Booster Doses: Frequently Asked Questions
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Eligibility

Why do I need a booster dose?

“Booster doses” will provide a boost in the fight against COVID-19 so eligible New Yorkers have continued protection against the virus.

Our federal health and medical experts have been analyzing the scientific data closely from New York, the United States and around the world to understand how long the vaccine's protection will last and how we might maximize this protection. Although COVID-19 vaccines remain highly effective in preventing severe disease and hospitalization, the available data of the Pfizer-BioNTech COVID-19 vaccine suggest that protection against COVID-19 infection begins to decrease over time following the initial doses of Pfzier-BioNTech vaccination for certain populations who are at increased risk. For those currently eligible, a booster dose of the COVID-19 vaccine will help maximize protection, prolong the vaccine’s durability and continue to safeguard the public health of our communities—and particularly those at increased risk of infection and severe disease.

 

If we need a booster dose, does that mean that the vaccines aren’t working?

No. COVID-19 vaccines are working very well to prevent severe illness, hospitalization, and death, even against the widely circulating Delta variant. That's why at this time, based on the currently available data of the Pfizer-BioNTech COVID-19 vaccine, booster doses are recommended to certain populations who may be at increased risk of infection or severe disease six months after their initial Pfizer-BioNTech vaccine series. It is normal for a vaccine's protection to wane over time, and the recommended booster dose for eligible New Yorkers will help maximize their protection, prolong the vaccine's durability, and keep at-risk New Yorkers healthy and safe.

 

Am I eligible for a booster dose?

At this time and in accordance with CDC guidance, the following groups of New Yorkers should receive their COVID-19 booster vaccine dose:

  • New Yorkers 65 years and older or residents in long-term care settings should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series,
  • New Yorkers aged 50–64 years with underlying medical conditions should receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series.

 

The following groups of New Yorkers may receive their COVID-19 booster vaccine dose:

  • New Yorkers aged 18–49 years with underlying medical conditions may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks, and
  • New Yorkers aged 18-64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.

 

What underlying conditions qualify New Yorkers as currently eligible to receive their COVID-19 booster dose?

According to the CDC, for the purpose of eligibility for a COVID-19 Pfizer-BioNTech booster dose, underlying conditions include:

  • Cancer (current or in remission, including 9/11-related cancers)
  • Chronic kidney disease
  • Chronic lung diseases, including COPD (chronic obstructive pulmonary disease), asthma (moderate-to-severe), interstitial lung disease, cystic fibrosis, and pulmonary hypertension, including 9/11-related pulmonary diseases)
  • Dementia or other neurological conditions
  • Diabetes (type 1 or type 2)
  • Down syndrome
  • Heart conditions (such as heart failure, coronary artery disease, cardiomyopathies or hypertension)
  • HIV infection
  • Liver disease
  • Overweight (defined as a body mass index (BMI) > 25 kg/m2 but < 30 kg/m2), obesity (BMI ≥30 kg/m2 but < 40 kg/m2), or severe obesity (BMI of ≥40 kg/m2), can make you more likely to get severely ill from COVID-19. The risk of severe COVID-19 illness increases sharply with elevated BMI.
  • Pregnancy
  • Sickle cell disease or thalassemia
  • Smoking, current or former
  • Solid organ or blood stem cell transplant
  • Stroke or cerebrovascular disease, which affects blood flow to the brain
  • Substance use disorders
  • Immunocompromised state (weakened immune system)

For more information on qualifying medical conditions, visit People with Certain Medical Conditions | CDC.

 

If I am immunocompromised, am I eligible for my additional dose of the COVID-19 vaccine?

According to the CDC, moderately to severely immunocompromised people should receive an additional dose of the COVID-19 vaccine. People with moderately to severely compromised immune systems are especially vulnerable to COVID-19, and may not build the same level of immunity to the two-dose vaccine series compared to people who are not immunocompromised. This additional dose intended to improve immunocompromised people’s response to their initial vaccine series.

An additional dose of an mRNA COVID-19 vaccine (at least 28 days following the last dose of the primary COVID-19 vaccine 7 September 24, 2021 series) should be considered for people with moderate to severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments. These conditions and treatments include but are not limited to:

  • Active treatment for solid tumor and hematologic malignancies
  • Receipt of solid-organ transplant and taking immunosuppressive therapy
  • Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
  • Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.

 

Factors to consider in assessing the general level of immune competence in a patient include disease severity, duration, clinical stability, complications, comorbidities, and any potentially immunosuppressing treatment.

People should talk to their healthcare provider about their medical condition, and whether getting an additional dose is appropriate for them.

 

Can I get a booster dose before I am eligible?

No. Individuals should only receive their booster dose if they are eligible.

 

What proof of eligibility is required for New Yorkers who are currently eligible based on their health conditions or employment status?

In order to prove eligibility, eligible New Yorkers are required provide written self-attestation confirming eligibility, which providers must collect. At this time, providers administering the COVID-19 booster dose will not be required to confirm eligibility in order to enable speedy administration and lower barriers to access for patients.

 

What occupations may qualify New Yorkers as currently eligible to receive their COVID-19 booster dose?

 

According to the CDC, the following occupations may make someone eligible for their COVID-19 Pfizer-BioNTech booster dose:

  • First responders (healthcare workers, firefighters, police, congregate care staff)
  • Education staff (teachers, support staff, daycare workers)
  • Food and agriculture workers
  • Manufacturing workers
  • Corrections workers
  • U.S. Postal Service workers
  • Public transit workers
  • Grocery store workers

 
For more information on this list, which may be updated in the future, please visit Who Is Eligible for a COVID-19 Vaccine Booster Shot? | CDC.

 

    Side Effects, Safety and Efficacy

    What are the side effects of the booster dose?

    Just like your COVID-19 initial vaccine series, you may not notice any changes in how you feel after your booster dose. But it’s also possible to feel a little “under the weather.” This can happen after any vaccine. 

    After the COVID-19 booster dose, you may have:

    • A sore arm where you got the shot
    • A headache
    • Chills
    • Fever
    • Tiredness
    • Nausea and vomiting

    These side effects are not dangerous and are just a sign of your immune system doing its job. They are easily treatable with over-the-counter pain medicine and fever reducers, and usually only last for a short period of time. Serious or long-lasting side effects are extremely rare. If you still don’t feel well after two or three days, you can reach out to their health care provider.

     

    Are COVID-19 booster doses safe?

    Yes. The booster doses are safe, effective, and free – but are currently only recommended for certain New Yorkers who are currently eligible. 

     

    Are there other non-COVID-19 vaccines that require more than two doses?

    Yes. Many vaccines require more than one or two doses for long-lasting protection. For example, the life-saving polio vaccine requires four doses; the hepatitis vaccine requires three doses.

    Other vaccines require occasional “boosts” like the tetanus-diphtheria (tetanus) vaccine, given to individuals every ten years. There are other vaccines that need to be administered even more often. For example, the influenza (flu) vaccine is recommended for individuals each year because of new strains emerging every season.

     

    How long do we expect booster doses to protect us, and will I need another?

    It is not fully clear at this time, which is why our federal and State health and medical experts have been, and continue to, monitor and analyze the scientific data closely from the United States and around the world. This enables us to analyze data as the virus evolves and continue to understand how long this protection will last, and how we might maximize this protection. We will continue to follow the science and communicate openly with New Yorkers as additional data becomes available.

     

    Can people who received Johnson & Johnson’s Janssen (J&J/Janssen) COVID-19 Vaccine get a booster dose of an mRNA vaccine?

    No. At this time and according to the CDC, there currently is not enough data to support getting an mRNA vaccine dose (either Pfizer-BioNTech or Moderna) if someone has previously gotten a J&J/Janssen vaccine.

     

    Will people who received Johnson & Johnson’s Janssen (J&J/Janssen) COVID-19 Vaccine need a booster shot?

    It is likely that people who received the J&J/Janssen COVID-19 vaccine will need a booster dose. Because the J&J/Janssen vaccine wasn’t given in the United States until 70 days after the first mRNA vaccine doses (Pfizer-BioNTech and Moderna), the data needed to make this decision aren’t available yet. These data are expected in the coming weeks. With this data in hand, CDC will keep the public informed with a timely plan for J&J/Janssen booster shots.

     

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

    An “additional dose” refers to another dose of vaccine that is given to someone who is immunocompromised and who may not have built enough protection after their initial COVID-19 vaccine series.

    A “booster dose" refers to another dose of vaccine that is given to someone who built enough protection after vaccination, but then that protection decreased over time.

    For Immunocompromised New Yorkers

    If I am immunocompromised, am I eligible for my additional dose of the COVID-19 vaccine?

    According to the CDC, moderately to severely immunocompromised people should receive an additional dose of the COVID-19 vaccine. People with moderately to severely compromised immune systems are especially vulnerable to COVID-19, and may not build the same level of immunity to the two-dose vaccine series compared to people who are not immunocompromised. This additional dose intended to improve immunocompromised people’s response to their initial vaccine series.

    An additional dose of an mRNA COVID-19 vaccine (at least 28 days following the last dose of the primary COVID-19 vaccine series) should be considered for people with moderate to severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments. These conditions and treatments include but are not limited to:

    • Active treatment for solid tumor and hematologic malignancies
    • Receipt of solid-organ transplant and taking immunosuppressive therapy
    • Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
    • Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)
    • Advanced or untreated HIV infection
    • Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.

    Factors to consider in assessing the general level of immune competence in a patient include disease severity, duration, clinical stability, complications, comorbidities, and any potentially immunosuppressing treatment.

    People should talk to their healthcare provider about their medical condition, and whether getting an additional dose is appropriate for them.

     

    If I am immunocompromised, when should I receive my additional dose?

    CDC recommends that people with moderately to severely compromised immune systems receive an additional dose of mRNA COVID-19 vaccine at least 28 days after a second dose of Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine.


    Immunocompromised individuals should confer with their physicians regarding the appropriateness and timing for receiving an additional dose of COVID-19 vaccine. The New York State Department of Health also encourages physicians to proactively reach out to their immunocompromised patients to discuss the benefits of receiving an additional dose.

     

    Why do immunocompromised individuals need an additional dose of the vaccine?

    According to the CDC, people who are moderately to severely immunocompromised make up about 3 percent of the adult population and are especially vulnerable to COVID-19 because they are more at risk of serious, prolonged illness.

    Studies indicate some immunocompromised people don’t always build the same level of immunity after vaccination the way non-immunocompromised people do, and may benefit from an additional dose to ensure adequate protection against COVID-19. In small studies, fully vaccinated immunocompromised people have accounted for a large proportion of hospitalized “breakthrough cases,” and were more likely to transmit the virus to household contacts.

     

    Can you mix and match the vaccines for my additional dose? For example, if I received the Pfizer-BioNTech for my initial vaccine series, can I receive Moderna’s COVID-19 vaccine for my additional dose?

    For people who received either Pfizer-BioNTech or Moderna’s COVID-19 vaccine series, a third dose of the same mRNA vaccine should be used. A person should not receive more than three mRNA vaccine doses. If the mRNA vaccine product given for the first two doses is not available or is unknown, either mRNA COVID-19 vaccine product may be administered.

     

    What should immunocompromised people who received the J&J/Janssen vaccine do?

    The FDA’s recent EUA amendment only applies to mRNA COVID-19 vaccines, as does CDC’s recommendation.

    Emerging data have demonstrated that immunocompromised people who have low or no protection following two doses of mRNA COVID-19 vaccines may have an improved response after an additional dose of the same vaccine. There is not enough data at this time to determine whether immunocompromised people who received the Johnson & Johnson’s Janssen COVID-19 vaccine also have an improved antibody response following an additional dose of the same vaccine.

     

    What are the benefits of people receiving an additional vaccine dose?

    An additional dose may prevent serious and possibly life-threatening COVID-19 in people who may not have responded to their initial vaccine series. In ongoing clinical trials, the mRNA COVID-19 vaccines (Pfizer-BioNTech or Moderna) have been shown to prevent COVID-19 following the two-dose series. Limited information suggests that immunocompromised people who have low or no protection after two doses of mRNA vaccines may have an improved response after an additional dose of the same vaccine.

     

    What are the risks of vaccinating individuals with an additional dose?

    There is limited information about the risks of receiving an additional dose of vaccine, and the safety, efficacy, and benefit of additional doses of COVID-19 vaccine in immunocompromised people continues to be evaluated. So far, reactions reported after the third mRNA dose were similar to that of the two-dose series: fatigue and pain at injection site were the most commonly reported side effects, and overall, most symptoms were mild to moderate.

    However, as with the two-dose series, serious side effects are rare, but may occur.

    Proof of Booster and Additional Dose

    How should I expect to receive proof of my COVID-19 booster dose and/or my additional dose?

    You should expect to receive proof of your booster dose on your original CDC COVID-19 vaccination card. If you lost your original vaccination card, please reach out to your health care provider to obtain a copy of your immunization record.  New York State does not replace lost vaccination cards because they are issued through the CDC.

     

    Do I need my COVID-19 booster and/or my additional dose to be considered “fully vaccinated” for proof of business and venue entry, where applicable?
     
    No. At this time, New Yorkers are still considered fully vaccinated two weeks after they complete their initial vaccine series – either two weeks after their second dose in a two-shot series such as the Pfizer-BioNTech or Moderna vaccines, or two weeks after a single-dose vaccine, such as the J&J/Janssen vaccine.