Covid Vaccines: Third Shots and Boosters

Authors: Heather Snyder, AGH Infection Control and Employee Health Manager

                Jeff Kukel, AGHRx RediScripts Pharmacy Manager

What is a COVID-19 vaccine booster?

A COVID-19 booster shot is an additional dose of a vaccine given to help increase antibody protection. Currently, booster shots are only approved for recipients who originally received Pfizer-BioNTech COVID-19 vaccine and fall into the following categories:

• People 65 years and older and residents of long-term care settings
• People aged 50–64 years with underlying medical conditions
• People aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting
• First responders (healthcare workers, firefighters, police, congregate care staff) 
• Education staff (teachers, support staff, daycare workers)
• Food and agriculture workers
• Manufacturing workers
• Corrections workers
• U.S. Postal Service workers
• Public transit workers
• Grocery store workers

Eligible individuals may receive a booster at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.

Is Atlantic General Hospital (AGH) offering the vaccine booster?

Based on recommendations from the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA), RediScripts, our AGH partner pharmacy will offer the Pfizer-BioNTech COVID-19 vaccine booster to eligible patients with an appointment. Eligible individuals can schedule an appointment by using www.agh.care/vaccine

What is a third dose of the coronavirus vaccine?

A third dose of the mRNA COVID-19 vaccines (Pfizer or Moderna) is identical to the first two doses. It can help protect people with weakened immune systems who did not have a strong enough response to the first two doses of the mRNA vaccines. Individuals in the following categories are eligible for a third dose of Covid-19 vaccines:

• Active treatment for solid tumor and hematologic malignancies (cancer)
• Recipients of solid-organ transplants on immunosuppressive therapy
• Receipt of chimeric antigen receptor (CAR)-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
• Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)
• Advanced or untreated HIV infection
• Active treatment with high-dose corticosteroids (i.e., ≥20 mg prednisone or equivalent per day when administered for ≥2 weeks), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis factor (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.

When can I get a third dose of COVID-19 vaccine?

People who have a weakened immune system can receive a third dose of either the Moderna or Pfizer vaccine as soon as 28 days after the second dose. Based on recommendations from the CDC, RediScripts, our AGH partner pharmacy will offer third doses of COVID-19 vaccine to eligible patients with an appointment. Eligible individuals can schedule an appointment by using www.agh.care/vaccine

How do I know if I need a third dose of COVID-19 vaccine?

If you are unsure about whether you have a health condition or receive treatment that affects your immune system, please contact your health care provider. They can work with you to help determine if a third dose of COVID-19 vaccine would be right for you.

Would a third COVID-19 shot have to be the same brand of vaccine I originally received?

Your third vaccine dose should ideally be the same type (Pfizer or Moderna) you received when you were first vaccinated. The third shot can be given to you when it has been at least four weeks (28 days) since your second shot, if you are considered immunosuppressed based on the criteria determined by the CDC. If the mRNA COVID-19 vaccine product given for the first two doses is not available, you may receive the other mRNA COVID-19 vaccine product.

Can I get an additional COVID-19 shot if I received the Johnson & Johnson vaccine?

Currently, the CDC does not recommend additional doses of Covid-19 vaccine for individuals who received the one dose Janssen (Johnson & Johnson) product. At this time, there is not enough data to support the use of an additional Janssen or mRNA COVID-19 vaccine dose in any population who received Jannsen. The FDA and CDC are actively working to provide ongoing guidance for this issue.