COVID Booster Shots: What Are They and Who Is Eligible to Get Them?

·7 min read

My immune system isn’t as strong as other people’s because of my history of radiation for cancer treatment. I hang out with my young niece and nephew almost every day, and without fail, I get sick whenever one of them has a cold. So I was immensely relieved when I reached full inoculation after the first two doses of the COVID-19 vaccine. But after breakthrough cases started rising this summer, my anxiety increased, even though fully vaccinated people rarely get sick enough to end up in the hospital or have seriously adverse outcomes.

In my reporting, I’ve talked to COVID long-haulers who have debilitating brain fog or extreme exhaustion. A few weeks ago, in a panic, I texted one of my best friends who is also chronically ill. Was she as worried about catching the Delta variant as I was? How could we put additional symptoms on our already long lists? “I cannot handle any more brain fog on top of the brain fog I have,” I said. “Yeah,” she agreed. “I don’t know, realistically, if I can take another bout of being sick from something new.”

As of August 13, the Centers for Disease Control and Prevention (CDC) recommended that people who are “moderately to severely immunocompromised” get a booster shot of the COVID-19 vaccine at least four weeks after they receive their second dose. The Biden administration has said it would recommend a third shot for the general population eight months after a second dose, but that guidance still needs to be approved by the FDA and officially recommended by the CDC, both of which are tasked with reviewing somewhat limited data on the vaccine’s effectiveness over time.

Given my health history and eligibility for a third shot, I jumped into action and secured an appointment for August 22. Getting an appointment for the booster was starkly different than getting an appointment for the original shot. The first time, I spent hours combing through the websites of different pharmacies to find an open appointment. For the booster, I casually chose a Sunday afternoon after looking through my options for five minutes.

Still, I felt more anxious leading up to my booster than I did with the two original shots. It’s hard to pinpoint the source of my anxiety: Part of it was shame that I needed a booster shot in the first place (hi, ableism); part was that I only knew one other person who had gotten the booster; and part was worry over how my body would react. That anxiety wasn’t soothed when I showed up for my booster and the pharmacist said she didn’t know what to tell me to expect because I was the first person she had ever given the booster to.

After years of chronic illness, I don’t flinch at needles, so the actual vaccination was easy. I waited in the pharmacy for the required 15 minutes to assess possible side effects, and then went home. By the time I went to sleep on Sunday night, I felt overly lethargic and a little achy. I slept fitfully. I’d pull on a sweatshirt because I felt cold, then strip it off with all my blankets because I felt hot. I woke up in the morning feeling like I was experiencing the beginning of a flu, symptoms which are par for the course with COVID vaccinations. My body was still achy, my head hurt, and the chills I had through the night persisted. 

I worked for a few hours, then fell headfirst into a three-hour nap. When I woke up, my flulike symptoms were slightly worse. Fortunately, my sister had made her famous homemade chicken noodle soup, which was the only thing I ate that day and the next. I went to sleep early on Monday night, and when I woke up on Tuesday I felt better. The body aches and chills had subsided. All that was left was a vaguely hungover feeling — I was tired and my head hurt but I could function. By Tuesday afternoon, I felt almost back to normal. By Wednesday, except for slight soreness where I’d received the shot, I didn’t feel a thing.

To answer your own questions about the booster shot, Teen Vogue speaks with Arizona-based pharmacist Sarina Dhaliwal, PharmD, and Purvi Parikh, an allergy and infectious disease doctor at New York University’s Langone Hospital.

What is a booster vaccine?

Currently, the available booster vaccine is simply another dose of the COVID vaccine. The purpose of the booster is to strengthen the immune system’s response to the virus and keep you safer. “The booster is given to maintain or boost the immune system response to the virus,” Dhaliwal says. “Boosters are very common,” she says, pointing out that certain other vaccines that are initially given in childhood may also require booster shots.

Who is recommended to get the booster shot and when?

As of now, only immunocompromised people are eligible for the booster shot. The White House recently announced a recommendation for the general population to get booster shots eight months after a second shot, starting in late September (and was considering shortening that timeline to five months), but FDA approval for third doses for non-immunocompromised individuals is still pending and seems to be contentious. 

Two senior FDA officials are set to leave the agency; according to The New York Times's sources, one reason for their departure is that they are “upset about the Biden administration’s recent announcement that American adults should get a coronavirus booster vaccination eight months after they received their second shot.” Neither of the officials believe there is enough data to justify the decision and they feel that the announcement is putting undue pressure on the FDA. 

While there does appear to be conflict regarding a recommendation for booster shots for the general population, the CDC is clear in its recommendation that moderately and severely immunocompromised people should get booster shots.

Does a booster mean the vaccines aren’t effective?

Not at all. “The vaccine is still extremely effective at preventing death and hospitalizations and severe infections,” Parikh says. “The idea is to get ahead of potential for future waning immunity in light of the variants.”

Parikh notes that unvaccinated people make up the vast majority of COVID hospitalizations and deaths occurring in the U.S. And as Teen Vogue has previously reported, the percentage of breakthrough cases in vaccinated people will increase as vaccination rates rise, but that isn’t cause for alarm. 

“It is clear that [the vaccine] will help keep you out of the hospital and ICU,” Parikh says.

Can we expect a need for additional booster shots in the future?

This discussion is ongoing in the medical community. The need for a booster shot for members of the general population has already led to disagreement among disease scientists, but even if an initial booster is approved, could there be a need for more? 

“It all depends on how successful we are at getting people fully vaccinated and minimizing overall infections as well as variants,” Parikh explains. “The variants are our biggest concern in vaccine immunity.” 

Another conversation is underway about whether wealthy nations should be giving people booster shots when many people in poorer countries haven’t even received their first shot yet.

Both Parikh and Dhaliwal stress that everyone should get vaccinated and follow the latest medical guidance. Dhaliwal wonders how the pandemic response would be different if high school or college required a course on public health. In her own public health 101 class, she recalls she was taught about pandemics, vaccines, and community health. She says, “It’s imperative for kids to learn about public health before they can even vote because this should not be a political problem.” 

Want more from Teen Vogue? Check this out: 8 Popular Myths About the COVID-19 Vaccine, Debunked

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Originally Appeared on Teen Vogue