Should you get a second COVID-19 booster dose?

New federal guidance on a second COVID-19 booster dose has left many Minnesota vaccine recipients questioning when and if they should get another shot.

Ruckus regarding the second COVID-19 booster dose

According to various reports, several newly eligible people have snapped up pharmacy vaccine appointments. The recent federal guidance allowed second COVID-19 booster shots for people who are 50 or older, have weakened immune systems, or have only received two doses of the less-effective Johnson & Johnson vaccine, but it didn’t specifically recommend that people seek them.

The expansion makes it easier to issue a stronger booster recommendation in the event of another pandemic wave, but for now, even infectious disease experts are uncertain. c, an Allina Health virologist, said the Food and Drug Administration and the Centers for Disease Control and Prevention bypassed their vaccine advisory committees, which could have issued clearer advice.

Recent studies on the vaccine

A recent U.S. study found slightly stronger immune responses when people switched between Pfizer and Moderna vaccines for their first boosters, but O’Horo said there is limited evidence over second boosters. People are going to receive protection whether they stick or switch with vaccine types, he said, so people shouldn’t delay boosters over this issue either. The exception is the single-dose J&J vaccine; people who have only received two doses of that type are encouraged to switch for their next booster dose.

Bloomington-based HealthPartners contributed to national research that motivated the CDC’s decisions. Results this week showed that vaccine effectiveness in preventing hospitalizations was 31% among single-dose J&J recipients and 67% among people who received two doses. Protection increased to 78% among J&J recipients who switched to other vaccines for boosters, and to 90% among recipients of Moderna and Pfizer vaccines for their initial shots and boosters.

Verdict on the second dose

Only 3.6% of doses administered in Minnesota involved the Johnson & Johnson vaccine, but it was given to Gov. Tim Walz and former Gov. Tim Pawlenty at a public event. Walz later received another type for his booster. Pawlenty is among nearly 29,000 Minnesotans who received only two J&J doses, making them eligible for a second booster regardless of age or health status.

COVID-19 vaccines lost effectiveness during the omicron wave. Fully vaccinated people made up 37% of COVID-19 deaths in the second half of 2021 in Minnesota, but 55% in the first month and a half of 2022, according to state breakthrough infection data. Even the latter number reflects reduced risk, though, because fully vaccinated people make up 79% of Minnesota’s adult population — and they are disproportionately older and at the greatest risk of severe COVID-19.

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