To Boost or Not to Boost Again?

Updated on May 2, 2022
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By Dr. Jerome Adams

The FDA recently approved a second booster dose of both the Pfizer-BioNTech COVID-19 vaccine and the Modern COVID-19 vaccine for those aged 50 years or older. A second booster, much like the first, can increase protection against infection, particularly in groups that are high risk for severe complications.

Recent studies on the effectiveness of COVID-19 vaccines show that the protection vaccines and boosters provide against the virus wanes over time and eventually disappears. In other words, immunity doesn’t last forever, and isn’t as strong on Day 90 as on Day 10. As time passes, you again become susceptible to infection. This is not unlike the annual flu vaccine, the difference being that while flu is most virulent in winter season, COVID-19 seems destined for prevalence in all seasons. 

If You’re a Senior, When Should You Consider a Second Booster?

While the FDA has approved a second booster shot for seniors, the Centers for Disease Control and Prevention (CDC) has issued only a permissive recommendation. This means that while you now have access to a second booster, the CDC has no official statement on the urgency of getting one. 

At the same time, the SARS-CoV-2 BA.2 Omicron subvariant is now dominant, and accounts for  more than half of COVID-19 cases in the United States. The variant is reportedly up to 50-percent more contagious than previous variants, which means that it’s easier to catch, especially if you have waning or no immunity. The good news is that while BA.2 is more contagious than previous COVID-19 variants, it’s not more dangerous. Additionally, research shows that vaccines are effective in protecting individuals against severe complications from infection with BA.2. This means that for those at risk of serious illness, like individuals 65+, being fully vaccinated and boosted is still the best protection against COVID-19. 

CDC guidelines recommend a second booster no earlier than four months after a first booster shot. So, if you got your first booster in December 2021, it’s time to start considering your second booster shot. But it’s also important to remember that these broad recommendations are not meant to be one-size-fits-all; consideration should also be given to personal health and risk factors, including personal level of immunity.

A Quick Spit Can Tell You if You Have Immunity or Not

Antibody testing is the only way to know whether an individual has a detectable level of immunity to protect them against COVID-19. The FDA has cleared a saliva antibody test under emergency use authorization (EUA) in doctors’ offices: the CovAb™ antibody test provides results in just 15 minutes with a quick oral swab. So, when you spit on a stick, antibody testing will give you the knowledge you need to make an informed decision about when to boost again.

Dr. Jerome Adams is a former vice admiral in the U.S. Public Health Service Commissioned Corps and served as the 20th Surgeon General of the United States. He is a distinguished professor and director of health equity initiatives at Purdue University. Follow him on Twitter: @JeromeAdamsMD

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