What to know about COVID vaccine third shots and boosters

Many people who anticipated a return to a carefree summer found their plans disrupted by the Delta variant behind recent high infection rates. The COVID-19 Delta variant has proven itself unforgiving to communities that have not successfully controlled its spread.

But unlike 2020, the vaccine is widely available to most Americans.

Our current vaccines continue to save lives—even as the virus mutates, modern medicine allows us to respond appropriately, says Alexis Cates, DO, an emergency medicine physician. Health officials have approved a third dose of the COVID-19 vaccine for eligible individuals, and are also reviewing the need for a booster shot in others.

What does this mean and what is the anticipated timeline?

The third dose

In August 2021, the FDA authorized a third dose of the COVID-19 vaccine for certain immunocompromised individuals. FDA guidance identifies this eligible group as “solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise.”

These individuals are more vulnerable to COVID-19 and may benefit from the additional protection of a third dose.

Dr. Cates says this authorization is mainly due to the concern that their immune response to the first two doses is much weaker compared to the immunocompetent (those able to produce a normal immune response).

Protection from illness

A “break-through” case of COVID-19 may still occur in these individuals, but there is some evidence this third dose may boost their immune response and provide further protection, explains Dr. Cates. The goal may not be to prevent disease altogether, but rather severe disease requiring significant interventions, hospitalizations, and death.

Currently, authorization for a third dose applies only to the Pfizer/BioNTech COVID-19 vaccine and the Moderna COVID-19 vaccine. Those who have received the single-dose Johnson & Johnson COVID-19 vaccine are advised to consult with their physicians before seeking an additional dose. Additionally, those following the Pfizer/BioNTech or Moderna vaccine regimens should consult with their physicians to determine eligibility and clear up personal concerns (if applicable).

COVID-19 booster shot

While the specific term third dose currently only applies to the guidance mentioned above, an additional dose for individuals who are not immunocompromised is being referred to as a “booster shot.”

The FDA is evaluating data to determine the need for a booster shot for the general public, but despite what some media headlines may suggest, a conclusion has not been made at this time. Current FDA guidance authorizes a booster shot for specific groups of individuals. It is normal for scientific and medical guidance to change based on new knowledge, especially when an evolving disease like COVID-19 is involved, notes Dr. Cates.

Physician guidance recommended

Many physicians are following guidelines as issued by the nation’s health officials and know how to interpret this information as it pertains to each individual’s case, Dr. Cates tells patients. As more groups may be recommended to receive an additional dose in the COVID-19 vaccine series soon, it will be particularly important to have this discussion with your doctor.

Dr. Cates encourages patients to bring their CDC-issued vaccine cards to their physician appointment and to bring up any adverse reactions they may have had.

The current vaccine regimens have been administered to millions of Americans and are demonstrated to greatly reduce the risk of hospitalization and death. If this changes over time, guidance can be changed. One thing cannot be changed—the fact that more than 650,000 Americans have died from COVID-19.

“Nothing can reverse that, but we have the means to protect those who are still with us one vaccination at a time,” says Dr. Cates. “I cannot stress enough the value of these vaccines and the need to stay current with your doses.”