Should You Get Your Second Booster Dose Now or Later? (UPDATED 5/23)

Should I Get a Second Booster Dose Now or Later?
Deciding when you should receive your second booster dose of COVID-19 vaccine can be a tough decision. While some may choose to get their second booster dose as soon as they become eligible, others may choose to wait until a later date. Currently, all adults ages 50 years and older and all individuals ages 12 years and older who are moderately or severely immunocompromised should receive a second booster dose of COVID-19 vaccine at least four months after receiving their first booster dose. Due to a recent substantial increase in COVID-19 cases and hospitalizations among older Americans, it is advised that these populations get their second booster dose of COVID-19 vaccine as soon as they become eligible.
However, if you are thinking about delaying your second booster dose vaccination, it is important that you consider your personal risk factors that may make you more susceptible to severe illness, hospitalization or death due to COVID-19. These risk factors could include your age, underlying medical conditions, when you were last infected with COVID-19 and your risk of exposure to COVID-19. North Dakotans are encouraged to speak with a trusted health care provider if they have further questions about when might be the best time for them to receive their second booster dose of COVID-19 vaccine.
Who should receive a second COVID-19 vaccine booster dose?
Before deciding whether you want a second booster dose, it is best to know if you are eligible. Currently, there are three populations eligible to receive a second booster dose of an mRNA (Pfizer or Moderna) COVID-19 vaccine at least four months after their first booster dose.
1. All adults ages 50 years and older
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- All adults ages 50 and older should receive a second booster dose of an mRNA (Pfizer or Moderna) COVID-19 vaccine at least four months after their first booster dose of any approved or authorized COVID-19 vaccine.
2. All individuals ages 12 years and older who are immunocompromised
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- All individuals ages 12 and older who are moderately or severely immunocompromised should receive a second booster dose of an mRNA (Pfizer or Moderna) COVID-19 vaccine at least four months after their first booster dose.
- Currently, adolescents aged 12-17 years old are only authorized to receive the Pfizer COVID-19 vaccine for all doses including their primary series, additional dose and booster doses.
- If you are moderately or severely immunocompromised and have not received your additional dose, you must do so before requesting any booster dose. Please refer to your health care provider if you have questions regarding if your medical condition qualifies you as a patient who is moderately or severely immunocompromised.
3. All adults ages 18-49 years old who have received their primary dose and first booster dose of Johnson & Johnson’s COVID-19 vaccine
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- All adults aged 18-49 years who received the Johnson & Johnson COVID-19 vaccine for both their primary dose and first booster dose at least four months ago are now eligible to receive a second booster dose of an mRNA (Pfizer or Moderna) COVID-19 vaccine.
- This guidance does NOT include adults aged 18-49 years who received the Johnson & Johnson COVID-19 vaccine for their primary dose but then received a first booster dose of an mRNA (Pfizer or Moderna) COVID-19 vaccine.
If you have not yet received your first booster dose of COVID-19 vaccine, please do so before inquiring about your second booster dose.
Reasons to Get Your Second Booster Dose Now
1. A second booster dose may lower your risk of dying due to COVID-19
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- Data from Israel indicates a second booster dose is safe and can save lives. Mortality due to the Omicron variant in this data set was significantly lower—a 78% reduction—in those ages 60 and older in Israel who received a second booster dose.
2. A second booster dose may lower your risk of becoming severely ill or hospitalized due to COVID-19
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- For the week of May 20, 2022, cases and hospitalizations continued to rise as the United States marked one million deaths from COVID-19. Because of the highly infectious Omicron variant and several subvariants, hospitalizations due to COVID-19 have substantially increased over the past several weeks. Receiving a second COVID-19 booster dose could help restore vaccine-induced immunity that may wane over time and protect you from developing severe illness or needing to be hospitalized due to COVID-19.
3. Your risk of severe COVID-19 illness increases with age
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- The older you are, the greater the benefit a second booster dose may bring you. For instance, a healthy 50-year-old is much different than someone who is healthy but may be 60, 70 or even over 80 years old. Older adults with COVID-19 are at an increased risk of requiring hospitalization, intensive care admission or a ventilator to help them breathe.
4. Your occupational or institutional settings may put you at a greater risk of exposure to COVID-19
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- Certain individuals are at higher risk of exposure to the COVID-19 virus depending on where they spend a majority of their time. Those who work in settings such as schools, daycares, medical clinics, factories, and other places where employees cannot safely social distance are at an increased risk. Additionally, those who live in group homes, shelters, nursing homes or are incarcerated may also be at greater risk of exposure to COVID-19.
5. You plan on traveling or attending large gatherings this summer
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- As temperatures begin to rise, we can expect more people to return to summer travel plans and to start attending large gatherings such as concerts, conferences, weddings and sporting events. Putting yourself in situations where there are many people could increase your risk of contracting COVID-19.
6. The last time you were infected with COVID-19 was a while ago
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- Both natural and vaccine-induced immunity has been shown to decrease over time. If you are up to date on your COVID-19 vaccines, meaning you have received your primary series and first booster dose, and you were infected with COVID-19 prior to January 2022, it may be beneficial for you to receive your second booster dose now. Those infected with COVID-19 prior to 2022 were likely not infected with the Omicron variant, which means they may not have as high of natural immunity against this widely circulating variant.
Reasons to Get Your Second Booster Dose Later
While it is not ideal to delay vaccination if you are currently eligible for your second booster dose of COVID-19 vaccine, certain individuals may choose to do so. Please speak with a trusted health care provider if you are considering delaying vaccination in order to ensure you are making the best decision regarding your health. The following are reasons why you and your health care provider may choose to delay your second booster dose vaccination.
1. You had a COVID-19 infection within the past 3 months
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- North Dakotans who recently tested positive for COVID-19 have likely developed natural immunity against the COVID-19 virus, including the widely circulating Omicron variant. These previously infected individuals may choose to delay vaccination for 90 days after they have recovered from their infection. Emerging evidence suggests the best protection against COVID-19 illness is hybrid-immunity, meaning combined immunity from both vaccination and naturally occurring infection.
2. If you won’t want another booster dose again in the fall
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- There is the possibility that another COVID-19 vaccine booster dose recommendation could come again in the future. If you are hesitant about getting your second booster dose now AND a potential third booster dose in the future, it may just be best to delay your second booster vaccination. This is because public health experts anticipate there to be a rise in COVID-19 cases again in the fall or winter seasons, meaning your second booster dose might benefit you more if you received it closer to the fall.
Talk with a trusted health care provider
North Dakotans are encouraged to have a conversation with a trusted health care provider regarding whether to receive their second booster dose now or later. Depending on your age, health status, when you had a prior infection and which COVID-19 variant you likely had, your health care provider may or may not determine it is best to delay a second booster dose.
It’s your health and it’s your decision
The North Dakota Department of Health works to provide educational resources and materials to the public for each individual to make educated and informed decisions regarding COVID-19 vaccines and their personal health. These new second booster dose recommendations give members of our community the freedom to choose whether they would like to receive another dose of COVID-19 vaccine depending on their own risk factors. For the many members within our community who remain at an increased risk of COVID-19, receiving a second booster dose may begin to help them feel the confidence they need to cautiously return to a more normal life.
Where can I get my second booster vaccination?
Information on COVID-19 vaccine providers and clinics near you can be found on the NDDoH COVID Vaccine Locator page. You can also contact the NDDoH Hotline at (866) 207-2880 for assistance. As a reminder, you can receive other routinely recommended vaccines (influenza, shingles and pneumococcal) at the same time as COVID-19 vaccine.
For more information, please visit the CDC’s COVID-19 Vaccine Boosters webpage.