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Everything you need to know about getting a COVID-19 booster

Which booster shot should you get and can you mix and match?
/ Source: TODAY

Guidance around booster shots and who can receive what and when have been changing quickly. Here is the latest guidance and what you need to know now.

Who is eligible for a booster?

All adults over the age of 18 can receive a booster dose of the Moderna COVID-19 vaccine at least six months after receiving their second shot. Adults over the age of 16 are eligible for a booster dose of the Pfizer-BioNTech COVID-19 vaccine five months after the second shot of the primary series.

In early January, the advisory panel to the Centers for Disease Control and Prevention voted in favor of Pfizer booster shots for 12- to 15-year-olds, to be administered at least five months after their second shot. The CDC agreed with the recommendation.

“We now recommend that all adolescents aged 12-17 years should receive a booster shot five months after their primary series,” Dr. Rochelle Walensky, the director of the CDC said. “This booster dose will provide optimized protection against COVID-19 and the omicron variant. I encourage all parents to keep their children up to date with CDC’s COVID-19 vaccine recommendations.”

Johnson & Johnson recipients (aged 18 and up) are encouraged to get a booster shot at least two months after they receive their initial shot. The Centers for Disease Control and Prevention recommends they receive a Pfizer or Moderna COVID-19 vaccine booster.

Should I 'mix and match' my booster shots?

The CDC does not have any preference on whether people should mix and match booster shots or get the same vaccine that they've already received, according to Dr. Rochelle Walensky, the director of the CDC.

"Some people very well may prefer to get the vaccine they originally got," Walensky said. "The vast majority of people did very well after getting their first vaccine, but the CDC now will allow new recommendations to mix and match and we do not indicate a preference."

"... There may be some people who would prefer a different vaccine or if you go into a pharmacy and they don’t have the vaccine you already got, it really is fine to get a different vaccine," Walensky continued.

Azar noted that the choice to allow mixing and matching will make it easier for people to get booster shots. There is some data that indicates a stronger antibody response from mixing and matching a booster, but Azar said it's hard to read too much into that information.

"What we know is that if you do get a different booster from the original that you got, if you mixed and matched, the likelihood of you getting the same or a greater antibody response two weeks later is greater if you do a mix and match," Azar said. "But what we don't know is whether or not those antibodies actually translate into better protection or more vaccine effectiveness."

Should anyone mix and match their booster shots?

Azar said there were two groups who might want to consider mixing and matching their booster shots.

"Women of childbearing age, who received a Johnson & Johnson (vaccine), because of the clotting issue, may want to elect to get an mRNA (vaccine)," Azar said, referring to rare blood clots that were found in some women of that age group who received Johnson & Johnson vaccines, which led to a temporary pause on the use of the vaccine.

Meanwhile, young men who received a Pfizer or Moderna vaccine may want to look at Johnson & Johnson.

"Remember that was associated with myocarditis in younger men?" asked Azar, referencing rare cases of mild heart inflammation in young men who received the mRNA vaccines. "They may want to choose an alternative like J&J. It's basically allowing people to make a choice, of course, obviously with the guidance of your healthcare provider."

Should I get a booster shot after a breakthrough COVID-19 case?

Mary, a 70-year old TODAY viewer who was fully vaccinated, sent in a video question: Can she get a booster shot after being diagnosed with a breakthrough case of COVID-19 three weeks ago?

According to Azar, the answer is yes.

"The rule of thumb I think here is that she’s in a group that is eligible for a booster because she’s 70," Azar said. "We generally say with the vaccine or a booster, 10 days after symptoms began or a positive test you can already get your booster. If you got monoclonal antibodies or convalescent plasma you’ve got to wait 90 days before you get a booster."

Azar also explained the concept of hybrid immunity, or the immunity you can get from getting fully vaccinated after COVID-19 infection.

"There is this concept of hybrid immunity, meaning if you got sick with COVID and then you get a vaccine, your immunity is better than if you got vaccine alone or infection alone, but we don’t know if the reverse is true. ... we don’t know if a breakthrough infection on top of a vaccine actually bolsters that immunity from the vaccine," Azar said.

Should I worry about waning immunity?

Walensky noted that the rate of disease is "markedly lower" for those who had received booster shots. Though both Walensky and Fauci noted that the unvaccinated population remains the most at risk.


This story was updated on Jan. 6, 2021 to include latest developments on boosters.