The last year and a half has been filled with uncertainty and lockdowns. But at long last, our lives are beginning to look a little more normal each day — all thanks to vaccines.

So why are mask and social distancing mandates still fluctuating?

Well, more than 185 million Americans have been fully vaccinated against COVID-19. And this has vastly helped to curb the spread of the virus. But until more people around the world are vaccinated, there is a high chance that variants will continue to develop. “Every unvaccinated individual is a potential variant factory,” says L.J Tan, MS, PhD. He’s the chief strategy officer for Immunization Action Coalition in St. Paul, Minnesota.

In order to keep our newly rediscovered freedom, we’ll need to stay ahead of COVID-19 variants such as the delta variant. And that means vaccinated people may need a booster shot to keep up their immunity.

There’s a lot of conflicting information floating around on the internet. And we know it can be confusing. So we rounded up answers to some of the most pressing COVID-19 booster-related questions for you.

(Managing your health is another way to keep your immunity strong. Download our prescription discount card to save on your most needed medications.)

What’s the current recommendation on boosters?

In September, after weighing evidence from the Food and Drug Administration (FDA) and its own advisory panel, the Centers for Disease Control and Prevention (CDC) recommended booster shots for vulnerable groups of people. The catch? This recommendation applies only to people who took the Pfizer-BioNTech vaccine.

According to this recommendation, you should schedule a booster shot if you received the Pfizer vaccine at least 6 months ago and you meet any of the following criteria:

  • You’re 65 and older
  • You live in a long-term care facility
  • You’re 50 to 64 years old with an underlying medical condition (such as diabetes, cancer, heart disease, asthma or other lung disease)

The recommendation also includes softer guidance for certain lower-risk groups. It specifies that you may consider a booster if:

  • You’re 18 to 49 years old with an underlying condition
  • You’re 18 to 64 and live or work in a setting that puts you at a higher risk for COVID-19 exposure (this group could include health care workers and frontline workers such as grocery clerks, teachers, public transit workers and more)

What if I received a non-Pfizer vaccine?

It’s possible that you’ll need a booster regardless of which vaccine you received. But health agencies are still collecting data to determine what the recommendation should be. In the meantime, they have issued some guidance on third doses for certain groups.

Third doses are different from boosters. These are shots that you receive shortly after your second dose. Rather than wait 6 months, you go back for a third jab as soon as 28 days after your second.

So who should get a third dose? The CDC recommends third doses for people who received mRNA vaccines (either Pfizer or Moderna) and who have moderately or severely compromised immune systems. This group makes up about 3% of the adult population. You may be eligible if:

  • You’re currently undergoing cancer treatment for tumors or cancers of the blood
  • You’ve had an organ transplant and take medication to suppress your immune system
  • You’ve had a stem cell transplant within the last 2 years
  • You have advanced or untreated HIV
  • You’re on medications that suppress your immune response, such as high-dose corticosteroids

What about the Johnson & Johnson vaccine?

Regulatory agencies haven’t yet issued guidance on additional doses or boosters. That will likely change soon, though. Johnson & Johnson has ongoing clinical studies to evaluate the effectiveness of a booster shot, but the FDA hasn’t evaluated the data yet.

What is a booster shot?

A vaccine teaches your body to produce antibodies against a specific disease to keep you from becoming seriously ill. Once you have received a vaccine, a booster shot acts as a reminder to your body to continue producing those antibodies. And this helps you stay protected against that disease.

A booster shot can be given weeks, months or years after the first vaccine dose. And it can either be an additional dose of the same vaccine or an altered version of it. An altered version of a vaccine can help people stay immune to a disease when it evolves, such as the delta variant of COVID-19.

We’re hearing a lot about booster shots right now because of COVID-19. But the concept of a booster shot is not new. Children usually receive booster shots for illnesses such as chickenpox, measles and tetanus to keep them immune for longer periods of time.

If booster shots are needed, does that mean a vaccine does not work properly?

Not at all. Tan emphasizes that the current conversation about booster shots is about keeping us protected from new variants of the virus.

When the vaccines were first released, Tan says that many people hung on to the initial announcement that they were 94.5% effective. When recently released data showed this number had dropped, some people were concerned it meant the vaccine wasn’t working at all.

But that 94.5% effectiveness rate was against the original strain of the COVID-19 virus. And new variants have evolved since then.

New variants of any virus will inevitably impact a vaccine’s effectiveness, says Tan. But this doesn’t mean a vaccine isn’t working. “It just means that as the variants change, the impact of the vaccine shifts. [The first doses of the COVID-19 vaccine] may not prevent you from getting infected, but it’s making sure you don’t die,” he says.

How long will protection from the first vaccine last?

We just don’t know yet. The COVID-19 pandemic is an ongoing situation, and new variants make it hard to set reliable expectations. So we will learn more about how long protection will last as time passes.

What we do know: Early data from Pfizer and Moderna showed their vaccines to be effective for at least 6 months. And according to a study published in the journal Nature, the 2 vaccines could provide long-lasting immunity.

But in May, the Israeli government released data suggesting that the Pfizer vaccine’s ability to prevent infection may decrease after a few months. Even if there is a slight decline in preventing infection, the data still showed that the vaccine was highly effective at preventing serious, life-threatening illness and hospitalization.

Who is likely to eventually need a booster shot?

Everybody who’s vaccinated will need a booster to maintain immunity. That said, the additional dose is most urgent for 2 groups of vulnerable people: the immunocompromised and people 65 and older.

According to Tan, these 2 groups aren’t able to create as strong of an immune response after full vaccination. And this puts them at higher risk for severe illness and hospitalization if they do contract the coronavirus. A booster dose of the vaccine would most likely keep them protected.

How often will I need a booster shot?

The answer may rely completely on COVID-19 variants, says Tan. If we are able to get more of the world vaccinated, we might be able to keep variants in check. And we might not need multiple rounds of booster shots.

That said, vaccine makers are preparing for the worst. They’re formulating their own plans as case variants continue to develop.

Take the vaccine manufacturer Moderna, for example. The company recently shared that its goal is to be able to produce a single-dose annual booster shot that will protect adults against COVID-19, flu and the common cold viruses.

There’s a lot of uncertainty around how the COVID-19 pandemic will develop, but we know that immunity is important. That’s still our best shot at containing the virus and getting back to life as we used to know it.

One thing that isn’t uncertain? How much we can save you on your next trip to the pharmacy. Download our app to save up to 80% on your prescriptions today.

Additional sources:
Severely immunocompromised people make up about 3% of the U.S. population: Centers for Disease Control and Prevention
The basics of vaccines: Centers for Disease Control and Prevention
July 2021 U.S. government statement on vaccine boosters: U.S. Department of Health and Human Services
September 2021 statement on booster vaccines: Centers for Disease Control and Prevention
Johnson & Johnson booster data: Johnson & Johnson press release
July 2021 international joint statement on vaccines: World Health Organization
Pfizer vaccine effectiveness through 6 months: Pfizer Press Release
Moderna vaccine effectiveness through 6 months: Moderna Press Release