Tips to Live By

How Do You Know If You Need a COVID-19 Booster Shot?

Oct. 14, 2022 - Katie McCallum

You're not alone if you have some COVID booster questions. How effective is the updated booster against omicron? Are my kids eligible?

There's also still the lingering question you may have of whether you and your family really need more doses or not...

Dr. H. Dirk Sostman, chief academic officer of Houston Methodist, is here to answer common questions you may have about getting a booster dose.

Are booster shots necessary?

A booster is an additional dose of vaccine that can help prolong protective immunity when there's evidence that protection via the initial vaccine series declines after some time.

"In essence, it's a 'top-up' of a person's antibody-mediated immune response," says Dr. Sostman. "Circulating antibodies are the first line of defense against getting infected or becoming ill if you are infected." 

And with the omicron variant now making up the vast majority of cases, updated boosters — ones specifically designed to increase immunity to the currently-circulating variant — are being recommended to help reduce symptom severity and the chance of severe disease.

They come at the perfect time, as some experts are predicting that another wave of COVID-19 could hit hard this upcoming fall and winter.

(Related: How Effective Is the Updated Booster Against Omicron? & 5 More Questions, Answered)

Who is eligible for the omicron-specific booster?

Everyone 5+ is eligible for the updated COVID-19 booster, but when exactly someone is eligible and for which updated booster vaccine can vary by age and whether you've recently been vaccinated or had COVID-19.

COVID Booster Eligibility:

Everyone 18+

Adults 18+ are eligible* for either the Pfizer or Moderna bivalent COVID-19 booster vaccine, both of which are specifically designed to increase immunity to the currently-circulating omicron variant.

*The FDA and CDC have stated that people are only eligible after at least two months have passed since completion of primary or booster vaccination. Additionally, they recommend that people recently infected with COVID-19 wait at least three months post-infection before being vaccinated with the booster.

(Related: How Effective Is the Updated Booster Against Omicron? & 5 More Questions, Answered)

Use the CDC's COVID booster tool to determine if and when you are due for a booster shot.

Teens ages 12 to 17

Teens ages 12 to 17 are eligible* for a booster dose of either the Pfizer or Moderna bivalent COVID-19 booster vaccine, both of which are specifically designed to increase immunity to the currently-circulating omicron variant.

*The FDA and CDC have stated that people are only eligible after at least two months have passed since completion of primary or booster vaccination. Additionally, they recommend that people recently infected with COVID-19 wait at least three months post-infection before being vaccinated with the booster.

(Related: How Effective Is the Updated Booster Against Omicron? & 5 More Questions, Answered)

Use the CDC's COVID booster tool to determine if and when you or your teen are due for a booster shot.

Kids Ages 5 to 11

Kids ages 5+ are eligible* for a booster dose specifically designed to increase immunity to the currently-circulating omicron variant.

  • Kids 5+ can receive the Pfizer bivalent COVID-19 booster vaccine
  • Kids 6+ can receive either the Pfizer or Moderna bivalent COVID-19 booster vaccine

*The FDA and CDC have stated that people are only eligible after at least two months have passed since completion of primary or booster vaccination. Additionally, they recommend that people recently infected with COVID-19 wait at least three months post-infection before being vaccinated with the booster.

(Related: How Effective Is the Updated Booster Against Omicron? & 5 More Questions, Answered)

Use the CDC's COVID booster tool to determine if and when your child is due for a booster shot.

Young Children Under the Age of 5 Aren't Yet Eligible for a Booster

Young children between the ages of 6 months to 4 years aren't yet eligible for the Pfizer or Moderna bivalent boosters that target the omicron variant.

They are, however, eligible for the primary vaccination series with either Pfizer or Moderna. (Related: 5 Questions About COVID-19 Vaccines for Young Children, Answered)

Use the CDC's COVID vaccine tool to determine which vaccine your child is eligible for.

If you don't meet these criteria, you may still be able to get a booster shot via a doctor-prescribed dose.

Because both vaccines are fully approved by the FDA, your doctor can choose to prescribe another dose of either of these vaccines as a booster, based on his or her best judgment for off-label prescribing. 

How do you know if you actually need a booster? Do your antibody levels matter?

"If you're eligible for a booster but aren't convinced you need another dose, consult your doctor. He or she can help you make a decision based on your individual benefits and risks of getting an additional dose," adds Dr. Sostman.

One such way your doctor may choose to help make this decision is to check your antibody levels, also called antibody titers. There are many components to immunity, and antibodies are an important one — especially in the early stages of infection.

"COVID-19 vaccination elicits robust antibody production in most people, but the levels of these antibodies wane over time," explains Dr. Sostman. "If you're unsure whether you need a booster, your antibody titers can be one piece of information your doctor uses while counseling you on your decision. If your titers are very low, a booster shot may be recommended. However, we do not recommend routine use of titer measurements."

Can you mix and match vaccines during your booster?

The CDC states that, "people ages 6 years and older can get a different product for their updated (bivalent) booster than they received for their primary series or last booster."

This is based on evidence that the known and potential benefits of receiving a different vaccine as a booster dose outweigh the known and potential risks of mixing and matching.

Do you still need a booster if you've recently had COVID-19?

COVID-19 immunity is complicated, especially for those who have both natural immunity (from recent infection) and vaccine-induced immunity. Understanding how these two might work together and whether protection can be additive has yet to be answered.

"We know that having COVID-19 can elicit an increase in antibodies that protect you from re-infection with the virus, so there's likely some time in which natural immunity can act as a 'booster'," says Dr. Sostman.

He points out that we don't know how long this might last, though, so eventually you will still need the updated booster.

The FDA and CDC have recommended that people recently infected with COVID-19 should wait at least three months post-infection before being vaccinated with the omicron booster. However, individual factors such as risk of severe COVID-19 disease or community outbreaks should be taken into account when determining timing of booster vaccination after infection.

How do you actually get your COVID booster?

If you need a COVID-19 vaccine or booster, you can schedule an appointment with a primary care doctor near you or get vaccinated at a local pharmacy.

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