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COVID-19 booster shots are available now for those 16 and older who are six months past initial doses of Pfizer or Moderna, and two months past an initial dose of Johnson & Johnson. Many people, though, still have questions about the vaccine boosters, if they’re needed and their efficacy in fighting omicron and other variants. 

While that landscape can be confusing, experts say the basics are clear: stay vigilant against COVID during the year-end holidays and get the shots. 

People who have received a booster and then get infected are more likely to experience milder illness or to have no noticeable symptoms, said Dr. Rebecca Wurtz, a professor at the University of Minnesota’s School of Public Health. Side effects from boosters run from no symptoms to a temporarily sore arm to “feeling really crummy for a day,” but they’re all still better than full-on COVID, she added.

Wurtz said she had recently talked to a friend who had earlier received two doses of the vaccine. “And then he got COVID about a month ago, and then got his third dose this past weekend," she said. "And he said that getting COVID was much worse than the third dose.”

‘It’s confusing. It’s frustrating’

While daily updates from public health officials on COVID, vaccinations and boosters are important, the torrent of information can sometimes be overwhelming. 

Some wonder when the call for more doses might end. Will there be a fourth booster? A fifth? How often, and for how long will people need to make vaccine appointments or take time away from work to get them? 

David Topham, a microbiology and immunology professor at the University of Rochester in New York, said he has seen data that shows people who have received only two doses of the Moderna or Pfizer vaccine are not protected against omicron. 

A third dose is protective, he said, offering about a 40-fold increase in antibody production. 

Waiting to administer a third dose provides a better, broader immune response, he added. Boosters given after six months not only increase antibody production, but the presence of memory B cells. Memory B cells generate a better immune response when someone is reinfected with an illness. When these cells see the virus, Topham said they can adapt and respond to new variants. 

Wurtz thinks annual COVID shots, reformulated to fight the latest mutation, may become the norm, like annual flu vaccinations. Right now, it’s clear immunity has waned, she said, and it is important for those who are eligible to get a Pfizer or Moderna booster now.

Some Minnesotans are skeptical about the booster because of changing guidelines. At first, only immunocompromised and older individuals were eligible. Now, all adults and older teens are urged to get it. 

Wurtz said guidelines change because the virus is changing and the public health system must adapt.

“It’s confusing, it’s frustrating, and it’s scary,” she acknowledged. Her best advice is for people to do what’s been shown to work: get a booster shot, mask when indoors in public, and limit in-person gatherings; take extra precautions in the 10 days leading up to in-person gatherings; get tested but remember “a single test this morning doesn’t mean you’re not positive by this afternoon.”

While booster shots provide much better protection against severe illness and death, breakthrough infections will continue to occur. 

She encourages people to stay home when they feel sick. Staying home with symptoms of any respiratory illness and getting a booster are steps people can take not just for themselves and their families, but for the good of everyone. 

Topham compares getting a booster shot to wearing a seatbelt.

“We all have to wear our seatbelts,” he said. “We have a federal law that says that, because when people were driving around without their seatbelts, they were getting more seriously injured if they had an automobile accident, and then they put a burden on the health care system. So, not only do you protect yourself when you get vaccinated or when you wear your seatbelt, but there are benefits to society and to others.”

Those who need emergency health care will be more able to access it if the hospital system isn’t continuously overwhelmed with COVID patients.

“My philosophy is that it's your responsibility to not present a danger to others,” Topham said. 

Some people are more concerned about disparities in global vaccine access than about their own COVID risks at home. They worry that getting a booster shot might be unfair to others who have yet to receive a single dose. 

Experts, though, say getting a booster at the local pharmacy will not prevent someone else from accessing the vaccine elsewhere in the world. 

Kathy Kinlaw, associate director at the Emory University Center for Ethics in Atlanta, is grateful people are concerned. “Individuals around the world should have access to the same measures that we have access to, to prevent serious illness and death — like the vaccine,” she said.  

“I think individual doses that have already been distributed in the United States, whether going into the states or through pharmacy programs are not likely to be redistributed and made available to other parts of the world,” she said. “Those commitments have already been made.”

Topham and Wurtz agree: Refusing a booster shot where they are widely available will not accelerate distribution in other areas, while getting one helps the global effort to keep the virus from replicating as it spreads.

“The more that this virus replicates, especially in people that have partial immunity, the more likely we're going to see new variants emerge, variants that could avoid vaccine-induced immunity,” Topham said. 

Kinlaw said the World Health Organization and GAVI, a global public-private sector immunization effort aligned with the WHO, are developing strategies for better global access, from manufacturing and delivery infrastructure to vaccination across communities. People can consider advocating to support those efforts.

Wurtz said she’s optimistic about finding answers around the potential need for additional doses as more is learned about omicron and other variants. With improved vaccine access, COVID, she said, will become more like a “recurrent cold that we all get from time to time.”

A dose of public thoughtfulness will also help, she said. 

“[If] I’ve got a cough and a cold, I’m going to stay home today, I’m not going to go to the gym, I’m not going to go out socializing with my friends tonight, because I have an infectious viral illness that could be COVID, or the flu, so I’ll stay home, and if I need to go out, I’ll wear a mask.”

Do you have questions about boosters, omicron, or vaccine access? Submit them here: 

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Sarah Gelbard

Author

The torrent of information on COVID and vaccines can sometimes be overwhelming. Public health leaders, though, say the basics are clear: take precautions against COVID during the holiday season — and get the shots.

The torrent of information on COVID and vaccines can sometimes be overwhelming. Public health leaders, though, say the basics are clear: take precautions against COVID during the holiday season -- and get the shots.



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