Which booster shot do I need to get? do you need it? :shot

Millions of Americans can now opt for additional defensive shots against COVID-19, regardless of the initial vaccine they receive.

Booster shot criteria depend on age, work, place of residence, and underlying health. In most cases, you will have to wait up to 6 months after the first two shots. In addition, the booster shot does not have to match the first vaccine you had.

When organizing maze-like information (ideally coordinated with your doctor), keep in mind that vaccines available in the United States are very effective, even without boosters.

“”Those who have undergone primary immunization need to understand that whatever it is, they have a very high level of protection against death, hospitalization and severe illness. ” Dr. Gregory Poland, Director of the Mayo Clinic Vaccine Research Group.

Messed up? Answer the quiz Determine if you need it now.

And read more about the science of boosters, and about ongoing discussions.

Many people now have boosters available, but who really needs them most?

People over the age of 65, people between the ages of 50 and 64 with certain basic health conditions, and Nursing care settings Like nursing homes, they all have an increased risk of being infected with COVID-19. The Centers for Disease Control and Prevention states that all these groups of people who were first vaccinated with the Moderna or Pfizer vaccine should receive booster immunization 6 months after the first series.

For people over the age of 18 who have taken only one Johnson & Johnson shot, the CDC also recommends taking a second shot two months after the first shot. Studies show that this can increase significantly It enhances your protection and is comparable to the levels found in two shots of the mRNA vaccine.

People with immunodeficiency You also need to get additional shots, Because the data often show that they do not get an effective immune response. However, this is not a very “booster”. It’s just getting them to the baseline.

Apart from these groups, he says, it’s a closer call on who needs to take shots. Dr. David Daudi, Johns Hopkins Bloomberg Infectious Disease Epidemiologist at the Graduate School of Public Health. “For the vast majority of people, there is no urgency to get this booster in a hurry,” he says.

People living in certain collective environments, such as homeless shelters and prisons, and High risk setting, Medical facilities, schools, grocery stores, etc. may also be at high risk for COVID-19. This also applies to people between the ages of 18 and 49 who have certain basic health conditions.

However, the CDC guidance is not very powerful for these groups. You have the option of getting a booster, but whether you get a booster depends on how far the virus has spread, whether other safety measures have been taken, the underlying health condition, and your personal risk. It depends on the feeling. ..

If you feel the risk is very high, go ahead and get a booster, Daudi advises. However, there is also debate about postponing it. Additional protection from boosters may help you at some point in the future when the infection is rising in your community. “”I myself fall into this category and I’m not going to get booster shots in a hurry, “he says.

Is the vaccine really exhausted over time? How much do I need to worry about?

Studies in other countries, such as the United States and Israel, show that the protection provided by vaccines has weakened slightly over time, especially as the rapidly transmitting delta mutants circulate. However, this does not cause an alarm. The most dramatic decline is associated with the ability of vaccines to block asymptomatic or mild breakthrough infections — for example, the CDC. Research on frontline workers It was found that the effectiveness of the vaccine in infection prevention decreased from 91% (time before delta) to 66% after Delta became dominant.

Fortunately, “there are few reports of serious illness, hospitalization, or death,” he said. Dial the huletInfectious Disease Specialist, Westchester County Health Department, Westchester, NY

In general, vaccines are still very defensive against hospitalizations of all ages. NS CDC study published in late September Comparing the actual efficacy of all three vaccines in hospitalization prevention, Moderna was 93%, Pfizer was 88%, and J & J was 71%.

However, among the elderly, the effect appears to be slightly diminished. How much remains an open debate, it depends on the vaccine.Moderna vaccine shows only “Mild decrease” in vaccine efficacy For hospitalization of people over 65 years old.that is Similar photo For Pfizer, some studies have shown that it may be slightly lower than Moderna.

The Johnson & Johnson vaccine started with less efficacy for hospitalization than either of the two mRNA vaccines, Not clear yet Whether that protection is waning like the other two.

When considering the slight decline in vaccine protection, he says, keep the situation in mind. Jonathan Golob, An infectious disease specialist at the University of Michigan. “Vaccines remain good for older people, with the only exception being people with severe immunodeficiency,” he says.

Is it a good idea to get a different vaccine than the one I got for the first time?

There are different ways of thinking about this “mix and match” strategy. Some Americans may find it attractive for a variety of reasons, but so far the data is very limited.

The good news is that switching to another vaccine looks very safe, says Mayo Clinic Poland. “This is a great social and scientific advance to enable people to mix and match,” he says.

That’s why Poland supports switching it. If you have bad side effects from the vaccine you got first, you can choose another one. Alternatively, it may be more convenient to get the first available one. If your supply is limited, you don’t have to worry about finding a particular vaccine. And finally, some early studies have shown that depending on the vaccine you used, you may be better protected.

This last reason may be especially true for the first person to get the J & J vaccine.Recently discovered research from the National Institutes of Health That follow-up J & J photographed with either the Moderna or Pfizer vaccine may produce a stronger immune response than a second dose of the J & J vaccine. Studies from Europe I support this conclusion.

“For me and my family, I would recommend the mRNA vaccine to anyone who has undergone J & J,” he says. Desicotis, Dean of the Faculty of Pharmaceutical Sciences, University of California, San Francisco.

When using Modana Shot, Pfizer boosters are small and can reduce side effects, but still provide a very strong immune response, Poland says. He will do this for boosters. People who have a Pfizer vaccine may want to follow it with Moderna, as the booster dose is high and the antibody booster can be large.

But other experts say it makes sense to keep things simple and stick to the original vaccine you received, especially if it worked first. All the data about boosters is relatively limited, but “the person who received the same product has much more experience,” says Hewlett.

Moderna boosters after two doses of the same vaccine, according to a NIH study Leads to the highest antibody levels — More than Pfizer — the difference is probably too small to be important to most groups. Also, the FDA-approved booster dose was only half that tested in that study.

In any case, scientists still don’t know how different antibody levels are converted into global immunity, so you can’t necessarily assume that more is better.

“No one knows what the actual level of protection will be in the long run for all of these different combinations and combinations,” says Daudi.

Is the booster safe?

Yes. “There is little risk” of serious complications from booster shots, says UCSF Kotis. It is reasonable to assume that “boosters can show almost the same side effects you had after their first or second series shot”.

There are some specific demographics that are at higher risk of adverse events than the general population.

Young men between the ages of 18 and 25 There is an increased risk of myocarditis and pericarditis (inflammation of parts of the heart) after mRNA vaccination. However, studies have shown that the majority of patients who develop this rare condition feel better within 6 weeks. For the J & J vaccine, women between the ages of 18 and 49 account for most cases of severe blood clots. Known as TTS.. This also remains very rare. In the United States, a total of less than 50 cases have been reported out of the 15 million people vaccinated with the J & J vaccine.

Still, it makes sense for people in these high-risk demographics to choose boosters based on this concern. This means that women aged 18-49 can consider choosing one of the mRNA vaccines, and young men may want to consider J & J as a booster.

The bottom line is that all three vaccines are safe for the general public, Poland says. When it comes to vaccine safety risks, he says, “the risks can hardly be quantified. The risks are very low.”

Not qualified as a booster. What should i do?

It hangs firmly.

If you are under the age of 65 and have no underlying health problems, say the vaccine is really holding up. Angela Rasmusen, A virologist at the University of Saskatchewan. “You really don’t need a booster — that’s what the data shows.”

Of course, some people are worried about the possibility of infection as well as hospitalization. In addition, some studies have shown that protection against infection may be reduced in young adults as well.

This is a perfectly valid concern, but vaccines are not designed to stop all infections. Only the most serious illness. One day, the COVID-19 vaccine could be in a triple inoculation series. In this series, everyone will be given two priming doses followed by boosters. “It may only be necessary to take this third dose to actually fix its long-term endurance.”

But we are not there yet. In fact, it’s good to remember that booster research hasn’t been decided yet. “Science isn’t that powerful right now — it’s still developing,” says Daudi. “There is no long-term data on whether these boosters will bring long-term benefits to protection or how much protection will be weakened without boosters.”

NPR’s Pien Huang contributed to this report.