Vaccine Booster Doses

Content last updated September 3, 2022

Staying up to date with booster doses as soon as you are eligible is your best protection against serious illness and death from COVID-19.

The Center for Disease Control and Prevention (CDC) and the Western States Scientific Safety Review Workgroup’s updated booster dose recommendations are as follows:

  • Children ages 5-11 should receive a booster dose five months after completing their primary vaccine series. Immunocompromised children should receive their booster at least three months after their primary series.
  • Everyone 12 and older should receive an updated bivalent booster dose two months after completing their primary vaccine series or prior booster dose.
If you received... Who should get a booster When to get a booster Which booster to get
Pfizer-BioNTech People 5 years and older

People 5 -11 years old can receive a monovalent booster at least 5 months after completing the primary series

People 12 years and older can receive an updated bivalent booster at least 2 months after  completing the primary series or prior booster dose

People 12-17 years old should only receive an updated bivalent Pfizer booster

People 18 years and older should receive an updated bivalent Pfizer or Moderna booster

Moderna People 12 years and older At least 2 months after completing the primary series or prior booster dose

People 12-17 years and older should only receive an updated bivalent Pfizer booster

People 18 years older and older
should receive an updated bivalent booster dose of Pfizer or Moderna

Novavax People 12 years and older At least 2 months after completing the primary series or prior booster dose

People 12-17 years old should only receive an updated bivalent Pfizer booster

People 18 years and older should receive an updated bivalent booster dose of Pfizer or Moderna

Johnson & Johnson People 18 years and older At least 2 months after completing the primary series or prior booster dose People 18 years and older should receive an updated bivalent booster dose of Pfizer or Moderna

Doses for Immunocompromised

If you are moderately or severely immunocompromised, guidelines will vary.

If you got… Should I get an additional dose? Can I get a booster?
Pfizer: Two doses administered 21 days apart for ages 5 years and older Yes, people age 5 years and older who are moderately or severely immunocompromised should get an additional dose 28 days after their 2nd shot.

Yes, an original monovalent Pfizer mRNA booster is recommended 3 months after the last dose to be up to date for those aged 5-11 years.

A 2nd mRNA booster is not recommended for those aged 5-11 years.

Yes, an updated bivalent mRNA booster is recommended 2 months after the last dose to be up to date for those ages 12 and older.

Pfizer: Three doses administered for children 6 months through 4 years old. The first two doses are to be administered 21 days apart and the third dose 8 weeks after the second dose. No, children 6 months through 4 years old who are moderately or severely immunocompromised should not receive an additional primary dose at this time. No, an mRNA booster is not recommended for children 6 months through 4 years old at this time.
Moderna: Two doses administered 28 days apart for ages 6 months and older Yes, people aged 6 months and older who are moderately or severely immunocompromised should get an additional dose 28 days after their 2nd shot.

No, an mRNA booster is not authorized for those 6 months through 11 years old at this time for those who received Moderna as their primary series.

Yes, an updated bivalent Pfizer mRNA booster is recommended 2 months after the last dose to be up to date for those 12 - 17 years and older.

Yes, an updated bivalent mRNA booster is recommended 2 months after the last dose to be up to date for those 18 years and older.

Johnson & Johnson: One dose, authorized for ages 18 and older Yes, people age 18 years and older who are moderately or severely immunocompromised should get an additional dose with mRNA vaccine 28 days after 1st dose of J&J.

Yes, an updated bivalent mRNA booster is recommended at least 2 months after the last dose for those aged 18 and older to be up to date.

Novavax: Two doses, administered 21 days apart for ages 12 and older No, people who are moderately or severely immunocompromised should not receive an additional primary dose at this time.

Yes, an updated bivalent Pfizer mRNA booster is recommended 2 months after the last dose to be up to date for those 12 - 17 years and older.

Yes, an updated bivalent mRNA booster is recommended 2 months after the last dose to be up to date for those 18 years and older.

Frequently Asked Questions

Do I have to get the same vaccine brand for my booster dose?

You can get a different vaccine for your booster dose than the vaccine you got for your primary series. The CDC made their decision following a careful review of the latest data (Moderna, Johnson & Johnson, mix and match boosters), and robust and deliberative discussion around booster shots.

People under 12 years old may only get a monovalent Pfizer-BioNTech vaccine. People 12-17 years and older should only receive an updated bivalent Pfizer booster.

Why are booster doses important?

Booster doses will help provide continued protection against severe disease. Booster doses were previously recommended only for populations at high risk for severe COVID-19, but the recommendation expanded to include everyone 5 years and older to help increase protection against COVID-19 illness. This is especially important with the rise of more contagious variants and cases of COVID-19 increasing across the United States.

The COVID-19 vaccines authorized or approved in the United States are still very effective at reducing the risk of severe disease, hospitalization, and death from COVID-19, even against variants. Still, the current vaccines may be associated with a drop in protection over time. Booster doses will increase vaccine-induced protection against COVID-19 and help immunity last longer.

Are you still vaccinating people with the primary series?

Yes. Getting everyone who is eligible vaccinated with a primary series is still a top priority. Hospitalization rates are 10 to 22 times higher in unvaccinated adults compared to vaccinated adults. People who are vaccinated are significantly less likely to get seriously sick (or sick at all) from COVID-19, compared to those who are unvaccinated.  Vaccinations can also help prevent individuals from getting ill and developing the long-haul symptoms reported by up to 50% of those who become ill from COVID-19.

If we need booster shots, does that mean that the vaccines aren't working?

No. The current COVID-19 vaccines we have in the U.S. are working well to prevent severe illness, hospitalization, and death, even against variants. However, public health experts are seeing reduced protection against mild and moderate COVID-19 illness, especially among high-risk populations.

The updated boosters were created to help boost immunity and provide better protection from some of the newer variants. It's important to get all recommended doses so you have maximum protection against variants.

If I don't get a booster dose, am I still fully vaccinated?

A person is fully vaccinated two weeks after receiving all recommended doses in the primary series of their COVID-19 vaccination.

A person is up to date with their COVID-19 vaccination if they have received all recommended doses in the primary series and all boosters when eligible.

How do I show that I'm eligible for a booster dose?

You can self-report that you are eligible for a booster dose. You do not need to show a recommendation from a health care provider.

Please take your vaccination card to your booster dose appointment so the provider can first confirm that you've completed the entire primary vaccine series. If you don't have your card, the provider can look up your record.

What’s the difference between an additional vaccine dose and a booster vaccine dose?
  • An additional dose is for patients who completed a primary mRNA vaccine series (Pfizer or Moderna) but did not have a strong enough immune response. 
  • A booster dose is for patients when it’s likely that their immunity after the initial vaccine series waned over time.
What does it mean to be immunocompromised?

The U.S. Food and Drug Administration (FDA), Advisory Committee on Immunizations Practices (ACIP), and Western States Scientific Safety Review Workgroup recommend a third dose of vaccine for moderately to severely immunocompromised people who received a two-dose mRNA series or one dose J&J vaccine.

If you have any of the following medical conditions, you are considered moderately to severely immunocompromised and may benefit from an additional dose of COVID-19 vaccine. This includes people who:

  • Are receiving active cancer treatment for tumors or cancers of the blood
  • Received an organ transplant and are taking medicine to suppress the immune system
  • Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
  • Have moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Have advanced or untreated HIV infection
  • Are receiving active treatment with high-dose corticosteroids or other drugs that may suppress the immune response.

While the vaccines we have are 90% effective against most virus variants, studies show that moderate to severely immunocompromised individuals do not always build strong immunity. The third dose is not considered a booster, but an additional dose for those who did not develop adequate immunity with the two-dose series.

What are underlying medical conditions?

People of any age with the conditions listed below are more likely to get severely ill from COVID-19. Severe illness means that a person with COVID-19 may:

  • Be hospitalized
  • Need intensive care
  • Require a ventilator to help them breathe
  • Die

COVID-19 vaccines (initial doses and boosters) and other preventive measures for COVID-19 are important, especially if you are older or have multiple or severe health conditions including those on this list. This list does not include all possible conditions that place you at higher risk of severe illness from COVID-19. If you have a condition not included here, talk to your health care provider about how best to manage your condition and protect yourself from COVID-19.

  • Cancer
  • Chronic kidney disease
  • Chronic liver disease
  • Chronic lung diseases
  • Dementia or other neurological conditions
  • Diabetes (type 1 or 2)
  • Down syndrome
  • Heart conditions
  • HIV infection
  • Immunocompromised state (weakened immune system)
  • Mental health conditions
  • Overweight and obesity
  • 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
  • Tuberculosis
What is the rationale for reducing the booster interval—from 5 months to 3 months—for people ages 5-11 who are moderately or severely immunocompromised?

People who are moderately or severely immunocompromised may not develop protective immunity after a primary series, even when the recommended mRNA vaccine primary series is used. They are also more likely to lose protective immunity over time and might need to get a booster dose sooner. Early data from several small studies show that people who are moderately or severely immunocompromised often develop increased antibody levels again after a booster dose given at an interval shorter than 5 months. There was no evidence of an increased safety concern. Currently, there is rapid spread of COVID-19 in the United States, and exposures to infected people are hard to avoid. Therefore, providing a booster dose as soon as possible makes sense for those at highest risk for severe complications.

Will people who are moderately or severely immunocompromised need a doctor’s note/prescription or other documentation to receive these doses?

No, individuals can self-identify and receive all doses anywhere vaccines are offered. This will help ensure there are not additional barriers to access for this population. If immunocompromised individuals have questions about their specific medical condition, they may discuss whether getting an additional dose is appropriate for them with their health care provider.