVID-19 vaccine?

The CDC recommends that:

  • People with moderately to severely compromised immune systems who are 18 and older and who completed their Moderna vaccine primary series should plan to get an additional full dose of Moderna COVID-19 vaccine at least 28 days after receiving their second shot.
  • People with moderately to severely compromised immune systems who are 5 and older who completed their Pfizer-BioNTech vaccine primary series should plan to get an additional full dose of Pfizer-BioNTech COVID-19 vaccine at least 28 days after receiving their second shot.
  • People with moderately to severely compromised immune systems who are 18 and older and who received Johnson & Johnson’s Janssen (J&J/Janssen) COVID-19 vaccine should not receive an additional primary dose. However, they should get a booster shot (you may choose the type of COVID-19 vaccine for your booster shot) at least 2 months after their single-dose J&J/Janssen primary shot.

Who is eligible for a First Booster Shot?

Individuals 18 and older who completed their Moderna primary series are eligible to receive a first booster shot at least five months after the completion of the primary vaccine series.  

Individuals 5 and older who completed their Pfizer primary series are eligible to receive a first booster shot at least five months after the completion of the primary vaccine series.  

Individuals 18 and older who received a Johnson & Johnson vaccine two or more months ago are also recommended to get a first booster shot.

The Pfizer and Johnson & Johnson COVID-19 booster shots are the same formulation and the same dose as the primary COVID-19 vaccine series. However, the Moderna booster shot is half the dose of the vaccine than the initial series.    

Individuals 18 and older may choose which vaccine they receive as a booster dose. You may get the same vaccine type that you originally received or you can get a different vaccine type for your booster.  Individuals 5 to 17 years of age are only eligible to receive the Pfizer vaccine as their booster. 

There are no specific occupations, living conditions or medical conditions that make someone eligible for a booster shot. Please talk with your medical provider if you have any questions about your eligibility.

 

What is the guidance for a Second Booster Shot?

People 12 and older who are moderately or severely immunocompromised can get a second booster shot at least 4 months after their first booster shot. People 12 to 17 years of age can get the Pfizer BioNTech COVID-19 vaccine and people 18 and older can get the Pfizer BioNTech or Moderna COVID-19 vaccine.     

People 50 and older can get a second booster shot of a mRNA COVID-19 vaccine (Pfizer BioNTech or Moderna) at least 4 months after their first booster shot. The older you are and the more chronic diseases you have, the more you should consider getting a second booster shot.

Those who received a primary vaccine and booster shot of Johnson & Johnson at least 4 months ago can also receive a second booster shot using an mRNA COVID-19 vaccine (Pfizer BioNTech or Moderna).

 

How was the decision to approve First and Second Booster Shots made?

Studies show after getting vaccinated against COVID-19, protection decreases over time and may also be decreased due to changes in circulating variants. Evidence also suggests some waning of protection overtime against serious outcomes from COVID-19 in older and immunocompromised individuals.       

CDC provides recommendations in real-time on how to keep you best protected against SARS-CoV-2. Current surveillance data from the United States demonstrate that it is critically important for people to remain up to date with CDC’s vaccine recommendations. CDC will continue to follow the evidence related to vaccine effectiveness and safety, waning immunity and protection against variants and will keep recommendations current on how to stay up to date with your COVID-19 vaccines.

 

Are Booster Shots safe?

Since Moderna and Pfizer initially submitted safety and effectiveness data on a single booster dose following primary vaccination to the FDA, additional real-world data have become available on the recently increasing number of cases of COVID-19 in the U.S. and on the risk of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the outer lining of the heart) following vaccination with these vaccines. These additional data enabled the FDA to reassess the benefits and risks of the use of these vaccines in people ages 5 and above.  

The FDA has determined that the benefits of a single booster dose of either the Moderna or Pfizer vaccines outweigh the risks in individuals age 5 years of age and older when used following completion of primary vaccination to provide continued protection against COVID-19 and the associated serious consequences that can occur including hospitalization and death.

Both Pfizer and Moderna are conducting post-authorization/post-marketing studies to assess known serious risks of myocarditis and pericarditis. In addition, the FDA and CDC have several systems in place to continually monitor COVID-19 vaccine safety and allow for the rapid detection and investigation of potential safety concerns.

The Food and Drug Administration (FDA) has determined that the known and potential benefits of a second COVID-19 vaccine booster shot outweigh their known and potential risks. This decision was based on safety and immune response data that was submitted from other countries and independently conducted studies as well as additional information on effectiveness submitted by the companies.

 

If we need additional Booster Shots, does that mean that the vaccines aren’t working?

No. COVID-19 vaccines are working well to prevent severe illness, hospitalization, and death, even against variants. However, public health experts are starting to see waningprotection, especially among certain populations, against mild and moderate disease. Booster shots will help provide continued protection against severe disease in the populations who are especially at risk.    

What are the risks to getting Booster Shots?

For many who completed their primary series with the Pfizer or Moderna vaccine, the benefits of getting booster shots outweigh the known and potential risks. So far, reactions reported after getting a booster shot were similar to that of the two-dose or single-dose initial series. Fever, headache, fatigue and pain at the injection site were the most commonly reported side effects, and overall, most side effects were mild to moderate. However, as with the two-dose or single-dose initial series, serious side effects are rare, but may occur.

 

Does this change the definition of “fully vaccinated” for those eligible for Booster Shots?

People are still considered fully vaccinated two weeks after their second dose in a two-dose primary series, such as the Pfizer or Moderna vaccines, or two weeks after a single-dose vaccine, such as the Johnson & Johnson vaccine. Getting booster doses are not included in this definition.

 

What does it mean to be up-to-date on COVID-19 vaccinations? 

The CDC recommends that people remain up-to-date with their vaccines, which includes additional doses for individuals who are immunocompromised or booster doses at regular time points. Getting a second booster shot is not necessary to be considered up to date at this time.  Ensure you are optimally protected against COVID-19 by getting vaccinated and staying up to date with booster shots.

 

Does the COVID-19 vaccine cause infertility?

COVID-19 vaccination is recommended for everyone ages 5 and older, including those trying to get pregnant now or might become pregnant in the future, as well as their partners.

Professional medical organizations serving people of reproductive age, including adolescents, emphasize that there is no evidence that COVID-19 vaccination causes a loss of fertility. These organizations also recommend COVID-19 vaccination for people who may consider getting pregnant in the future.

Professional societies for male reproduction recommend that men who want to have babies in the future be offered COVID-19 vaccination. There is no evidence that vaccines, including COVID-19 vaccines, cause male fertility problems. 

 

Will people need to show a doctor’s note/prescription or other documentation?

Individuals don’t need a note or prescription to get any booster shots. You just need to self-attest and receive a shot wherever vaccines are offered. This will help ensure there are not additional barriers to access for these select populations receiving their booster shot.

 

Do I need to be a citizen of the United States or a resident of Anne Arundel County or Maryland to be eligible to receive the COVID-19 vaccine?

No one will ask for proof of citizenship or residency at any Anne Arundel County Department of Health COVID-19 vaccine clinic.

 

Do I have to pay for any Booster Shots or a Third Dose?

No, COVID-19 vaccines are free for everyone who is eligible, regardless of insurance or immigration status.

 

Can I go anywhere for my Booster Shots?

Yes. You can go to any provider that has COVID-19 vaccine as long as it is after the CDC recommended time interval for the first booster shot (5 months) or the second booster shot (4 months) and you are in one of the approved age groups.

You do not need to go back to the place where you received your first two doses of the series or a single dose initial series. To find a vaccination provider near you, please visit, https://coronavirus.maryland.gov/pages/vaccine. For a list of Anne Arundel County Department of Health booster clinics, please visit AACounty.org/covidvax.

 

Am I still able to get a first dose or second dose of the COVID-19 vaccine?

Vaccination is the leading public health prevention strategy to end the COVID-19 pandemic and continues to be our priority. The Anne Arundel County Department of Health, pharmacies and doctor’s offices still have many opportunities for you to get vaccinated. Please visit, https://www.aacounty.org/covidvax or http://staging.aahealth.org/vaccine-locations to schedule your first or second dose today! 

 

Can I get my COVID-19 vaccine and my flu shot at the same time?

Yes! Currently the CDC and ACIP recommend that if a person is eligible, both influenza and COVID-19 vaccines can be administered at the same visit, without regard to timing. If you have concerns about getting both vaccines at the same time, speak with a health care provider. 

 

General Prevention Recommendations for COVID-19

The most effective steps individuals can take to reduce the spread of the COVID-19 virus, including variants, include: 

  • Getting vaccinated and staying up-to-date on vaccinations. Vaccines are safe, free and effective.
  • Having at-home tests to use any time you have symptoms, regardless of vaccination status, and isolating if positive.  
  • Continuing to wear a mask in indoor public settings for those who are not fully vaccinated or are in close contact with people at a higher risk of severe disease.  
  • Visit your doctor or go to an urgent care center as soon as you become positive, especially if you are at a higher risk for severe disease. Treatment is most effective within the first 5 days of symptoms. 
  • Frequently and thoroughly wash your hands with soap and water for 20 seconds or use alcohol-based hand sanitizer containing at least 60% alcohol.
  • Avoid touching your eyes, nose and mouth.
  • Practice proper respiratory etiquette, including coughing and sneezing into the back of your elbow or into a tissue. Immediately throw away the tissue and wash your hands.

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