A Second COVID-19 Booster Shot: The Latest

A second booster dose of the COVID-19 vaccine has been approved by the FDA as needed for certain populations.

Mar. 29, 2022 5   min read

Health experts agree the best current form of protection against COVID-19 is to be fully vaccinated – either with a single dose of the Johnson & Johnson vaccine or two doses of the Pfizer-BioNTech or Moderna vaccine – and receive a booster dose of a COVID-19 vaccine five months later.

In January 2022, the CDC issued guidance allowing all individuals ages 12 and older to receive a booster dose of the COVID-19 vaccine five months after their initial vaccination series.

Following research conducted over the last few months, the FDA announced a second booster dose of the Pfizer-BioNTech and Moderna COVID-19 vaccines has been approved for use for individuals ages 50 and older at least four months after their initial booster dose.

Emil Lesho, DO, an infectious disease specialist with Rochester Regional Health, speaks to the latest guidance.

Purpose of a booster shot

A booster shot, as its name suggests, gives a boost to the immune system and helps it continue protecting the body against infection.

Healthcare providers administer a shot as an additional dose of a vaccine. There are several booster shots currently recommended by the Centers for Disease Control and Prevention, including the tetanus, diphtheria, and pertussis (Tdap) vaccine. Experts recommend adults get this particular booster shot every 10 years.

Booster shots are also administered for tetanus, pertussis, polio, COVID-19, and other diseases.

“For decades, vaccination against severe disease has required booster doses or multi-stage doses,” Dr. Lesho said. “The concept of booster doses to increase an individual’s immunity to a specific disease over time is not new. We continue to work to protect the health of our community in the safest ways possible.”

Recent research

In recent weeks, two of the mRNA vaccine manufacturers – Pfizer and Moderna – submitted data to the U.S. Food and Drug Administration (FDA) requesting that their vaccines be approved for a fourth dose.

On March 29, 2022, the FDA authorized a second booster dose of either the Pfizer or Moderna vaccine for all individuals ages 50 or older. The second booster should be administered at least four months after the initial booster was given, according to the new guidance.

Both Pfizer and Moderna cited data in Israel and the U.S. as evidence in favor of approving a fourth booster dose of the COVID-19 vaccine. According to Pfizer, “rates of confirmed infections were 2 times lower and rates of severe illness were 4 times lower among individuals who received an additional booster dose” compared to those who only received one booster dose.

“The guidance issued by the FDA does not apply to everyone in the general public,” Dr. Lesho said. “Research is still being conducted as to the potential use of a second booster dose in other ages groups.”

Immunocompromised individuals

The newly-approved guidance updates emergency use authorization for Pfizer and Moderna to authorize a second booster shot for individuals ages 50 and older.

A fourth shot – or second booster dose – of mRNA vaccines is recommended for immunocompromised individuals ages 12 and older with the Pfizer vaccine and ages 18 and older with the Moderna vaccine. Some of these individuals include:

  • Those undergoing active cancer treatment for tumors or blood cancers
  • Stem cell transplant recipients – either within the last 2 years or currently on immunosuppressant medicines
  • Organ transplant recipients taking immunosuppressant medicines
  • Patients with moderate or severe primary immunodeficiency
  • Patients with advanced or untreated HIV infection
  • Those currently being treated with high-dose corticosteroids or other drugs that may suppress your immune response 
  • Those on medications for bowel conditions such as Krohn’s disease or ulcerative colitis

Where to find a booster shot

Booster doses of the COVID-19 vaccine are widely available.

Anyone who wants to obtain their COVID-19 vaccine – either for their initial vaccinations or a booster dose – can find them at primary care offices, pharmacies, and clinics run by local public health departments.

Those who received the Johnson & Johnson vaccine can receive doses of the Pfizer-BioNTech and Moderna COVID-19 vaccines as a booster. There is evidence that receiving the Johnson & Johnson vaccine first and a booster dose of either the Pfizer or Moderna vaccine second gives a broader protection than two shots of the Johnson & Johnson.

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