The Centers for Disease Control and Prevention (CDC) recently updated its recommendations regarding COVID-19 vaccinations. Certain immunocompromised individuals and people ages 50 years and older who received an initial booster dose at least four months ago are eligible for another booster to increase their protection against severe disease from COVID-19. Additionally, the CDC recommends that adults who received a primary vaccine and booster dose of Johnson & Johnson’s Janssen COVID-19 vaccine at least four months ago can receive a second booster dose of a Pfizer-BioNTech or Moderna COVID-19 vaccine.
The Israeli study of a second booster also factored into the decision, even though it is not fully published yet. The study offered a second booster dose to people age 60 to 100 and then looked at mortality. After 15 days there was already a big difference in deaths and hospitalizations from COVID between the two groups. For those age 60 to 69, people with just one booster had a two-fold higher rate of death from COVID. And for those over 80, the rate was almost 10 times as high.
The FDA is looking into the future at BA.2 and what other variants may emerge next. The coming BA.2 wave could mimic what happened with omicron, and older individuals and immunocompromised people will be hit hardest. In this case, a second booster is likely to provide added protection for these vulnerable groups.
Why limit to people over 50?
A fourth booster does not seem to create much of a benefit when it comes to more severe outcomes for those who are younger.
This comes from another Israeli study, just published in NEJM, that looked at a fourth dose of the vaccine in health care workers during omicron. A second booster only provided a marginal benefit to those under 60.
The age 50 to 60 category, especially in those without health problems, right now is a gray zone. The data on efficacy of a second booster in this group is limited, so it’s hard to say what the benefit is. These individuals may do well with just one booster if they don’t have additional comorbidities.
CVS said that eligible patients can schedule an additional dose four months after their initial booster at CVS.com, MinuteClinic.com or through the CVS Pharmacy app. Same-day or walk-in vaccination appointments may be possible, CVS said, but subject to local demand.
