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FAQs: COVID-19 Vaccine Boosters

A senior citizen after receiving a booster shot.

Booster doses of the COVID-19 vaccines are recommended for people age 5 years and older as soon as eligible. Here are answers to some of the most frequently asked questions about COVID-19 vaccine booster doses.

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

A primary series is generally an initial two-dose series of an mRNA COVID-19 vaccine (Pfizer or Moderna) or a single dose of Johnson & Johnson vaccine. An additional dose can be given after the second dose of Moderna or Pfizer, and the first dose of Johnson & Johnson, to people who likely did not have a protective immune response to the initial vaccination. This additional dose is recommended for moderately to severely immunocompromised people. A booster dose is given to people who have received a primary series. The intent is to boost immunity because protection is likely to have waned over time.

If we need booster doses, does this mean the COVID-19 vaccines are no longer effective?

No. The COVID-19 vaccines continue to be remarkably effective at reducing risk of severe disease, hospitalization, and death from COVID-19, and continue to offer protection against variants. Protection against severe illness and death was the original goal of vaccines. A booster dose could help fully vaccinated people at greater risk maintain the highest protection over time, and data suggests that boosters help broaden and strengthen protection against Omicron and other variants. People who received their initial vaccine series will experience waning immunity over time. Receiving a timely booster dose when you are eligible restores those antibody levels and provides significant protection.  

How old do you have to be to receive a COVID-19 booster dose?

Booster doses are authorized for fully vaccinated Pfizer-BioNTech (Comirnaty), Moderna (Spikevax), and Johnson & Johnson vaccine recipients who are 5 years old or older. 

When should I get a COVID-19 booster dose?

Those who originally received a two-dose series of either the Pfizer or Moderna vaccine can get a booster five months after their last dose. Those who originally received the Johnson & Johnson vaccine can get a booster two months after their last dose. 

More info: COVID-19 Vaccination Schedule.

Those who are moderately to severely immunocompromised are eligible to get an additional dose with their primary vaccination series to strengthen the initial immune response, as well as a booster dose.

Why are some people now getting a second booster?

A second booster dose may offer a real advantage to those who are at increased risk for severe illness or death from COVID-19. This includes people who are moderately to severely immunocompromised, are age 65 or older, or who are age 50 and older with underlying medical conditions. The Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) will continue to study if/when additional boosters will be recommended for more people. But for now, individuals at highest risk have another opportunity to add another layer of protection against COVID-19.

Who can get a second booster dose?

Certain people who are at the higher risk for severe illness or death from COVID-19 now have the choice to add another layer of protection with a second booster dose.  

  • People age 50 and older who received an initial mRNA booster dose (Pfizer-BioNTech or Moderna) at least four months ago should receive a second booster dose of an mRNA COVID-19 vaccine. A second booster dose may be most beneficial for people who are age 65 and older, or who are age 50-64 with certain underlying medical conditions.
  • People age 12 and older who are moderately to severely immunocompromised who received an initial mRNA booster dose (Pfizer or Moderna) at least four months ago should receive a second booster dose of an mRNA COVID-19 vaccine (Pfizer, age 12+; Moderna, age 18+). 
  • Adults who received a primary vaccine and booster dose of the Johnson & Johnson (Janssen) COVID-19 vaccine at least 4 months ago may receive a second booster dose using an mRNA COVID-19 vaccine (Pfizer or Moderna).

People who are now eligible to receive a second booster dose are encouraged to talk to their healthcare providers to assess individual risks and the benefits of another dose in strengthening ongoing protection.

I’m immunocompromised. Does this mean I should now get five doses?

If you are moderately to severely immunocompromised, received the Moderna or Pfizer vaccine and you are age 12 years or older, you may now receive as many as five doses – the three-dose primary series, plus two booster doses. Children age 5-11 years should get a three-dose primary series, plus one booster dose.

If I originally received the Johnson & Johnson vaccine and its booster, should I get another dose?

If it has been at least four months since your booster, you may choose to receive another booster, this time an mRNA vaccine (Pfizer or Moderna) to boost your ongoing protection. According to a recent CDC study, three doses of a messenger RNA vaccine perform the best, while a Johnson & Johnson vaccine followed by a mRNA booster shot is next best. Two shots of Johnson & Johnson provide a lower level of protection.

Can I get a booster dose of a different vaccine than I initially received?

It depends on your age. If you are 5-17 years old, you are only eligible to receive the Pfizer vaccine. If you are an adult age 18 years or older, a COVID-19 booster dose does not have to match the vaccine given for the primary series. Some people may prefer the vaccine type originally received, and others may choose to get a different booster. 

Which vaccine is the best for a booster?

The COVID-19 mRNA vaccines developed by Pfizer and Moderna are recommended in most cases. Individuals who are unable to receive an mRNA vaccine can receive Johnson & Johnson’s COVID-19 vaccine.

Are the side effects worse for the booster?

Adults and children may have some side effects from a COVID-19 vaccine including pain, redness or swelling at the injection site, tiredness, headache, muscle pain, chills, fever and nausea. Serious side effects are rare, but may occur.

Am I still fully vaccinated if I haven’t gotten a booster?

Yes, a person is still considered fully vaccinated two weeks after the 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 Johnson & Johnson vaccine. Fully vaccinated does not mean optimally protected. To be optimally protected and up to date on their recommended COVID-19 vaccinations, a person needs to get a booster shot when eligible.

What is considered “up to date” on COVID-19 vaccinations?

Everyone is considered up to date until the time they are eligible for another dose. Fully vaccinated individuals are eligible for a booster 5 months after the second dose in a two-shot series, (Pfizer-BioNTech or Moderna vaccines), or two months after the J&J/Janssen vaccine. A person would need to get all recommended booster shots to be considered up to date.

Where can I get a booster dose?

Vaccines are widely available at many locations across the state, including local health departments, pediatricians, family physicians, community health centers, adult and children’s hospitals, and pharmacies. Ohioans are encouraged to call their provider for more information or visit gettheshot.coronavirus.ohio.gov or call 1-833-4-ASK-ODH (1-833-427-5634) to locate a provider or make an appointment.

How much does a booster dose cost?

There is no out-of-pocket cost for a COVID-19 vaccine. Your provider may ask for your insurance, Medicare, or Medicaid information, because providers can charge an administration fee to insurance. You will not have to pay a fee directly.

Do I have to get my booster at the same place where I received the original vaccine series? What if it isn’t open anymore?

No, you do not need to visit the same vaccine provider for your booster dose. To find a provider near you, visit gettheshot.coronavirus.ohio.gov or call 1-833-427-5634.

Do I need to bring my COVID-19 vaccine card to my appointment? What if I lost it?

Ohioans are encouraged to bring their existing COVID-19 vaccine card to be updated. If you cannot find your vaccine card, you should first contact your original vaccine provider to see if they can locate your records. If they are unable to assist, please contact your local health department. If they are unable to assist, please review this information on how to mail a request for your vaccination records to the Ohio Department of Health. You will not be able to obtain a new vaccine card by request, but will be able to access your vaccination records. If you do not have your card, you can still get your booster dose.

Updated May 26, 2022.

For additional information, visit coronavirus.ohio.gov. For answers to your COVID-19 questions, call 1-833-4-ASK-ODH (1- 833-427-5634).

Your mental health is just as important as your physical health. If you or a loved one are experiencing anxiety related to the coronavirus pandemic, help is available 24 hours a day, seven days a week. Call the COVID-19 CareLine at 1-800-720-9616.