Editor’s note: This article is subject to change based on Centers for Disease Control and Prevention (CDC) recommendations.
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.
Received Moderna 2 shots series, then Moderna booster, then caught covid. How many more boosters do you suggest?
Hi William, Here are the latest recommendations from the CDC: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html . If you have further questions, please ask your provider for the proper booster vaccination for your situation. -Thanks, Jordan
I am a 78 year old healthy female and have had four Pfizer shots so far. Does it matter which provider I get next, either Pfizer or Moderna?
Hi Marge, Here are the latest recommendations from the CDC: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html . If you have further questions, please ask your provider for the proper booster vaccination for your situation. -Thanks, Jordan
If you received the monoclonal infusion for Covid is there a waiting period before you can get the booster? (Besides the 5-month post vaccination).
Hello Heidi,
If you received monoclonal infusion, you should wait 90 days at least to get a COVID-19 booster shot, according to the Centers for Disease Control and Prevention (CDC).
Thanks,
Jake
I had my second shot of Moderna last March. I'm 82 and obese. I had a very strong reaction with a fever of 102 for 3 days and then extreme fatigue for 4 more days. I finally talked myself into the booster last Monday. It was the Pfizer booster and once again I'm dealing with a fever of 101.5 and fatigue and aching now on Thursday. Why am i having such a strong, terrible reaction?
Hi Karen,
Every person is different, so there may be many different reasons why you are having these side effects from the vaccine. However, side effects after vaccination are a normal sign that your body is building protection. If the side effects are worrying or do not seem to be going away after a few days, you should contact your doctor or health care provider.
Here is a helpful resource from the CDC that provides ways to relieve side effects: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html.
If you haven’t already, we also encourage you to enroll in v-safe: https://vsafe.cdc.gov/en/. V-safe allows you to share how you feel after COVID-19 vaccination using your smartphone. V-safe uses text messaging and web surveys to provide personalized health check-ins after COVID-19 vaccination.
Thank you,
Jake
If someone received the J & J vaccine in April, is it recommended to stay with the same vaccine or will the Pfizer or Moderna vaccine be more effective?
Hi Dawn,
You can get any of the COVID-19 vaccines if you received the Janssen (Johnson & Johnson) COVID-19 vaccine at least two months ago. There is no recommendation at this time saying which vaccine is more or less effective for the booster dose.
Thank you,
Jake
I over 65, received my Moderna vaccines in February and March, had Covid in early October, and had about 1/3 of the monoclonal antibody treatment before I had an adverse reaction, after which the treatment was stopped. How long do i have to wait before getting the Moderna booster?
Hi Aileen,
Due to the complicated nature of your question, we strongly recommend you talk to your provider. If you have a Marshfield Clinic Health System, you can find contact information for him or her by clicking here: https://www.marshfieldclinic.org/doctors.
Thank you,
Jake
Do you have Moderna boosters? I see in the news that it was approved.
Hi Midge,
At this time, we are working on updating internal systems to make sure patients are provided booster doses according to CDC recommendations. We anticipate starting to schedule Moderna boosters soon. We appreciate your patience while we get this right.
If you are interested in receiving the Moderna booster, please complete this form to be called and emailed once we begin scheduling these booster appointments: https://www.marshfieldclinic.org/MedicalSpecialties/Pages/COVID19-Vaccine-Survey.aspx.
Thank you,
Jake
Do you have to get the third vaccination the same place as the others were
given
Hi Henrietta,
No, you do not need to get your third vaccination at the same location.
Thanks,
Jake
I received both doses of the Pfizer vaccine last March. Will I be contacted to set up an appointment for the booster shot or do I need to do that?
Hi Sandy,
We are not able to contact patients that are due for their booster dose of the Pfizer vaccine, so you will need to do that. We apologize for this inconvenience.
Thanks,
Jake
I am at 80 years old with no underlying health conditions nor am I immuno suppressed. I received both Moderna shots in February/March. I will be interested to get the information as to when I can receive my booster shot of Moderna
Hello Pat,
The FDA will begin discussions about Moderna booster doses on Oct. 14. From there, it will depend on what the recommendations are from the FDA and CDC to determine who is eligible. Please stay tuned for more information as it becomes available.
jimalfonso400@gmail.com
Very interesting article.
Hi Carol,
We're glad to hear you found the article helpful. Thank you for sharing.
Hope you have a great day,
Jake
I am taking prednisone for Polymyalgia rheumatic and I also have Hashimoto Thyroiditis and want to know if I can get a booster immunization ?
Thank you for your question Barbara.
We are unable to provide medical advice on this platform. Please ask your primary or specialty care provider if you should receive the additional dose of the COVID-19 vaccine. Your health care provider knows your health history and will be able to give the best recommendations.
Thanks,
Jake