Research

With Omicron on the Rise, Experts Answer COVID Booster Questions

Nov. 24, 2021

Update

January 5, 2022: The Pfizer/BioNTech COVID booster is now authorized for adolescents 12 to 15 years old and is now recommended to be given five months after completion of the primary vaccine series, instead of six. The Centers for Disease Control and Prevention also recommends a third dose of the Pfizer/BioNTech COVID vaccine for some immunocompromised children ages 5-11.

Learn more on the CDC website.


Thanks to a recent decision from the U.S. Food and Drug Administration, all U.S. adults are now eligible for COVID vaccine boosters. On Friday, November 19, the FDA authorized use of Moderna and Pfizer/BioNTech COVID vaccine boosters for anyone 18 and older. That decision was closely followed by support from the Centers for Disease Control and Prevention. But what does this mean for you?

Our experts, who have been deeply involved in testing COVID vaccines and boosters, answer your questions below.

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Angela Branche, M.D.

Associate professor of Infectious Diseases and co-director of the Vaccine and Treatment Evaluation Unit at URMC

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Ann Regina Falsey, M.D.

Professor of Infectious Diseases and co-director of the Vaccine and Treatment Evaluation Unit at URMC

Who can get a COVID booster?

(updated January 5, 2022)

Branche: The CDC updated its guidance on COVID boosters on January 5, 2022 due to broader FDA authorization of the Pfizer/BioNTech COVID booster. They now recommend that anyone 12 and older get a COVID booster - either five months after completing the Moderna or Pfizer primary COVID vaccine series or two months after getting the Johnson & Johnson shot. The Pfizer/BioNTech or Moderna COVID boosters are preferred, but the Johnson & Johnson booster may be considered in some situations.

Should I get a COVID booster if I’m pregnant?

Falsey: If it has been more than six months since your original vaccination, boosting during pregnancy is very reasonable. Pregnant people who get COVID can become seriously ill which can be bad for both you and your baby. Boosting your antibodies during pregnancy should lead to better protection of your baby after it is born and will boost levels of helpful antibodies in your breast milk.

If you get a COVID vaccine primary series or booster while pregnant or just after delivery, you may also be eligible to participate in a COVID Vaccine Pregnancy study through the University of Rochester Medical Center. The study will track your immune response to the booster, as well as your baby’s. Sign up to participate.

Which booster should I get? Should it be the same as my original COVID vaccine?

(updated January 5, 2022)

Branche: The FDA and the CDC approved a mix-and-match approach to COVID vaccine boosters, but the CDC now recommends the Moderna or Pfizer/BioNTech boosters for anyone 18 or older and the Pfizer/BioNTech for anyone 12 or older. The Johnson & Johnson booster may be considered in certain situations.

Should I wait to get a new booster targeting the Omicron variant?

(updated January 5, 2022)

Falsey: No, don’t wait. Get vaccinated or boosted as soon as possible. While we still need more data, preliminary information suggests that mRNA vaccines may provide protection from the Omicron variant – particularly after a booster dose.

How long should I wait to get a booster after recovering from a COVID infection?

Branche: While vaccination remains effective, a small percentage of vaccinated people may experience breakthrough infections. These cases are largely mild and rarely require hospitalization. Vaccinated individuals who recover from a breakthrough infection are expected to have high levels of circulating antibodies that are likely to be broadly protective for several months. These individuals would therefore likely not require a booster for three to six months after they have recovered, though it would be safe to obtain a booster dose as early as two weeks after full resolution of symptoms.

What are the COVID booster side effects?

Falsey: The side effects of the boosters are very similar to those associated with the original shots. Side effects such as myocarditis (inflammation of the heart) remain very rare for both the primary series and boosters of the mRNA vaccines produced by Moderna and Pfizer/BioNTech. And it’s important to note: You are much more likely to develop myocarditis in response to a COVID infection than to the vaccines.

If I need a booster, does that mean the COVID vaccines aren’t working?

Falsey: While it is true that immunity from vaccines has waned over time, the efficacy for severe disease remains very high. The overwhelming majority of people hospitalized and dying from COVID are unvaccinated. Though we are seeing infections among people who are vaccinated, most of those so-called breakthrough infections are mild to moderate upper respiratory or flu-like illness.

When am I considered fully vaccinated?

Falsey: You are considered fully vaccinated about two weeks after receiving two doses of the mRNA COVID vaccines (Moderna or Pfizer/BioNTech), or two weeks after a single Johnson & Johnson shot. Boosting, while a good idea for many, is not required to be considered fully vaccinated.

Can I stop wearing a mask in public once I’m boosted?

Branche: COVID transmission is still very high in our region and many other parts of the country. While being fully vaccinated is very effective at preventing severe illness and death and boosters are about 90 percent effective at preventing symptomatic infection, there is a small possibility of having a mild or asymptomatic infection. To reduce transmission and protect the vulnerable, you should continue to wear a mask in public indoor settings – especially in areas with high COVID transmission.

Is this the last COVID vaccine dose I will need?

Branche: Scientists around the world are working to answer this important question. The best tool we have to end the pandemic is vaccination. Until we get the vast majority of the world vaccinated, it is likely that transmission will continue with intermittent surges, which, along with the emergence of new variants of concern, will determine if and when another booster dose is needed.

Get Boosted

UR Medicine patients can schedule a COVID booster appointment by logging into their MyChart account and following the “Appointments and Visits” process. You can also find COVID vaccine and booster clinics near you on the Finger Lakes COVID-19 Vaccine Hub website or this resource page from the CDC. If you have difficulty locating a place to get a booster, contact your primary care provider who will be able to further direct you.