A patient receives his booster dose of the Pfizer-BioNTech COVID-19 vaccine...

A patient receives his booster dose of the Pfizer-BioNTech COVID-19 vaccine at a clinic in Southfield, Mich., on Aug. 24. Credit: Getty Images/Emily Elconin

The Centers for Disease Control and Prevention last week recommended a third shot of the Pfizer-BioNTech COVID-19 vaccine for seniors, those with underlying medical conditions and front-line workers who may be at higher risk of exposure to the virus because of their jobs.

The Biden administration initially sought to provide boosters for the general population, but the CDC panel’s recommendation curtailed that plan.

A third dose of the vaccine was already available to those with severely compromised immune systems.

With federal scientists continuing to study who should get a third shot — with the stakes extraordinarily high as the delta variant continues to surge — here are some pertinent questions about vaccine boosters:

So who is eligible for the vaccine and when can they receive it?

A CDC panel recommended that boosters of the Pfizer vaccine be offered to anyone 65 and older and those 18 and older who have underlying health problems such as heart ailments, chronic kidney and lung disease and diabetes.

CDC Director Dr. Rochelle Walensky also made a recommendation that the panel rejected — endorsing boosters for individuals who work or live in settings that increase their risk of developing severe COVID. They include health care workers, teachers and educational staff, police and firefighters, public transit, grocery store and correctional workers. Residents of nursing homes, prisons and homeless shelters are also eligible, the CDC said.

"In the group that is older … there is clinical evidence that those doubly vaccinated people are [still] at a higher risk of severe illness," said Dr. Aaron Glatt, chairman of medicine and chief of infectious diseases at Mount Sinai South Nassau hospital in Oceanside said earlier this month.

He added that while that risk is low, "there is benefit to getting the third dose in those subgroups."

The extra dose would be given once individuals are at least six months past their last Pfizer shot.

What if I don't fit on this list?

Healthy Americans under the age of 65 who do not work in high-risk settings are not yet eligible for a third shot.

The Biden administration announced last month a plan to dispense boosters to nearly everyone to shore up their protection but the Food and Drug Administration and CDC signed off on Pfizer boosters for a much narrower slice of the population than the White House envisioned.

Is there a risk to taking a third dose?

To date, reactions after receiving the Pfizer-BioNTech booster were similar to those of the two-shot primary series, according to the CDC. Fatigue and pain at the injection site were the most commonly reported side effects, and overall, most side effects were mild, officials said.

If a booster shot is needed, does that mean that the vaccines aren’t working?

No. Data continues to show that the COVID-19 vaccines are working effectively to prevent severe illness, hospitalization, and death, according to federal data. However, public health experts said protection can wane over time, especially among certain populations, against mild and moderate disease.

What about boosters to the Moderna and Johnson & Johnson vaccines?

At this time, the booster authorization only applies to people whose primary series was Pfizer-BioNTech vaccine.

But those in recommended groups who got the Moderna or Johnson & Johnson vaccines will likely need a booster shot, federal officials said, once approved by the FDA.

Moderna's application to the FDA wasn't completed until earlier this month and is still under review. Data on boosters for Johnson & Johnson's single-dose vaccine may not be available for a few more months, officials said.

The government has no data on whether it is safe or effective to mix-and-match brands and give those took the Moderna or Johnson & Johnson booster a Pfizer shot.

A third dose of either the Pfizer or Moderna vaccine was previously available to members of the public with severely compromised immune systems due to underlying medical issues, such as cancer, HIV, stem cell or organ transplant recipients, and those who did not develop significant antibodies after the initial doses.

For those individuals, a third shot has been recommended about 28 days after the second vaccine dose.


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