A healthy living blog from Marshfield Clinic Health System

COVID-19 vaccine boosters: What you need to know

Editor’s note: This article is subject to change based on Centers for Disease Control and Prevention (CDC) recommendations.

person showing her COVID-19 booster shot

Will I need a booster shot? Research has shown that more doses of the COVID-19 vaccine can improve a person’s response to their initial vaccine series.

Will I need a booster shot? It’s been a question circling even before the Emergency Use Authorization was given for the initial series of COVID-19 vaccines.

Research has shown that protection against the virus from the COVID-19 vaccines can wane and may not be as effective against COVID-19 variants. However, additional research has shown that more doses of the COVID-19 vaccine can improve a person’s response to their initial vaccine series.

For this reason, the Centers for Disease Control and Prevention (CDC) recommends individuals 5 years and older receive a bivalent booster dose.

Bivalent and monovalent COVID-19 booster shot

Bivalent booster doses should be administered two months after the primary COVID-19 vaccine series or at least two months from monovalent booster dose.

In September 2022, updated bivalent boosters became available. The updated (bivalent) booster shots are called “bivalent” because they protect against both the original virus that causes COVID-19 and the Omicron variant BA.4 and BA.5, according to CDC. Previous booster shots are called “monovalent” because they were designed to protect against the original virus that causes COVID-19. However, CDC states that “they also provide some protection against Omicron, but not as much as the updated (bivalent) boosters.”

Individuals 6 years and older may choose which mRNA bivalent booster vaccine they receive. The Moderna bivalent booster is available for people age 6 and older, and the Pfizer bivalent booster is available for people age 5 and older.

“Some people may have a preference for the vaccine type that they originally received and others may prefer to get a different booster,” said Penny Funk, clinical quality nurse specialist at Marshfield Clinic Health System. “This type of mix and match dosing for booster shots is allowed for 6 years and older.”

People who are immunosuppressed

CDC recommends individuals 5 years and older who are moderately to severely immunocompromised should receive an additional primary dose of mRNA COVID-19 vaccine 28 days after the completion of the initial series.

People who are immunocompromised should also receive an mRNA bivalent booster two months after completion of their three-dose primary series.

This includes people who have:

  • Been receiving active cancer treatment for tumors or cancers of the blood.
  • Received an organ transplant and are taking medicine to suppress the immune system.
  • Received a stem cell transplant within the last two years or are taking medicine to suppress the immune system.
  • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome).
  • Advanced or untreated HIV infection.
  • Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response.

Note: You can self-attest to your moderately or severely immunocompromised status, which means you do not need any documentation of your status in order to receive COVID-19 vaccine doses you might be eligible to receive.

CDC recommends the additional primary dose of an mRNA COVID-19 vaccine be administered at least four weeks after the second dose. However, if it has been a longer span of time since you received your two-dose series, it’s still important to schedule the third dose as soon as you can.

“In my discussions with patients who are on immunosuppressant drugs, I emphasize that their response to the COVID-19 vaccine might be blunted as their immune system is suppressed,” said Dr. Thomas Bartow, rheumatology physician with Marshfield Clinic Health System. “A third dose soon seems prudent to help ensure they are protected from COVID-19.”

Dr. Bartow also recommends discussing with your provider the timing of the COVID-19 vaccine and your medication to improve the response. In August 2022, the American College of Rheumatology published guidelines to assist providers and patients in that discussion.

You should talk to your primary or specialty care provider about your medical condition, any questions you have and whether getting an additional dose is appropriate for your health. If you qualify, you can schedule an additional dose with Marshfield Clinic Health System at marshfieldclinic.org/CovidVaccine.

At this time, there is not enough data to determine whether immunocompromised people who received the Janssen (Johnson & Johnson) COVID-19 vaccine also have an improved antibody response with an additional dose.

COVID-19 doses recommendations

CDC recommends everyone stay up to date with COVID-19 vaccines for their age group. Review these resources when scheduling your COVID-19 vaccine or booster shots.

COVID-19 vaccine and booster shot recommendations may be updated as CDC continues to monitor the latest COVID-19 data.

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