All U.S. adults are eligible for COVID vaccine boosters following a decision last month by the U.S. Food and Drug Administration. On Nov. 19, the FDA authorized use of Moderna and Pfizer/BioNTech COVID vaccine boosters for anyone age 18 and older. That decision was closely followed by support from the Centers for Disease Control and Prevention.

But what does this mean for you?

Experts at UR Medicine, who have been deeply involved in testing COVID vaccines and boosters, provide answers to frequently asked questions.

Dr. Angela Branche is an associate professor of Infectious Diseases and co-director of the University of Rochester Vaccine and Treatment Evaluation Unit

Dr. Ann Regina Falsey is a professor of Infectious Diseases and co-director of the Vaccine and Treatment Evaluation Unit at the University of Rochester Medical Center

Who can get a COVID booster?

Branche: According to the CDC, everyone over 18 is eligible for a COVID booster at least six months after completing their primary series of Moderna or Pfizer COVID vaccines, but some groups are particularly encouraged to get boosters, including:

n Anyone 18 and over who got the Johnson & Johnson shot at least two months ago

n Anyone 50 and older who completed the Moderna or Pfizer COVID vaccine series at least six months ago

n Anyone 18 and older who lives in a long-term care setting

Should I get a COVID booster if I’m pregnant?

Falsey: If it has been more than six months since your original vaccination, boosting during pregnancy is very reasonable. Pregnant people who get COVID can become seriously ill which can be bad for both you and your baby. Boosting your antibodies during pregnancy should lead to better protection of your baby after it is born and will boost levels of helpful antibodies in your breast milk.

If you get a COVID vaccine primary series or booster while pregnant or just after delivery, you may also be eligible to participate in a COVID Vaccine Pregnancy study through the University of Rochester Medical Center. The study will track your immune response to the booster, as well as your baby’s. Sign up to participate.

Which booster should I get? Should it be the same as my original COVID vaccine?

Branche: The FDA and the CDC approved a mix-and-match approach to COVID vaccine boosters, allowing you to get any of the three COVID boosters authorized for use in the U.S. (Moderna, Pfizer/BioNTech and Johnson & Johnson). However, if you tolerated your original COVID vaccine well and didn’t have significant side effects, it might be best to seek a booster of that same vaccine.

Should I wait to get a new booster targeting the Omicron variant?

Falsey: No, don’t wait. Get vaccinated or boosted as soon as possible. While we must take the new Omicron variant seriously and it will surely reach our community sooner or later, the Delta variant is a very real and current threat – causing high rates of COVID cases and hospitalizations across Monroe County. There is some concern that the Omicron variant may evade current vaccines or infection immunity, but we just don’t know that yet. It will take time to answer that question and to develop a new vaccine, so in the meantime, protect yourself.

What are the COVID booster side effects?

Falsey: The side effects of the boosters are very similar to those associated with the original shots. Side effects such as myocarditis (inflammation of the heart) remain very rare for both the primary series and boosters of the mRNA vaccines produced by Moderna and Pfizer/BioNTech. And it’s important to note: You are much more likely to develop myocarditis in response to a COVID infection than to the vaccines.

If I need a booster, does that mean the COVID vaccines aren’t working?

Falsey: While it is true that immunity from vaccines has waned over time, the efficacy for severe disease remains very high. The overwhelming majority of people hospitalized and dying from COVID are unvaccinated. Though we are seeing infections among people who are vaccinated, most of those so-called breakthrough infections are mild to moderate upper respiratory or flu-like illness.

When am I considered fully vaccinated?

Falsey: You are considered fully vaccinated about two weeks after receiving two doses of the mRNA COVID vaccines (Moderna or Pfizer/BioNTech), or two weeks after a single Johnson & Johnson shot. Boosting, while a good idea for many, is not required to be considered fully vaccinated.

Can I stop wearing a mask in public once I’m boosted?

Branche: COVID transmission is still very high in our region and many other parts of the country. While being fully vaccinated is very effective at preventing severe illness and death and boosters are about 90 percent effective at preventing symptomatic infection, there is a small possibility of having a mild or asymptomatic infection. To reduce transmission and protect the vulnerable, you should continue to wear a mask in public indoor settings – especially in areas with high COVID transmission.

Is this the last COVID vaccine dose I will need?

Branche: Scientists around the world are working to answer this important question. The best tool we have to end the pandemic is vaccination. Until we get the vast majority of the world vaccinated, it is likely that transmission will continue with intermittent surges, which, along with the emergence of new variants of concern, will determine if and when another booster dose is needed.

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