(CDC) Considerations for use of a COVID-19 vaccine booster dose 11-19-2021

CDC has expanded recommendations for booster shots to now include all adults ages 18 years and older who received a Pfizer-BioNTech or Moderna (mRNA) COVID-19 vaccine as part of their primary series. Get more information and read CDC’s media statement.

(CDC) Considerations for use of a COVID-19 vaccine booster dose (November 19, 2021) https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#considerations-covid19-vax-booster

Recommendations (Use link to see full recommendations.) for use of a single COVID-19 booster dose after completion of a primary series can be found in the Overview of COVID-19 vaccine recommendations and are summarized as follows:

  • Recipients of an mRNA primary series (Pfizer-BioNTech or Moderna):
    • People aged ≥50 years and residents aged ≥18 years in long-term care settings should receive a single COVID-19 vaccine booster dose (Pfizer-BioNTech, Moderna, or Janssen) ≥6 months after completion of their primary mRNA vaccine series
    • All other persons aged ≥18 years may receive a single COVID-19 vaccine booster dose (Pfizer-BioNTech, Moderna, or Janssen) ≥6 months after completion of their primary mRNA vaccine series based on their individual benefits and risks.
  • People aged ≥18 years who received a Janssen primary series should receive a single COVID-19 vaccine booster dose (Pfizer-BioNTech, Moderna, or Janssen) ≥2 months after their Janssen primary dose.
  • Currently, a booster dose is not recommended in people aged <18 years.

-          Pregnant people can receive any of the currently FDA-approved or FDA-authorized COVID-19 vaccines as a booster dose.

-          These booster dose recommendations also apply to people who received two doses of different mRNA COVID-19 vaccine products for their primary series.

-          The sections on People who received COVID-19 vaccine outside the United States and People who received COVID-19 vaccine as part of a clinical trial should be consulted for booster dose recommendations in these groups.

Individual benefit-risk assessment considerations for receiving a booster dose

For people aged ≥18 years whom ACIP and CDC recommend may receive a COVID-19 booster dose, the following individual benefits and risks can be considered.

The benefits of a COVID-19 booster dose may include a reduced risk of SARS-CoV-2 infection and a reduced risk for severe COVID-19. Receiving a booster dose may prevent morbidity (including post-COVID symptoms) and may reduce transmission of the virus to other people. People in this risk category should consider the following risk factors for SARS-CoV-2 infection and the potential impact of SARS-CoV-2 infection:

  • Risk of exposure to SARS-CoV-2Factors that would be expected to affect the risk of exposure to SARS-CoV-2 include work or residence in certain settingslevel of community transmissionrates of COVID-19 vaccination in their community; the likelihood of frequent interactions with possibly unvaccinated people from outside an individual’s household; and adherence to current prevention measures.
  • Risk for developing SARS-CoV-2 infection: A person’s risk for developing SARS-CoV-2 infection may vary based on time from completing a primary COVID-19 vaccine series and time from prior SARS-CoV-2 infection due to waning immunity. Serologic testing or cellular immune testing is not recommended as part of the individual risk benefit assessment.
  • Risk for severe infection related to underlying conditions: A person’s risk of developing severe COVID-19 may vary by the type, number, and level of control of specific medical conditions as well as other yet to be defined variables. Pregnant people may receive a COVID-19 vaccine booster. Separately, also see section on Considerations for COVID-19 vaccination in moderately or severely immunocompromised people.
  • Potential impact of SARS-CoV-2 infectionSARS-CoV-2 infections that are not severe may still lead to morbidity (e.g., post-COVID-19 symptoms). A person’s individual circumstances should also be considered; these may include living with/caring for a person who is medically frail or immunocompromised or a child who is not eligible for COVID-19 vaccine or the inability to work or meet other personal obligations when infected, even if not severely ill with COVID-19.