Pfizer COVID-19 boosters: What you need to know

A woman pulls her sleeve up as she is given a shot by another woman.
CentraCare nurse Amy White, left, receives the first dose Pfizer’s COVID-19 vaccine at St. Cloud Hospital from nurse Lynette Van London. In coming days, people 65 and older and those with underlying health conditions will be able to get an extra shot of the Pfizer vaccine.
Paul Middlestaedt for MPR News 2020

Updated: Sept. 24, 3:30 p.m. | Posted: Sept. 21, 1:40 p.m.

If you got two doses of the Pfizer COVID-19 vaccine this past spring, you may be eligible for a third shot soon.

The Food and Drug Administration approved a plan that will make boosters available for a limited number of people, including those who are 65 years or older. The Centers for Disease Control and Prevention endorsed the same.

The rollout comes as the highly contagious delta variant continues to surge through the country, leading to an unsettling number of new cases, hospitalizations and deaths. 

Who can get boosters?

According to the Minnesota Department of Health, upwards of 1 million Minnesotans may qualify for the booster.

In addition to those 65 and older, the CDC also said people 50 to 64 who are at high risk of getting a severe case of COVID-19 should get a booster shot. Those conditions include diabetes and cystic fibrosis, among others.

People 18 to 49 with underlying conditions may also get a shot, but Minnesota Department of Health officials say people in this group should consult with their doctors first.

The final recommendations, which doctors and other vaccines providers are required to follow, may also include people 18 to 64 whose job may put them at higher risk of developing a severe case of COVID-19, like health care workers, teachers and grocery store employees, plus people in homeless shelters or prisons.

The CDC didn’t provide details on what these high-risk jobs include, and state health officials say people should talk to their doctors first to assess their individual risk.

That’s on top of immunocompromised people — like solid organ transplant patients — who were given the go-ahead to get a third dose of Pfizer and Moderna vaccines earlier this summer.

When can I get my third shot?

The CDC says eligible people can get booster shots at least six months past their second Pfizer shot. But there’s no rush: You still have powerful protection against the worst of the virus if you wait longer.

Where can I get my third shot?

The same places you got your first shots: your health care provider, your local pharmacies, public health vaccine clinics. And there’s no need to get your booster at the same place you received your first two shots. 

Health care systems and some pharmacies are likely to send out reminders to eligible patients when it’s time to get a booster. And they can query a state database to see your vaccine record, too. 

But it’s a good idea to bring your vaccine card to your appointment. 

“I encourage all patients to have their vaccine card with them when they get their booster to speed up the process and so the booster can be recorded on their vaccine card,” said Minnesota Pharmacists Association Executive Director Sarah Derr.

However, pharmacies also have access to the Minnesota Immunization Information Connection and she said pharmacists “can look to see if the patient has had the two previous vaccinations before receiving the booster.”

Much like last time, pharmacies will ask about age, underlying health conditions or occupations to make sure patients are eligible for the third shot, said Derr. 

Health care providers will offer booster doses, too. For instance, Mayo Clinic said it will allow patients to schedule a vaccine appointment or they can walk in for a shot.

My loved one is in long-term care. How will they get their boosters?

There’s a lot we don’t know yet about the logistics around the vaccine rollout in long-term care facilities. 

According to Patti Cullen, the president and CEO of Care Providers of Minnesota, which represents many long-term care facilities across the state, Moderna was the vaccine given to the vast majority of long-term care residents across the state. This means most long-term care residents in the state will not get the Pfizer booster. Instead, they'll have to wait for Moderna's booster to get approval or for Pfizer to be approved for use for people who got initial doses of another vaccine.

"We have our booster vaccine plans ready. We have our checklists where we know who got what dose when, and we just have to wait," Cullen said.

When the vaccines first became available to this group early in 2021, pharmacies were involved in bringing shots to these facilities and likely will be involved again for boosters, said Derr. 

The state health department is asking long-term care providers to work with local public health and local health care providers as well.

President Joe Biden’s administration said everyone 16 and older would get a booster shot. I’m confused!

This was a hot topic of deliberation among FDA and CDC experts parsing Pfizer’s application for approval of boosters.

The company applied for everyone 16 and older to get boosters. Meanwhile, Biden pledged earlier this summer to make boosters available this fall to most people.

But a wide majority of the FDA’s advisory panel said the available evidence doesn’t support blanket approval — at least not at this point in the pandemic, narrowing eligible groups to people 65 and older and those with underlying health conditions.

Vaccine experts advising the CDC endorsed boosters for those groups as well.

But in an unusual move, top FDA and CDC officials went against their advisers and added people in high-risk jobs to the list of people eligible for Pfizer booster shots.

"As CDC Director, it is my job to recognize where our actions can have the greatest impact," said Dr. Rochelle Walensky in a statement. "At CDC, we are tasked with analyzing complex, often imperfect data to make concrete recommendations that optimize health. In a pandemic, even with uncertainty, we must take actions that we anticipate will do the greatest good."

Empty vials of the Pfizer-BioNTech COVID-19 vaccine
Empty vials of the Pfizer-BioNTech COVID-19 vaccine are displayed at a regional vaccination center in Ludwigsburg, Germany.
Thomas Kienzle | AFP via Getty Images file

Do I need to get the same brand of shot?

Yes. If you got the Pfizer vaccine initially, you should get a Pfizer booster.

What sort of side effects can I expect from a third shot?

According to the state health department, Pfizer’s clinical data suggest people should expect a response that’s similar to when they received the second dose of the Pfizer vaccine. So, if you felt pretty crummy after your second shot, prepare for that to be the case again. 

What if I got the single-shot Johnson & Johnson vaccine or the two-dose Moderna vaccine?

The timeline on booster shots for people who got Moderna or Johnson & Johnson vaccines is still unclear. 

National Institute of Allergy and Infectious Disease director Dr. Anthony Fauci said experts are likely to take up this question within weeks. 

And Johnson & Johnson just released new data that suggests a second dose of its vaccine at six months provides a substantial increase in protection against the virus, though that protocol has yet to be approved by the FDA. 

What happens next?

The exact date when people can start lining up for third shots is up in the air. But Minnesota officials say the state is ready to start giving doses as soon as federal officials issue their final guidance and that there’s more than enough vaccine for people who are seeking their first, second or third dose. 

MPR News reporter Peter Cox and The Associated Press contributed to this report.

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