COVID-19 Vaccine Booster Dose: Who Should Get It? And How?

covid 19 vaccine booster dose

National healthcare leaders recently called for booster doses of the Pfizer-BioNTech COVID-19 vaccine for some individuals. Does that mean the vaccine isn’t doing its job?

Not at all, said Kristin Dascomb, MD, an Infectious Diseases physician and the Medical Director for Employee Health at Intermountain Healthcare. “We have full confidence that the vaccines work. If you look at the data, you’ll see that people who are vaccinated are significantly less likely to develop severe disease, be hospitalized, or die.”

Instead, the booster news demonstrates that with COVID, we’re still learning and adapting. Research has shown that the Pfizer vaccine may lose some of its effectiveness around six to eight months after a person is fully vaccinated, particularly among older and immunocompromised individuals. A booster dose will help extend effectiveness of the vaccine by reminding the immune system what it needs to do to protect the body.

Can I get a booster?

Research has shown that young and healthy people have excellent immunity months after vaccination. That’s why only certain groups are eligible for a booster dose right now. Individuals must have been vaccinated with the Pfizer vaccine at least six months ago and belong to one of the following groups:

  • Age 65 and older
  • Adults who live in high-risk settings, such as long-term care facilities
  • Adults who work in high-risk settings, such as first responders (healthcare workers, firefighters, police), education (teachers, school staff, daycare workers), food service, grocery stores, corrections industry, manufacturing and more
  • Age 50 and over with underlying medical conditions, or
  • Adults age 18-49 with underlying medical conditions who may choose to receive a booster dose after considering individual risks and benefits. People in this group may want to discuss the decision with their physician.

What's considered an underlying medical condition?

  • Cancer
  • Chronic kidney disease
  • Chronic lung diseases, including COPD (chronic obstructive pulmonary disease), asthma (moderate-to-severe), interstitial lung disease, cystic fibrosis, and pulmonary hypertension
  • Dementia or Alzheimer’s
  • Diabetes (type 1 or type 2)
  • Down syndrome
  • Heart conditions (such as heart failure, coronary artery disease, cardiomyopathies or hypertension)
  • HIV infection
  • Immunocompromised state (weakened immune system)
  • Liver disease
  • Obesity (BMI ≥30 kg/m)
  • Pregnancy
  • Sickle cell disease or thalassemia
  • Smoking, current or former
  • Solid organ or blood stem cell transplant
  • Stroke or cerebrovascular disease, which affects blood flow to the brain
  • Substance use disorders

How can I get a booster shot?

Eligible individuals can get a booster shot anywhere the Pfizer vaccine is being offered to the public. The website will allow you to search for locations that have Pfizer. Some locations may allow walk-in visits, but others will require an appointment. Remember to take your vaccination card with you so you can show that you have received the Pfizer vaccine. Boosters will be given based on the honor system, so no need to provide a note from your doctor to prove you have an underlying medical condition.

What if I've lost my vaccination card?

If you’ve lost your card, contact the provider who gave you your COVID vaccine for help. They can check their records. Utah also provides easy access to personal or family immunization records through the Docket mobile phone app. To get started, download the free app by searching “Docket” in the App Store or on Google Play.

What should I expect from side effects?

The Centers for Disease Control and Prevention (CDC) says people who have received a booster shot report side effects similar to what they experienced after their first two shots. The most common side effects after a booster are fatigue and pain at the injection site and overall. Most side effects were mild to moderate; serious side effects are rare. Contact your physician if the redness or tenderness where you got the shot gets worse after 24 hours or if your side effects are worrying you or do not seem to be going away after a few days.

I want a booster shot but I got a different vaccine. Can I mix and match my vaccines?

“Not at this time,” said Dr. Dascomb. “We’ll get data on the Moderna and Johnson & Johnson vaccines shortly. Just hold tight and wait.” In the meantime, remember that all the vaccines are proving to be very effective at keeping people out of the hospital.

I usually get a flu shot this time of year. Can I get my booster at the same time?

The CDC says yes and recommends that all of us get the flu vaccine by the end of October, even if we’re not eligible for the COVID-19 booster.

Will COVID-19 become like the flu, and require annual vaccinations?

No one has a crystal ball. We may need to develop vaccines that are customized to different variants of the virus, said Dr. Dascomb. Or we may need to get boosters, just as we do with the tetanus shot.

I'm not in an eligible group. Should I be worried that my vaccine will stop working?

Dr. Dascomb doesn’t want us to worry. Data from across the country show that the vaccines are doing a remarkable job of preventing severe disease, hospitalization, and death. Recent figures from the Utah Department of Health show that unvaccinated Utahns had 6.4 times greater risk of getting COVID-19, 7.3 times the risk of being hospitalized, and 5.9 times the risk of dying than people who are vaccinated.

“COVID-19 is an ever-changing situation, but the available vaccines are working,” she said.