On December 9, the Centers for Disease Control and Prevention (CDC) recommended booster shots against COVID – 18 for the youth of 16 and 17 years who received their second dose of the vaccine at least six months ago. In a statement, CDC Director Dr. Rochelle Walensky said that “initial data suggests that boosters of COVID – 19 help to extend and strengthen protection against Ómicron and other variants. ”
This extends the agency’s previous reinforcement recommendations, which only applied to people from 18 years or more. Booster vaccines are now widely available to anyone who received their second dose of the Pfizer-BioNTech or Moderna vaccine at least six months ago and to those who received a Johnson & Johnson vaccine at least two months ago.
Adults can receive any vaccine as a booster, regardless of the vaccine they originally received, a strategy known as “mix and match”. Currently only the Pfizer-BioNTech vaccine is licensed for youth of 16 and 17 years.
“Vaccines against COVID – 19 have proven to be the best and most effective defense against COVID – 19, ”said Dr. Janet Woodcock, Acting Commissioner of the Food and Drug Administration (FDA), in a statement in November. Authorizing the boosters “helps provide continued protection against COVID – 19, including the serious consequences that can occur, such as hospitalization and death. ”
Before the boosters were authorized, Pfizer-BioNTech and Moderna published results indicating that the protection these vaccines offer against infection decreased over time. But the data also showed that those vaccines still appear to offer excellent protection against serious illness, hospitalization, and death.
The data appear to indicate that booster vaccines are safe and effective, and that they may help protect people who are susceptible to serious illness, based on an analysis of the evidence conducted by the FDA. Initial research indicates that boosters significantly increase the levels of protective antibodies against the Omicron variant which has spread rapidly around the world and has raised the urgency to administer booster doses as soon as possible.
To help end the confusion , Consumer Reports spoke with experts and examined the data to better understand what we know about booster doses, who should get them, and the reason for the debate in the scientific community.
Who is eligible to receive a booster?
Now that the health authorities have expanded the eligibility of the booster to those who have 16 years of age or older and received mRNA vaccines (Moderna or Pfizer-BioNTech) at least 6 months prior or Johnson & Johnson vaccine at at least two months prior are eligible.
Initially, the CDC recommended that those who were 50 years or older and received an mRNA vaccine at least 6 months earlier should get the booster. People between 18 and 49 years could choose to get the reinforcement. The agency had previously said that anyone who received the Johnson & Johnson vaccine at least two months prior should get the booster.
But after Ómicron was identified, a new variant with a high potential for spread globally, the CDC expanded the booster recommendations on 29 November, saying that people older than 18 years should receive a dose. On December 9, the agency further expanded that recommendation, allowing people of 16 years in Go ahead and choose to get a booster.
Anyone who is vaccinated and immunocompromised has been eligible for a booster shot since August. This includes people who take immunosuppressive medications after an organ transplant, as well as people who have a similar level of impaired immune system, one that has prevented their immune system from generating sufficient protection after the first two injections. Research indicates that for people who have received an organ transplant, a third dose can safely and significantly raise levels of protective antibodies. These populations are eligible for a third dose four weeks after their second vaccination.
Until 20 December, about 60. 8 million people in the United States had received booster shots.
What is the evidence for the need for a booster?
Pfizer-BioNTech, Moderna and Johnson & Johnson have published data that helps to Explain why they say you would need a booster dose. Pfizer has also released very preliminary data suggesting that a booster vaccine may help boost protection against the Omicron variant.
In previous data that Pfizer and BioNTech submitted to the FDA, the companies cited a preliminary study by the healthcare company Kaiser Permanente, which found that vaccine efficacy against delta variant infections decreased from 93% one month after initial vaccination to 53% four or more months after vaccination. The efficacy against hospitalization remained at 93%. The evidence presented by Pfizer indicated a particular concern about decreased immunity in older people.
The 15 September, Moderna published data showing that people who were immunized with that vaccine between December 2020 and March 2020 were 36% less likely to develop an infection in vaccinated than those who were immunized between July and October 2020. The company said that this apparent decrease in protection against infection supported the use of a booster dose. But he also said the vaccine was still approximately 95% effective in preventing COVID hospitalization – 19.
In its submission to the FDA to request the authorization of a booster dose, Johnson & Johnson noted that, although its vaccine was still very effective against the most severe cases of COVID – 19 (resulting in hospitalization or death), its efficacy against COVID – 18 moderate to severe, which was less than that of mRNA vaccines from baseline, had decreased over time, due to reduced protection against variants of the coronavirus. During the FDA advisory committee meeting to discuss Johnson & Johnson booster vaccines, experts from the FDA and CDC noted that the lower level of protection for people who had only received one dose of Johnson & Johnson caused them to the booster was especially important for this group.
Ómicron has also changed the calculation of booster vaccines. Although researchers are still studying the extent to which the variant evades vaccination protection, it seems much more likely that it will at least cause infection in vaccinated people compared to many earlier variants, although vaccinated people may still be protected against serious diseases. But now that Ómicron is the dominant strain of the virus in the United States, public health authorities have repeatedly urged everyone who is eligible to receive a booster vaccine to receive it.
Do booster doses improve immunity?
According to a study published October 7 in the New England Journal of Medicine, a booster dose for people in Israel who were 60 years or older who had been fully vaccinated at least five months previously significantly reduced the risk of any infection or serious illness.
The data presented by Pfizer to the FDA also indicated that a booster dose significantly increased the antibody levels, a partial measure of the body’s immune response. Data from Moderna showed a significant increase in antibody levels with a booster of their vaccine, and data from Johnson & Johnson showed the same for a booster of their vaccine.
Are there additional risks with a booster dose?
Data presented during the FDA and CDC meetings on booster doses showed that side effects were similar to those with the second dose of an mRNA vaccine.
Still, other rare risks could arise, such as myocarditis (inflammation of the heart) that some people experienced after their second dose of an mRNA vaccine when millions more receive their booster shots in the coming months.
So far, FDA-evaluated data indicates that the benefits of a booster dose outweigh the risks of develop myocarditis, which has been extremely rare and usually resolved in a short time, according to the ag
Should I get the same vaccine as the first time?
That depends on you. “Eligible individuals can decide which vaccine they receive as a booster dose,” the CDC statement said. “Some people may have a preference for the type of vaccine they originally received and others may prefer to receive a different booster.”
A study conducted by the National Institutes of Health indicates that a booster from Moderna or Pfizer can raise the antibody levels of Johnson & Johnson receptors much more than a Johnson & Johnson booster. This investigation is still preliminary; we are studying which boosters may offer the greatest protection to recipients of the Johnson & Johnson, Moderna and Pfizer vaccines.
Please note that the Moderna booster dose is different from that of the first vaccines : 50 micrograms instead of 100. Therefore, if you are to receive a booster dose of Moderna, you should make it clear to the provider that you do not want one of the initial vaccines. Pfizer and Johnson & Johnson doses have not changed for booster doses.
Where can I get a booster shot?
They are being administered in the same places where coronavirus vaccines are available, including hospitals, pharmacies, doctors’ offices and clinics. You don’t need to get the booster shot where you received the first one, but remember to bring your vaccination card. Check with your state department of health or visit vaccines.gov to find a location near you.
Are booster dose formulas being changed to accommodate to the new variants?
The doses of the booster vaccine that are being administered so far have the same formula as the doses of the initial vaccine.
But companies are working on versions of their vaccines that can target new variants, if necessary, says Dr. Gregory Poland, director of the Vaccine Research Group at the Mayo Clinic in Rochester, Minnesota. Modifying mRNA vaccines for another specific strain is a relatively quick process. What is not clear at this time, he says, is how the FDA will regulate these modified vaccines, whether it will treat them as new products (whose approval or authorization could take a long time), or as annual flu vaccines (whose approval would be much longer.
Pfizer and BioNTech and Moderna say they are investigating the need for an Omicron-specific booster and are preparing to test and manufacture one if necessary.
Will we need boosters forever?
In the future, we may need a regular booster against coronavirus like we do against the flu, says Dr. Joshua Barocas, associate professor of medicine from the University of Colorado School of Medicine, which specializes in infectious diseases.
But whether that’s the case depends on how well we control the ongoing pandemic, says Dr. Anna Durbin , director of the Center for Research on Immunizations and professor in the department of international health at the Johns Hopkins Bloomber School of Public Health. The best way to ensure that we do not need them soon or regularly is to prevent the spread of the disease, and the best way to do that is to vaccinate the unvaccinated, both in the United States and around the world. The more unvaccinated people, the more likely new variants will emerge.
Are there reasons to delay booster doses?
On 13 September, a group of vaccine researchers, including Two senior officials who recently announced plans to resign from the FDA’s Office of Vaccine Research and Review published an article in The Lancet medical journal stating that, for the time being, protection against any infection appears to be waning , protection against serious illness and hospitalization appears to remain strong. Because of that, the authors wrote that the limited supply of available vaccines should be used primarily to vaccinate the unvaccinated around the world.
“Even if some benefit may ultimately be obtained from the booster, it will not outweigh the benefits of providing initial protection to the unvaccinated,” they wrote.
For the same reason, the World Health Organization has asked rich countries not to distribute booster vaccines until at least the end of this year.
Consumer Reports is an independent, nonprofit organization that works side by side with consumers to create a fairer, safer, and healthier world. CR does not endorse products or services, and does not accept advertising. Copyright © 2020, Consumer Reports, Inc.
Consumer Reports does not have any financial relationship with advertisers on this site. Consumer Reports is an independent nonprofit organization that works with consumers to create a just, safe, and healthy world. CR does not endorse products or services and does not accept advertising. Copyright © 2021, Consumer Reports, Inc.