COVID-19 Fact vs. Fiction: Who really needs a booster shot?

PITTSBURGH — More than 25 million people have already received COVID-19 vaccine booster shots, according to the CDC.

Booster demand is actually outpacing demand for first shots of the vaccine, and now Pfizer has asked the FDA to allow anyone over the age of 18 to get a booster.

So, are they really needed for everyone? Consumer Investigator Angie Moreschi looks at the debate in our latest Fact vs. Fiction report.

Two camps on boosters

There are basically two camps when it comes to booster shots: those eager to get them and those who feel like it’s too soon and would rather wait.

It’s all about the risk for breakthrough cases. Right now, there are increasing numbers of vaccinated people getting COVID-19, but the CDC reports most of those cases don’t lead to serious illness or hospitalization.

QUESTION 1: Is a booster shot really needed?

We talked with UPMC infectious disease specialist Dr. Linda Nabha, who points to the more infectious delta variant as a key factor.

Dr. Linda Nabha: Those who have lax or waning immune systems and are at high risk of catching COVID-19 in addition to this very infectious variant -- it literally created the perfect storm.

Angie: Are they (people with breakthrough cases) getting serious COVID-19? Are they being hospitalized? Or is it just mild symptoms or asymptomatic?

Dr. Nabha: For the majority of individuals, they’re very mild symptoms. Most people will think they have a little cold, a runny nose, something you think of as a sinus infection. But there have been cases of those who are really immunocompromised and who are older age who have been hospitalized, gotten sick, and unfortunately died.

Q-1 ANSWER: While the number of serious breakthrough cases is still relatively low, the risk is growing. So, Dr. Nabha says “yes” booster shots are needed for older and immunocompromised patients, but not necessarily for younger, healthier people.

Current CDC Recommendations

Right now, for Moderna and Pfizer, boosters are recommended after six months, but only for people in high-risk groups including:

those 65 years or older
Age 18+ who live in long-term care settings
Age 18+ who have underlying conditions
Age 18+ who work or live in high-risk settings

However, this week, Pfizer again asked the FDA to approve its COVID-19 booster shot for everyone 18 and older, even though that request was denied just two months ago, when the booster was first approved for high-risk individuals.

As for those who got the Johnson & Johnson shot, a booster is recommended for everyone over age 18, after two months.

QUESTION 2: If you’re not in one of the approved, recommended groups and still want the vaccine, is it a good idea to try and get the booster anyway?

Dr. Nabha: The CDC says you don’t need it. The data shows they’re very well protected, and that data also shows if they have a breakthrough case, their symptoms are extremely mild.

Q-2 ANSWER: At this point, Dr. Nabha says you should talk to your doctor, but generally she doesn’t think people not in the recommended categories should try to get the booster. The data, so far, shows it is not needed and you are still well protected.

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QUESTION 3: On the other hand, if you are in one of the recommended groups, but feel it’s too soon, is it bad idea to wait to get the booster?

Dr. Nabha: It might just be. It’s getting colder out there, and we know that viruses increase in the winter months. People congregate at home; we have the holidays coming. So, remember that during that time last year is when we saw the rise in COVID-19 cases in the winter. If you are someone of a certain age or if you have an immunocompromising condition or chronic medical condition, your immunity is likely waning, and this is the time to really think about getting that booster shot sooner rather than later.

Q-3 ANSWER: So, ‘yes’ Dr. Nabha says it could be a bad idea to wait.

QUESTION 4: Finally, if you do get a booster, will you get better protection if you mix and match brands?

So, if you originally got Pfizer, is it better to get Moderna for your booster, or vice versa? Or if you got J&J should you get one of the mRNA vaccines (Pfizer or Moderna)?

ANSWER: Research shows it is safe and effective to get a booster shot that’s different from the original vaccine you got. For those who originally got the J & J vaccine, a recently released study sponsored by the National Institutes of Health suggests you could get better protection from one of the mRNA vaccines, rather than another J&J shot.

If you started with Pfizer or Moderna, the answer is still unclear.

Dr. Nabha: UPMC is looking at that exact question. We don’t have the actual data yet. That’s being worked out currently and we hope to be able to provide that data in the very near future.