Covid-19 Second Booster: your questions answered

Photo by Daniel Schludi on Unsplash

As a public health nurse, I am keenly aware of the confusion and misinformation that surrounds the Covid-19 vaccine.

In the interest of time (and my own sanity), I am writing for the readers who believe in science, trust the experts, and want to maximize their chances of avoiding severe illness, hospitalization, and death.

In our third year of the Covid-19 pandemic, there have been three vaccines approved in the US to combat the virus, produced by BioNTech Pfizer, Moderna, and Janssen.

Despite the prevalence of safe, effective, and widely available vaccines, only 66.9% of the total US population is fully vaccinated. It is an unfortunate reality today that vaccines, healthcare, and science in general, have come under attack, and for some, the refutation of them is a mark of allegiance to a political ideology.

I am not here to unpack all of that; I certainly do not have the time, nor the spoons.

Rather, I’d like to clarify one of the most common questions I field as a public health nurse who runs Covid-19 vaccine clinics: “Should I get my second booster?”

The answer is: it depends.

Photo by Roger Starnes Sr on Unsplash

Covid-19 vaccines: what do they DO?

First, to understand the nuances of current Covid-19 vaccine guidelines, we should understand the basic science of viruses and vaccines, chiefly what they do, and what they do NOT do.

1. Coronaviruses, (including SARS-CoV-2, the specific virus that causes the disease Covid-19) are highly contagious, and like most viruses, they change (or mutate) often. Viruses mutate to improve their own chances of survival over time, and so mutation is never a surprise.

2. Consequently, vaccines made for diseases caused by viruses, such as the flu vaccine, can need to be reformulated often because those viruses change often. How often? Viral mutation rates vary among virus types. Sometimes we’re lucky, such as with the Mumps virus, and the mutation rate of the virus is low enough that two vaccine doses early in life will usually provide a lifetime of protection. On the other hand, the influenza virus, which is responsible for the flu, mutates so regularly that we KNOW we have to reformulate flu vaccine every single flu season, and every flu vaccine is manufactured to fight more than one flu strain at a time.

3. However, regardless which viral strains are active, we do know that someone who receives the Flu vaccine, or the Covid-19 vaccine, and subsequently still becomes infected is far less likely to experience severe illness.

4. Which leads me to the most important point: It is currently IMPOSSIBLE to completely prevent infection from the rapidly mutating SARS-CoV-2 virus. What the vaccines excel at, is greatly reducing the chance that you will be severely ill, hospitalized, or die from the infection.

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Second Boosters: currently with caveats

If you live in the United States, second boosters with mRNA vaccines (Pfizer and Moderna only) are available for anyone over the age of 50 years old, and also to anyone over the age of 12 who is moderately to severely immunocompromised.

Given that, the question now is: WHEN is the best time for these folks to get this second booster?

You may be wondering, “If I’m approved by the FDA to get the vaccine now, shouldn’t I just get it now?” and that’s where the debate heats up.

The reality is that experts have differing opinions when it comes to second boosters, especially for folks under the age of 60.

Covid-19 is a new disease, so the pool of research data cannot be that deep. Scientists are racing to conduct coronavirus studies and publish the resulting data. However, the data we do have so far strongly support having folks over the age of 60 getting a second booster dose.

You should always consult with your personal physician regarding any vaccination, as they are the best experts on your care. But if you have recently recovered from Covid-19, say, within the last three months, your own doc may recommend you hold off on your second booster for now. You may have developed some immune protection directly from having the illness, it’s easier to manage your viral exposure in the summertime, and there may be more targeted Covid-19 vaccines available in the fall. These might be legitimate reasons to hold off on getting a second booster right this minute.

Things are more straightforward for the immunocompromised. The consensus is this: anyone over the age of 12 should have their second booster as soon as possible. However, it is worth unpacking the term ‘immunocompromised’, which can be unclear.

Immunocompromised, as defined by the CDC, means you are currently being treated for a tumor, cancer, or have received a solid organ transplantation. Other immunocompromised conditions as outlined by the CDC include HIV / AIDS, and certain genetic conditions that greatly reduce the ability of your body to fight off germs. As you can see, that list is very short and specific.

Vaccine Recommendation: the condensed version

SARS-CoV-2 is a brand new virus, and we learn more about it every day. Therefore, we must adjust our public health strategies in response to what we find out. You should consider Covid-19 to be a constantly evolving master lesson on what viruses can do, and how you can effectively and safely respond.

That said, there have been BILLIONS of Covid-19 vaccinations administered across the globe, and we can now confidently say that it is a safe and effective vaccine that greatly reduces life-threatening illness.

The takeaway here is:

1. If you are over the age of 12 and immunocompromised (as defined above), you should get your Covid-19 second booster as soon as possible.

2. If you are over the age of 50, and you have recently had Covid, consult with your physician.

In fact, consult with your physician anyway! They are always going to be the best source of information as they know your medical history, and can speak to the ideal strategy for you.

The last three years have been one hell of a ride for all of us. Uncertainty abounds, but the scientific community came together and achieved the unimaginable – a safe and effective vaccine, the first of its kind, that is successfully fighting a novel virus.

Now, armed with more information, I hope that you have gained some confidence in the science of vaccines, and you can now choose to protect your community and yourself, without anxiety or fear.