Do Americans Need a Second Booster Shot?

The US Food and Drug Administration (FDA) recently authorized second booster doses of the  Pfizer/BioNTech and Moderna coronavirus vaccines for adults 50 and older, and for individuals 12 and older who are immunocompromised. The second booster means a fourth shot for those who received three doses of an mRNA vaccine (two doses and a booster) and a third shot for those who received the Johnson & Johnson vaccine (one dose of the Johnson & Johnson vaccine and a booster shot of an mRNA vaccine). Those eligible can receive the second booster shot as early as four months after their first booster dose. 

Within hours of the FDA announcement, the Centers for Disease Control and Prevention (CDC) released a statement that the second booster dose will be available for people who received the Johnson and Johnson vaccine. This news comes amid reports that the highly transmissible BA.2 subvariant of omicron is now the dominant strain in the United States and accounts for over half of U.S. COVID-19 cases, the CDC estimates. With the new omicron subvariant on the rise, some are wondering if they should roll up their sleeves to get another shot. Others are seeing decreasing COVID-19 numbers and hospitalization rates and are asking themselves if another shot is necessary?

Health experts believe that a second booster shot offers extra protection to those at highest risk of getting severe COVID-19. A recent study by CDC revealed that, “During the U.S. omicron outbreak, two mRNA doses plus a booster were 94% effective against severe illness and death.” In addition, a recent 40-day study from Israel that included more than half a million people aged 60 to 100 revealed that a second booster of the Pfizer–BioNTech COVID-19 vaccination lowered COVID-19 deaths by 78% compared with individuals who received only one booster shot. “The main conclusion is that the second booster is lifesaving,” said Ronen Arbel, Health Outcomes Researcher at Clalit and Sapir College. 

The decision to get a second booster may differ for individuals based on age and underlying health conditions, such as heart and lung disease, diabetes, cancer, and obesity. Although COVID-19 cases are approaching a pandemic low, a boost can also help reduce hospitalization if the U.S. experiences a recent surge in cases, like those we are seeing in other countries. According to the World Health Organization (WHO), “More than 5.2 million COVID-19 infections were reported across Europe during the week ending March 20, 2022, and countries including the United Kingdom have also detailed rising hospitalization rates.” The BBC recently reported that after battling a new wave of COVID-19 infections for more than a month, Chinese authorities have extended their lockdown of Shanghai to cover the entire city. “Reported cases have risen to more than 13,000 a day.”

While it is uncertain if the U.S. will see another COVID-19 wave like delta or omicron, what we do know is that boosters give us increased immunity. A report from the UK Health Security Agency showed that, “Protection against mild COVID-19 cases increases about 65-75% following a booster dose and later drops to 45-50% after two months.” These numbers tell us that at some point, we will all need increased protection against what appears to be a “never-ending” pandemic. Public health professionals like Dr. Anthony Fauci, believe that we have to prepare for the possibility that COVID-19 is here to stay. “Right now we’re fortunate enough to have a vaccine that is extremely efficacious for the strain that now is circulating in our own country,” said Fauci. Whether that preparation includes an annual, bi-annual, or a booster shot every four months, people who want that extra layer of protection should get the second booster when eligible. While it is important to get boosted, it is equally important to get vaccinated with a first and second dose because they lower the risk of COVID-19 infection, hospitalization, and death. Currently CDC data show that only 66.1% of people in the U.S. are fully vaccinated, which places close to 35% of the population at risk. It is recommended that everyone 5 years of age and older get vaccinated against COVID-19 and children 12 years of age and older who are fully vaccinated should get a COVID-19 booster shot.

One thing that we have learned from the pandemic is that when positive COVID-19 cases increase in other countries, we see rising infections in the United States shortly after. We also know that Europe relaxed COVID-19 restrictions and that decision, along with the surge of the BA.2 variant, combined with waning immunity, has made the country vulnerable to rising infections. Will the relaxing of COVID-19 mandates in the US have a similar effect? It is hard to say at this point. Testing and the reporting of infections are down, so it is hard to gauge true rates of infection. A better indication might be hospitalizations and death rates. Both of which, fortunately, are lower than previously seen but we should be extremely wary if they begin to rise again. If they do, Americans may be placing themselves at increased risk if they delay booster shots and vaccinations.


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