Answers to Your Questions About Covid Booster Shots

This week, the Food and Drug Administration authorized Pfizer-BioNTech Covid vaccine booster shots for certain older Americans and those considered at high risk for complications from Covid-19. Here are answers to some of your questions.

The F.D.A. authorized booster shots for a select group of people who received their second dose of the Pfizer-BioNTech vaccine at least six months ago. Eligible people include Pfizer recipients who are over 65 or who live in long-term care facilities. The agency also authorized boosters for adults who were at high risk of severe Covid-19 because of an underlying medical condition.

A scientific committee for the Centers for Disease Control and Prevention has recommended a third dose for people over 50 with underlying medical concerns, but it said that people 18 to 49 with at-risk conditions should make decisions based on their individual risk.

People with weakened immune systems who received the Pfizer or Moderna vaccines also are eligible for a third shot at least four weeks after their second dose. For these patients, the third shot is not really a booster dose, but is now part of the recommended immunization schedule for those with compromised immune systems who don’t generate a robust response after just two shots. About 3 percent of Americans are in this group for a variety of reasons, including those who received an organ transplant.

Regulators have not made additional recommendations about booster shots for recipients of the Moderna and Johnson & Johnson vaccines, but officials say those may come soon. The Moderna vaccine uses similar technology as the Pfizer vaccine, and the company has applied for F.D.A. authorization of booster shots. The Johnson & Johnson vaccine is given as a single dose and uses a different method to stimulate antibodies to the virus. The company has not submitted an application for boosters to the F.D.A., but it has reported that two doses of its vaccine delivered 94 percent efficacy against mild to severe Covid-19 in the United States, up from 74 percent conferred with a single shot.

The C.D.C. has said the risk of complications from Covid-19 is highest for people with high blood pressure, diabetes, obesity, cancer, chronic lung or kidney disease, heart disease, dementia and certain disabilities. You can find a complete list here, although the agency may offer additional guidance in the coming days.

The category of immunocompromised people who are eligible for a third Pfizer or Moderna shot (technically not a booster dose) includes people who are undergoing cancer treatment; those who have received an organ or stem cell transplant and are taking medicine to suppress the immune system; people with primary immunodeficiency, or advanced or untreated H.I.V. infection; or people taking high-dose corticosteroids or other drugs that suppress the immune response.

Although the F.D.A. authorized booster doses for health care workers, emergency responders, teachers and others whose jobs put them at high risk of exposure, the C.D.C. panel did not support the recommendation. A final decision on recommendations about occupational risk and eligibility for boosters is expected to come from Dr. Rochelle Walensky, the C.D.C. director. Stay tuned.

Dr. Walensky this week is expected to endorse the recommendations of the agency’s scientific advisers, and people who meet the criteria could start getting the shots immediately afterward. Health departments, pharmacies and doctors’ offices will dispense boosters much the same way that they administered the first and second doses. Call ahead to find out about scheduling, and bring your vaccine card. Proof of an underlying medical condition won’t be required, but you may want to discuss the risks and benefits with your doctor.

You will be able to find more information about getting a booster shot in the coming days on your state’s health department website or pharmacy websites. People who are immune compromised also can talk to their physicians about the best way to get a third shot. Since the F.D.A. fully approved the Pfizer-BioNTech vaccine as a two-dose regimen last month, physicians have had broad latitude to prescribe a third dose to people they deemed in need of one.

While people who are severely immune compromised can get a third shot sooner, everyone else who qualifies should wait until at least six months after their second shots. In addition to a lack of safety data, getting a booster too soon is probably a waste of a dose and may not increase your antibodies in a meaningful way.

While the Biden administration has said it supported booster shots for everyone who is eight months post-vaccination, the plan has been rejected by F.D.A. scientists. But the recommendation could change in the coming weeks or months as more data becomes available on the durability of vaccine antibodies over time. The good news is that the consensus in the scientific community is that all the vaccines continue to provide strong protection against severe illness, hospitalization and death from Covid-19.

While data are limited, so far reactions reported after the third mRNA dose from Pfizer or Moderna were similar to that of the two-dose series: fatigue and pain at the injection site were the most commonly reported side effects, and, overall, most symptoms were mild to moderate, the C.D.C. says. A survey from Israel, where booster shots already are being given, found that 88 percent of Pfizer vaccine recipients said that in the days after the third dose, they felt “similar or better” to how they felt after the second shot. About a third of respondents reported some side effects, with the most common being soreness at the injection site. About 0.4 percent said they had difficulty breathing, and 1 percent said they sought medical treatment because of one or more side effects.

It’s not recommended. For now, Pfizer vaccine recipients are advised to get a Pfizer booster shot, and Moderna and Johnson & Johnson recipients should wait until booster doses are approved for their manufacturer’s vaccine.

Some people who have received the Johnson & Johnson vaccine are seeking a Pfizer booster shot on their own. San Francisco health officials have said that they will accommodate these requests as long as people consult with their doctors first.

Read more:
A C.D.C. Panel Recommends Booster Shots for Many Americans

This week, I answered a reader question about how much protection you get from a mask when nobody around you is wearing one. I was surprised to learn how a simple folding, knotting and tucking method can improve the efficiency of a surgical mask. One C.D.C. study found that a standard surgical mask protected the wearer from only about 7.5 percent of the particles generated by a simulated cough. But knotting the loops and tucking in the sides of the medical mask reduced exposure by nearly 65 percent. Covering the surgical mask with a cloth mask, a technique known as double masking, reduced exposure to the simulated cough particles by 83 percent.

Watch the video to see the “knot and tuck” method:
How to Double Mask Correctly

If you’ve been having trouble sleeping, try these four simple exercises to soothe your body, calm your mind and — hopefully — ease you into slumber. We’ve illustrated each exercise, which include the yoga poses “cat/cow” and child’s pose, as well as two exercises called “thread the needle” and a low lunge.

Move your way into sleep:
Four Light Exercises to Help You Sleep

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Stay well!

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