explainer

Should I Get a COVID-19 Booster Shot?

Photo: Saul Martinez/Bloomberg via Getty Images

The holiday season is fast approaching, and while COVID-19 vaccines mean we can now travel and gather indoors somewhat safely, health officials are still concerned the uptick in Thanksgiving and end-of-year activity will cause a repeat of last year’s massive holiday-driven spike in infections. With that in mind, experts (including Dr. Anthony Fauci) have said booster shots will be an essential tool to help keep numbers under control throughout the holidays. After months of confusion about who should be getting booster shots, the FDA on Friday approved boosters of Pfizer-BioNTech and Moderna vaccines for all adults over the age of 18. The CDC is expected to follow suit and recommend a booster shot for anyone more than six months past their second dose, and the center’s advisory panel has already voted in favor. Here’s what we know so far.

Do I need a booster shot?

The CDC recommends that anyone over 18 who got the one-shot Johnson & Johnson vaccine get a booster two months after the first shot. As for Moderna and Pfizer-BioNTech, boosters had already been recommended for a few groups: adults over 65, long-term care residents over 18, and people over 50 with underlying medical conditions. Younger adults with underlying conditions and those who work in high-risk environments had also been eligible per the CDC. Before Friday’s announcement, 13 states and some smaller localities like New York City had already expanded booster eligibility to all adults.

And now it looks like we’re about to get new nationwide guidelines allowing anyone over 18 to get boosters of Pfizer or Moderna. The CDC’s independent advisory panel voted unanimously to recommend shots for anyone over 18. It’s not clear yet if the CDC will simply deem the general public eligible for boosters or outright recommend them. Regardless, assuming the final sign-off comes through from the CDC director, booster shots could be available as soon as this weekend.

When should I get one?

The CDC’s recommendation is expected to be that anyone who got their second dose more than six months ago should get a booster. Johnson & Johnson’s single-shot vaccine is eligible for a booster two months after the first shot.

Can I mix and match vaccines?

According to the FDA, yes. In October, the administration approved a plan that lets adults pick whether they want their booster to be Pfizer, Moderna, or Johnson & Johnson no matter what their original shot was. The plan is mainly to help make boosters more accessible — if your closest vaccine provider is only offering one type, you won’t have to go looking for one that matches your first dose — but some studies have found mixing vaccines creates a stronger immune response than multiple doses of the same vaccine.

Will the booster shots have any side effects?

So far, it seems the side effects from the booster shots are about the same as what people felt after first doses — mainly fatigue and soreness at the injection site.

Are boosters really going to help?

Fauci has been pushing for all adults to get booster shots throughout the past month, citing studies that have shown they dramatically increase individuals’ protection against hospitalization and death. There’s substantial evidence immunity diminishes in vaccine recipients of all ages, and though the vaccines initially seemed to be waning in infection prevention but holding up in preventing hospitalization and death, small upticks in hospitalizations of fully vaccinated coronavirus patients suggest boosters will be necessary not just to prevent infection but also to ensure breakthrough cases remain mild.

Some experts have their doubts that distributing boosters will do much to fortify our collective protection against COVID. One FDA regulator said that while boosters will help individuals keep themselves protected, the “greatest impact on a population level is still dependent on increasing vaccine uptake” (i.e., getting first shots in people’s arms). It’s proving more and more difficult to get Americans lined up for more shots: 85 percent of the adult population is eligible for boosters, but only 17 percent has actually gotten one. The main demographic seeking them out seems to be fully vaccinated white people with higher socioeconomic status and better access to medical care — the group least vulnerable to exposure, severe disease, hospitalization, and death. It seems the population mainly responsible for driving the spread of COVID is the 40 percent of Americans who are still unvaccinated.

Will we need booster shots forever?

No one knows! It’s possible the COVID vaccine could become like a flu shot, administered once or even twice a year — and it could be different each time depending on which variant health experts expect to see.

What We Know About COVID-19 Booster Shots