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Our Infectious Diseases experts answer frequently asked questions about boosters*, Omicron and navigating social situations.
*this information has been updated 1/6/2021 per new CDC and FDA guidance
With recommendations for COVID-19 vaccine rapidly changing, keeping track of age-related eligibility for vaccine and boosters is a challenge. The most recent change is CDC's authorization of a booster in children and adolescents 12 years old and older, and a third dose for immunocompromised children 5-11 years old. The timing for boosters has also changed from 6 months to 5 months following completion of primary series.
Ongoing research is being done to consider whether 5-11 year old children will need a booster. Additional information can be found at the Centers for Disease Control and Prevention.
Just like studying for a test in school, the more your body is taught something the better it remembers. The goal of vaccination is to train your body’s immune system to respond quickly to an infection. The first two doses of the COVID-19 vaccine taught your body what the virus looks like and gave it practice fighting it. But over time, your body might need a reminder. The booster dose is that reminder.
A booster dose can also be used to teach the body something new, such as how to respond to a slightly different virus. For example, vaccine makers are working on a booster for the Omicron variant because they think it might be different enough from the original virus that the immune system needs a new lesson on how to recognize it. More research is needed to know if the Omicron variant less responsive to the current vaccine. Preliminary data has shown that a booster of an mRNA vaccine (Pfizer or Moderna) improves protection from severe disease caused by the variant.
Some people’s immune system needs more lessons at the beginning to learn how to fight the virus. For example, some people who have had organ transplants or are on medications that affect their immune system might not respond to the first two doses like a healthy person. Those people may need a third dose of the vaccine instead of just two doses. This third dose is different from a booster because it is required to train the immune system, not just a reminder.
Everyone age 12 and older are recommended to get a booster dose 5 months after their second dose. It is possible that children and adolescents younger than 12 may eventually need boosters, but currently the protection from the initial two doses seems to be quite strong.
We are rapidly learning more about the Omicron variant. Although there is concern that Omicron has mutations that allow for breakthrough infections after vaccination, immunization is still our best defense against severe infections. We do not know enough yet about severity of Omicron in children but it is important to get all children aged 5 and above vaccinated.
There is no one right answer to this question as the answer is very specific for each person. While we know that cases are rising and health system are being stretched, vaccination reduces the risk of severe infection to immunized individuals. Mental health needs to be considered along with physical health. While some vaccinated people may choose to gather with others, it is important to continue the other protective measures such as mask wearing to prevent transmission. Keeping cases down can help ease the burden on our healthcare system and protect people unable to be protected by vaccination such as young children and people with altered immune systems.