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If you've been patiently waiting for months to get your COVID booster shot or for your child to get theirs, get excited. The wait is over for people 12+ who received the Pfizer vaccine and adults who have received the other vaccines.
On Monday, January 3, the Food and Drug Administration expanded eligibility for the Pfizer-BioNTech COVID-19 booster shot to now include individuals ages 12-15 and certain immunocompromised children ages 5-11 (e.g. those who've undergone a solid organ transplant). That is, however, as long as it's been the recommended amount of time since they completed their initial vaccination — something that the FDA also recently updated. As of Monday, the organization shortened the time needed between the second Pfizer dose and the booster shot from six to five months. On Tuesday, the Centers for Disease Control and Prevention gave the green light for the reduced interval and on Wednesday, it endorsed the expanded booster eligibility for children ages 12-15 who received the Pfizer shot. That being said, people who received the two-dose Moderna vaccine should still wait at least six months after completing their vaccination to get a booster shot and those who originally got the Johnson & Johnson/Janssen inoculation, at least two months after their first shot.
"Throughout the pandemic, as the virus that causes COVID-19 has continuously evolved, the need for the FDA to quickly adapt has meant using the best available science to make informed decisions with the health and safety of the American public in mind," Acting FDA Commissioner Janet Woodcock, M.D., said in a statement. "With the current wave of the Omicron variant, it's critical that we continue to take effective, life-saving preventative measures such as primary vaccination and boosters, mask wearing and social distancing in order to effectively fight COVID-19." (Related: New Research Shows Pfizer's Booster Shot Helps Protect Against the Omicron Variant)
So why the expanded eligibility and reduced waiting period for the Pfizer booster? The FDA made these updates after reviewing "real-world data" from Israel on more than 6,300 people ages 12-15 who received a Pfizer booster shot at least five months following their second dose. The data — which showed there were no new cases of myocarditis or pericarditis (two types of heart inflammation) to date in these individuals — "enabled the FDA to reassess the benefits and risks of the use of a booster in the younger adolescent population in the setting of the current surge in COVID-19 cases," according to Monday's statement from the organization.
"In the setting of a tremendous number of Omicron and Delta cases in this country, the potential benefits of getting vaccinated in this age range outweigh that risk," Peter Marks, M.D., Ph.D., director of the Center for Biologics Evaluation and Research at the FDA, said during a press briefing on Monday, according to CNN.
And the same can be said (read: the pros of the shot far outweigh the risks of infection) for adults ages 18+ — a population that's been eligible to receive a COVID-19 booster shot, as long as they've waited the recommended number of months post-completion of their primary vaccination, since November 19, 2021.
Then on December 9, 2021, the CDC announced that all 16- and 17-year-olds are officially eligible for the boosters as well. At this time, they can only receive the Pfizer-BioNTech booster, because that's the only vaccine the CDC has approved for use in people under age 18. "Although we don't have all the answers on the Omicron variant, initial data suggests that COVID-19 boosters help broaden and strengthen the protection against Omicron and other variants," said Dr. Walensky in the December announcement.
Reminder: Some people were eligible for boosters even before this development. Specifically, adults age 18 and up who received the Johnson & Johnson COVID-19 vaccine at least two months ago were already eligible to get a booster shot as of late October. Certain populations — such as those age 65+ or at high risk of COVID-19 — were also previously approved for Moderna and Pfizer boosters. And some states, including Arkansas, Colorado, and Maine, had previously made boosters available to all adults even before the nationwide approval from the FDA and CDC. (FYI, authorities also recently said it's ok to "mix and match" boosters.)
How to Get Your COVID-19 Booster Shot and What to Expect
You can either schedule an appointment at the same place where you got your original vaccine, or you can go somewhere new to get your booster — either works. (Need help finding a vaccination location? Use the CDC's vaccine provider tool to find one.)
Some interesting news: You also have your pick of vaccines, too. "You may choose which COVID-19 vaccine you receive as a booster shot," according to the CDC's website. "Some people may prefer the vaccine type that they originally received, and others may prefer to get a different booster. CDC's recommendations now allow for this type of mix and match dosing for booster shots."
There's some evidence suggesting that using the "mix and match" approach — receiving a booster of a different vaccine than your original — may have advantages. A clinical trial led by the National Institute of Allergy and Infections Diseases is evaluating the mixing of COVID-19 vaccines in 450 patients and found that boosters from all three vaccines increased immune response "irrespective of the kind of booster or primary vaccines series used," according to the American Medical Association. The two mRNA vaccines (Pfizer-BioNTech and Moderna) seem to trigger stronger antibody responses than the J&J shot, but all boosters worked well in neutralizing Delta and Beta variants, according to the AMA.
No matter which booster you decide to get, be sure to bring your CDC Vaccination Record card to your booster appointment. (Also read: What to Do If You Lose Your COVID Vaccine Card)
Just like with the first round of vaccinations, you may experience some side effects from the COVID booster shot — namely, pain, redness, and swelling in the arm that got the shot; tiredness, headache, muscle pain, chills, fever, and nausea, according to the CDC. "Reactions reported after getting a booster shot were similar to those of the two-shot or single-dose primary series," according to the CDC. Side effects should resolve in a few days, but the CDC advises you to contact your doctor if they do not resolve within a few days, or "if the redness or tenderness where the shot was given gets worse after 24 hours."
Why You Should Get a COVID Booster Shot
Yes, getting vaccinated in the first place is a great move in protecting yourself and others from COVID-19. However, "there's no doubt that immunity wanes," said Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases, during a This Is Our Shot event on Wednesday, November 17. "It wanes in everyone. It's more dangerous for the elderly but it is across all age groups."
Dr. Fauci specifically referenced data from Israel, which started giving boosters to adults over the age of 60 in late July. Then, in August, the country extended boosters to those age 40 and up, along with people considered high risk for COVID-19 complications like pregnant people and teachers. That data found a third dose of the Pfizer-BioNTech vaccine prevents infections in adults over the age of 60 by 11.3 times more than those who didn't get a booster. Boosters also lowered the rate of severe illness by 19.5 times.
Several studies have also shown that the effectiveness of the vaccines drops over time. Pfizer has released data noting that their third dose restored vaccine protection against COVID-19 to 95.6 percent (previous data showed the vaccine's efficacy falls to about 77 percent after 120 days, while another showed decreases down to 47 percent over the course of six months after the second shot). Moderna has said its booster dose increases COVID-19 antibodies up to 44 times that of non-boosted previous levels (data showed it was 93 percent effective at preventing COVID-19 after 5.3 months).
"It's clear now that the vaccines' efficacy at preventing even mild infection is decreasing over time," says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. "And, in vulnerable individuals, a booster can help prevent more severe disease. By getting boosters, we will rectify this waning protection and get back to a level of protection we had with the first round of shots." Not to mention, "there is some data to show that the boosters also reduce [the number of] minor infections" of COVID-19, making it less likely that you'll contract a minor breakthrough infection compared to if you only have two shots, says William Schaffner, M.D., medical director of the National Foundation for Infectious Diseases. (Related: What Is a Breakthrough COVID-19 Infection?)
Dr. Russo urges people who aren't concerned about getting a "mild" case of COVID-19 to consider this: "'Mild COVID is defined as COVID that doesn't land you in the hospital. It can still be extraordinarily debilitating, and lingering symptoms can last for weeks and sometimes months. (Related: Half of COVID-19 Patients Experience Lingering Symptoms for Six Months, Says Study)
Doctors say it's difficult to tell what this will mean for COVID-19 vaccines going forward. "We shouldn't be surprised if we require a periodic booster the way we get our annual flu shot," says Dr. Schaffner. Dr. Russo, however, is hopeful that people may not need to get a COVID shot that often. "I think this is a three-shot vaccine at the end of the day," he says. "Unfortunately, we only got three to six months out of the first round, but I'm sure we'll get more time with the booster. Whether it will be a year or more, we just don't know yet."
In the meantime, the to-do is clear: Get vaxxed and get boosted.
The information in this story is accurate as of press time. As updates about coronavirus COVID-19 continue to evolve, it's possible that some information and recommendations in this story have changed since initial publication. We encourage you to check in regularly with resources such as the CDC, the WHO, and your local public health department for the most up-to-date data and recommendations.