What you need to know: COVID-19 booster shots versus additional doses

This blog was written by Adriana B. Díaz Bula, a PharmD candidate completing her Pharmacy Benefit Management Rotation at Abarca.

At present, much talk has been circulating as to whether booster shots or additional doses for the COVID-19 vaccine are necessary, safe, or effective. As part of our mission to bring better care to our communities through education and the latest updates in current health trends and topics, in this blog, we explore the difference between booster shots versus additional doses and answer questions like ‘who are the people who may need the booster shot or additional doses?’ 

This summer, the US Department of Health and Human Services (HHS) announced a plan to begin offering COVID-19 booster shots starting September 20th, 2021. As a result, some populations have already started to receive additional doses.

But, potentially confusing information is beginning to emerge about who should receive additional doses and when they should get them. 

Here’s what you need to know:

What’s the difference between a booster dose and an additional dose?

According to the US Centers for Disease Control and Prevention (CDC), a “booster shot” is a dose of a vaccine that is given to someone who built enough protection after their vaccination but whose immunity has decreased over time. An additional dose may be necessary when a person has not developed a strong enough immunity from the first dose(s). For example, moderate to severely immunocompromised patients may not build up enough protection from the initial vaccination and may require an additional dose to ensure their immunity.

Why are COVID booster shots controversial?

Based on data that was released earlier this year, the Biden administration was set to begin offering booster shots to people eight months after their second dose. However, the CDC does not recommend booster shots at this time because COVID vaccines are still proving to be highly effective against severe coronavirus cases and deaths.

A recent report from two US Food and Drug Administration (FDA) vaccine experts who are leaving the agency this year found that boosters are not yet necessary. These findings are supported by groups like the World Health Organization that say boosters are irresponsible when so much of the global population is still waiting on their first doses.

Who is eligible for an additional dose?

Additional doses are available now for people who are considered moderately or severely immunosuppressed and received the Pfizer or Moderna vaccines. This includes those who:

  • Receive active cancer treatment for tumors or cancers of the blood.
  • Received an organ transplant and are taking medicine to suppress the immune system.
  • Have either had a stem cell transplant within the last two years or are taking medicine to suppress the immune system.
  • Were diagnosed with DiGeorge syndrome or Wiskott-Aldrich syndrome. 
  • Are diagnosed with HIV and have a high viral load or low CD4 count, or are not currently taking medication to treat HIV.
  • Are taking drugs such as high-dose steroids or other medications that may cause severe immune system suppression.

 What about the Johnson & Johnson COVID vaccine?

As we wait for more research, there is not yet a recommendation for a booster or additional dose for those who received the Johnson & Johnson vaccine–even if they have a qualifying medical condition.

Studies are still being done on both booster shots and additional doses, and Abarca will continue to update its clients and members as guidance becomes available. Regardless, you should consult your healthcare provider before getting an additional dose to determine if it is appropriate for you.

This blog was written by Adriana B. Díaz Bula, a PharmD candidate completing her Pharmacy Benefit Management Rotation at Abarca.

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