October 27, 2021


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Americans can recieve COVID-19 booster shots in September. Who’s eligible and what to know

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Medical studies show vaccines still provide strong protection against the most serious effects of COVID-19, including variants. 

Sara Tew/CNET

For the most up-to-date news and information about the coronavirus pandemic, visit the WHO and CDC websites.

Saying “We have a responsibility to give all of you the maximum amount of protection,” President Joe Biden on Wednesday said a booster shot for the Pfizer and Moderna COVID-19 vaccines will become available for adults starting the week of Sept. 20. The recommendation for a booster follows recent studies that found the effectiveness of coronavirus vaccines begin waning around the six-month mark, with an increased risk of infection risk, US Surgeon General Vivek Murthy said earlier in the day. Under the plan, those who are eligible will be able get a booster shot eight months after they received their second dose. A booster shot would help shore up protection from the virus for those who are fully vaccinated as the delta variant takes hold across the country.

The US Food and Drug Administration is expected to authorize a third dose of the Moderna and Pfizer vaccines soon for those 18 and older (it has already authorized a third dose for some immunocompromised people). Murthy says those who were vaccinated early on will be eligible for the booster first, and priority will go to those most vulnerable, including health care workers, nursing home residents and seniors.

What does all this mean in the US? Read on for what we know about COVID-19 booster shots today, including why they’re needed, how they relate to breakthrough infections, and what the controversy has been surrounding third shots. We’ll be updating this as new information is released.

What is the Biden administration advising for coronavirus booster shots?

Health officials with the Biden administration on Wednesday recommended an additional shot for American adults who are fully vaccinated with the Pfizer and Moderna shots. The guidance follows reports from Israel that the protection the Pfizer vaccine provides may start to decrease after eight months. The administration recommends a booster vaccination eight months after becoming fully vaccinated, which for those who received their shots in January and February would be as early as mid-September. Booster vaccines are expected to be available the week of Sept. 20.

“The COVID-19 vaccines that are authorized in the United States have been remarkably effective, even against the widespread delta variant. But we know that even highly effective vaccines become less effective over time,” Murthy said. “Recent data makes clear that protection against mild and moderate disease has decreased over time. This is likely due to both waning immunity and the strength of the widespread delta variant.”

“We believe that that third dose will ultimately be needed to provide the fullest and continual extent of protection that we think people need from the virus,” Murthy said Wednesday. “Our plan is to stay ahead of this virus by being prepared to offer COVID-19 booster shots to fully vaccinated adults 18 years and older.”

Will everyone who is fully vaccinated need a booster shot?

Right now, health and medical officials with the Biden administration recommend that adult Americans who are fully vaccinated with the Pfizer or Moderna vaccines get a third shot starting this fall. For instance, if you got your second shot Feb. 1, you could get your booster shot on Oct. 1. The administration officials are recommending booster shots for everyone 18 and over.

Murthy said the FDA will evaluate booster shots for those under 18 years of age, and the administration will follow FDA recommendations for minors.

Administration officials said they expect those who received the one-dose Johnson & Johnson vaccine will also need another jab, but since it didn’t receive approval (and thus start being administered) until March, more research is necessary. “We expect more data on J&J in the coming weeks,” Murthy said. “With that data in hand, we will keep the public informed with the timely plan for J&J booster shots.”

How will I get the booster shot?

The current one-dose vaccine shot from Johnson & Johnson and two-dose versions from Moderna and Pfizer are free to anyone who wants to get vaccinated. The COVID-19 booster shots will also be free, and no ID or insurance will be required, according to Jeff Zients, White House COVID-19 response coordinator.

“It will be just as easy and convenient to get a booster shot as it is to get a first shot today. We have enough vaccine supply for every American,” Zients said, adding that those who are eligible will be able to get a booster at roughly 80,000 places across the country, including over 40,000 local pharmacies. Zients said 90% of Americans have a vaccine site within five miles of where they live.

Are COVID-19 booster shots available now?

Some who already are eligible under guidelines from the Centers for Disease Control and Prevention can now go out and get their third dose of a COVID-19 vaccine. The list of immunocompromised people who can get a third shot includes solid organ transplant recipients or people who have an “equivalent level of immunocompromise” and who have a reduced ability to fight off infections, making them more vulnerable to the coronavirus. Booster authorization hasn’t been expanded more broadly to those with other chronic medical conditions yet.

The CDC recommendation is for an additional dose of the two-shot vaccine for certain immunocompromised people, which is a small group. Within that category, the recommendation is for those 18 and older for the Moderna vaccine, and 12 and older for the Pfizer vaccine. The FDA didn’t authorize an additional dose of the Johnson & Johnson vaccine, and because of a lack of data the CDC doesn’t recommend a second dose for immunocompromised people who got the one-shot vaccine at this time.

About 3% of US adults are immunocompromised, according to the CDC, but research suggests they account for about 44% of hospitalized breakthrough cases of COVID-19. Not only are they more likely to get very ill from COVID-19, they also have a lower antibody response to vaccines and are at a higher risk of transmitting the virus. 

Those with other conditions, like diabetes and heart disease, aren’t advised to get a booster, at least for now. Here’s a list of people the CDC recommends get an extra dose if they got the Pfizer or Moderna vaccine: 

  • Those with advanced or untreated HIV infection.
  • Cancer patients and transplant recipients who are taking certain immunosuppressive drugs.
  • Those receiving active cancer treatment for tumors or cancers of the blood.
  • Those with moderate or severe primary immunodeficiency. 
  • Patients being treated with high-dose corticosteroids or other drugs that may suppress immune response. 
  • People who received a stem cell transplant within the last two years and are taking certain drugs. The CDC says to talk to your medical provider about your health condition and whether a third shot is appropriate. 

If you’re unsure if you’re qualified, the CDC says to talk to your medical provider about your health condition and whether a third dose is appropriate. 

What’s behind the need for COVID-19 booster shots?

Calling the eradication of the COVID-19 virus “unlikely,” a UK scientific advisory group says (PDF) there’s a “realistic possibility” that a variant will emerge that is resistant to the current battery of vaccines. Governments, public health organizations and vaccine makers are all tracking developments in coronavirus variants like delta and lambda, hoping to determine if booster shots targeting new variants will be needed soon among the general population.

As of July, in the US, “breakthrough” coronavirus cases caused by the dominant delta variant amount to less than 1% of people who are fully vaccinated. Both the Moderna and Pfizer vaccines have proved to be more than 90% effective against hospitalizations and death. Nonetheless, a CDC study shows that vaccinated people can both contract the highly contagious delta variant and spread it. According to a widely reported internal CDC memo, the delta variant spreads as easily as chicken pox, which is considered more contagious than the flu but less contagious than measles

The surge in new COVID-19 cases is primarily affecting unvaccinated people and causing community spread, and in turn, prompting the return of mask mandates and guidance in hard-hit areas, even for people who have full vaccine protection. The debate over mask use and vaccine boosters underscores how scientists and other health experts continue to grapple with the uncertainties of COVID-19.

According to Murthy, “We are concerned that this pattern of decline we are seeing will continue in the months ahead, which could lead to reduced protection against severe disease, hospitalization and death.”

What’s the controversy over booster shots?

Israel is now administering third doses of the vaccine to those 50 and older, and the UK has similar plans for September. However, this is resulting in a backlash among countries that are struggling to deliver first and second shots to residents. 

World Health Organization Director-General Tedros Adhanom Ghebreyesus called for a “moratorium” on booster shots in high-income countries, citing the global disparity in vaccine distribution. Of the 4 billion doses administered globally, 80% have gone to high- and upper-middle income countries that make up less than half the world’s population, he said. 

“We cannot accept countries that have already used most of the global supply of vaccines using even more of it, while the world’s most vulnerable people remain unprotected. We call on vaccine producers to prioritize Covax,” Tedros said, referring to the world’s COVID-19 vaccine distribution program.

Psaki on Tuesday said the US will have enough vaccines to both provide boosters for those who are fully vaccinated in the US and meet the global demand. “We have long planned from enough supply,” she said

The US has so far shipped 115 million vaccine doses to 80 different countries, Zients said Wednesday. “Our wartime efforts will continue doing everything we can to get even more people vaccinated both here at home and around the world. We can and must do both at the same time because that’s what it’s going to take to end this pandemic,” he said.

What’s the difference between boosters and a new COVID-19 vaccine?

Moderna’s and Pfizer’s current two-dose vaccine provide effective protection against all known variants of COVID-19, including the delta variant, according to ongoing studies and self-reported statistics. But Pfizer announced in July that a third dose of its vaccine is currently under development. The company said its own research showed a booster shot of its current vaccine increased antibody levels five to 10 times higher over its two-dose shots, noting that its results haven’t been published or peer-reviewed. This week, Pfizer submitted data to the FDA to receive approval for a booster shot.

What’s happening with Johnson & Johnson boosters?

At this time, the FDA and CDC haven’t extended the authorization and recommendation for an additional dose to the Johnson & Johnson vaccine, citing insufficient data. Administration officials said they anticipate a second dose will be needed.

Residents in San Francisco who received Johnson & Johnson’s one-dose COVID-19 vaccine were given the green light to get a supplemental dose of an mRNA vaccine, though it still isn’t recommended by the city’s health department. Dr. Grant Colfax, San Francisco’s health director, said there isn’t conclusive evidence that getting a dose of Pfizer or Moderna benefits those who got the J&J shot, but there’s also no evidence to show it’s harmful, the San Francisco Chronicle reported. “If people received the Johnson & Johnson and are requesting a second shot, we will accommodate them, but our policy has not changed,” Colfax said.

San Francisco’s decision to legitimize Johnson & Johnson vaccine recipients getting an mRNA vaccine comes in light of a small study that suggests the vaccine isn’t nearly as effective against the delta variant as the other vaccines. (Another study suggests that Johnson & Johnson remains effective, and the drug-maker continues to assert that the vaccine is effective.) 

Biden press conference

The Biden administration says booster shots would be free.

Screenshot by Corinne Reichert/CNET

Is it OK to mix and match COVID-19 vaccines?

According to a New York Time story , administration officials will recommend people get a booster for the same vaccine they originally received.

The CDC now says a third dose of a different vaccine brand is permitted if a dose of the same type isn’t available.

Other global health agencies and countries are testing administered vaccines from two different manufacturers. In the UK, for example, a recent study found that those who received a first dose of the AstraZeneca vaccine and a second of Pfizer had a higher immune response than those who received two doses of the AstraZeneca vaccine.

While we watch how the situation develops, here’s what we know about the delta variant, more about COVID-19 boosters and info on whether you need to continue to wear a mask.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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