Who Is Eligible for a COVID Booster? Here’s What to Know About the New Advice on Vaccines

The shots will be free and available eight months after your second vaccine dose, if the plan is approved.

A COVID-19 booster shot may be in your not-too-distant future. That’s right: Fully vaccinated Americans may be eligible for an extra dose in the coming months, US government officials announced on Wednesday.

But before you sprint to your physician’s office or local pharmacy, there are some things you ought to keep in mind. Additional reviews and approvals are needed before booster doses can be widely administered to millions of eligible Americans.

As of right now, the government is preparing to offer booster shots beginning the week of September 20—and even then, you’ll still have to wait your turn. People will be eligible for those extra doses eight months after the date they received their second shot.

So what does it all means for you and your family? And what if you had the one-dose Johnson & Johnson/Janssen (J&J) vaccine? Here’s what the nation’s top doctors are saying about the plan for booster shots.

What does the announcement on COVID-19 booster shots really mean?

Health officials have long acknowledged there might be a point in the pandemic at which boosters would be needed. That point hadn’t arrived—until now, apparently. Even a week before the August 18 announcement, health officials were insisting that there was no need for the general public to receive additional doses. Most fully vaccinated individuals are “adequately protected and do not need an additional dose of COVID-19 vaccine at this time,” Janet Woodcock, MD, acting commissioner of the US Food and Drug Administration, said in a statement dated August 12.

So what changed? New data on how the vaccine is holding up against infections, both in the US and in other countries, prompted the decision to pull the trigger on booster doses, members of the White House COVID-19 Response Team explained during a press briefing on Wednesday.

“Even though our vaccines are currently working well to prevent hospitalizations, we are seeing concerning evidence of waning vaccine effectiveness over time—and against the Delta variant,” Rochelle Walensky, MD, director of the US Centers for Disease Control and Prevention (CDC), told reporters.

For example, Dr. Walensky cited preliminary data though August 6 from two vaccine effectiveness studies. The studies, which include more than 4,000 heath care personnel, first responders, and other frontline workers in eight locations across the country, show waning effectiveness against both symptomatic and asymptomatic infection in the context of the Delta variant, from 92% prior to Delta to 64% with Delta, she said.

Data from other countries, including Israel, further suggest that people who were vaccinated early may be at increased risk of severe disease, she noted.

“Given this body of evidence, we are concerned that the current strong protection against severe infection, hospitalization, and death could decrease in the months ahead, especially among those who are at higher risk or who were vaccinated earlier during the phases of our vaccination rollout,” Dr. Walensky said.

She said the plan for booster doses is meant to maximize protection and stay ahead of the virus.

Who can get a booster dose—and how soon?

A few things need to happen before most Americans can begin receiving their third dose.

First, the FDA must review the safety and effectiveness of giving a third dose of a Moderna or Pfizer vaccine to people who are already had their two doses. If the FDA were to grant emergency use of a third dose, then the CDC’s Advisory Committee on Immunization Practices (ACIP) would conduct its own review of the evidence, and it would make a recommendation for or against booster doses.

Pending those approvals, additional doses of the two mRNA vaccines would be made available to fully vaccinated people ages 18 and older, beginning the week of September 20.

However, eligibility for a booster would depend on when you received your second mRNA shot.

“The plan is for the rule to be simple: Get your booster shot eight months after you got your second shot,” Jeffrey Zients, White House COVID-19 Response Coordinator, told reporters. “So if you got your second shot on February 1st, you can get a booster starting on October 1st.  If you got your second shot on March 12th, you can get your booster starting on November 12th, and so on.”

That means people who were among the very first Americans eligible for the two-shot Moderna and Pfizer vaccines, including health care providers, nursing home residents, and other seniors, would likely be eligible right away. Third shots would be delivered directly to residents of long-term care facilities, health officials said.

According to Zients, there’s enough vaccine for every American, and it will be widely available. “And importantly,” he said, “vaccines will be free, regardless of immigration or health insurance status: no ID or insurance required.” Just remember to bring proof of your second shot.

Will you be eligible for a booster if you got the J&J vaccine?

Health officials recognize that people who got the one-dose J&J vaccine will likely need a booster too. But remember, the J&J vaccines weren’t available in the US until March 2021. So the evidence on immunity over time is limited compared with the mRNA vaccines.

With more data anticipated in the next few weeks, stay tuned for decisions about booster doses for those who received the J&J vaccine.

Aren’t some people already getting extra doses?

Indeed, they are. Just last week, the CDC recommended an additional dose of vaccine for people who are moderately or severely immunocompromised and considered at greater risk of serious illness from COVID-19.

So, if you’re among the 3% of the US population that fits that description, you’re free to go get your shot. The reason is that people who have weakened immune systems don’t always build the same robust response to the vaccine as others. That extra dose is meant to ensure that they get as much protection as possible.

By contrast, the plan for booster shots targets folks who likely developed antibodies to the SARS-CoV-2 virus with vaccination but who may experience waning immunity over time.

That’s what health officials are hoping to guard against. “You want to stay ahead of the virus,” said Anthony Fauci, MD, chief medical adviser to President Biden on COVID-19, said during Wednesday’s briefing. “You don’t want to find yourself behind playing catch-up.”

What about people who are unvaccinated?

This new suggestion for booster doses in fully vaccinated people doesn’t change the guidance currently in place for unvaccinated people—and that’s to get the COVID vaccine ASAP.

According to the latest data on COVID in the US, rising cases are concentrated in areas with lower vaccination rates, Zients said. “We know getting more people vaccinated it the best way to end this pandemic,” he said.

It’s also “the best way to protect ourselves from new variants that could arise,” Biden said on Wednesday. “So all those of you who are unvaccinated, please get vaccinated for yourself and for your loved ones, your neighborhood, and for your community.”

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