The Centers for Disease Control and Prevention (CDC) has strengthened its guidance on COVID boosters for people 18 and older, saying they "should" get a booster shot six months after their initial Pfizer or Moderna series or two months after the one-dose Johnson & Johnson vaccine.

The importance of getting vaccinated is only highlighted by the emergence of new variants, such as omicron, which originated in South Africa.

"I strongly encourage the 47 million adults who are not yet vaccinated to get vaccinated as soon as possible and to vaccinate the children and teens in their families, as well," said CDC director Dr. Rochelle Walensky.

The CDC previously approved a “mix and match” approach, giving booster-eligible people the ability to get a different COVID vaccine than their initial series. Some people may prefer the vaccine type they received originally, while others may choose to get a different booster. Learn more here.

Why do I need a booster?

Dr. David Priest
Dr. David Priest

Boosters are needed because the potency of the vaccines wane over time. Decreasing antibodies isn't unique to the COVID vaccines, said Dr. David Priest, Novant Health chief safety, quality and epidemiology officer. Take the flu shot, for example, which people are encouraged to get each year.

"What a booster does is increase the amount of neutralizing antibodies, making it less likely that someone would have a serious illness that results in hospitalization – or worse," Priest said. Data shows people who are 65 and older need a booster more than any other group, he added.

“The small number of people who are vaccinated and have to be admitted to the hospital are generally over the age of 65. They were vaccinated early in the pandemic and often have other medical issues," Priest said.

People who are “profoundly immunosuppressed” are also strongly encouraged to get a booster.

“If you’ve had an organ transplant, are receiving chemotherapy or living with uncontrolled HIV, the booster is even more important because you generally don’t respond to vaccines in the same way,” Priest said.

Schedule your booster today. It's free.

Eligible for a booster? An appointment is required, but you don't need to be a Novant Health patient to schedule. And keep in mind, all COVID-19 vaccines are free for everyone — even people without insurance.

Ways to schedule include:

  • MyChart is the best way to schedule an appointment. Anyone can create a MyChart account by visiting Appointment availability can be accessed under Visits > Schedule an appointment > COVID-19 Vaccine.
  • Anyone can schedule an appointment online.
  • Primary care clinics: established patients are able to call their primary care clinic to schedule an appointment at that clinic, if it is offering the vaccine, or at the nearest Novant Health vaccination site.
  • Those who do not have access to the internet or a primary care provider can call 855-NH-VAC-4U (855-648-2248) for scheduling assistance.

What's this I'm hearing about a fourth dose?

Dr. Charles Bregier
Dr. Charles Bregier

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Some people with weakened immune systems will become eligible for a fourth dose — administered at least six months after their third dose, the CDC said. Immunocompromised individuals became eligible for a booster in August, meaning the earliest someone could receive a fourth dose would be in early 2022.

"Any patient who has a history of being moderately to severely immunocompromised should discuss whether or not they are good candidates for a fourth dose with their health care provider," said Dr. Charles Bregier, Novant Health medical director of corporate health. "And get a fourth dose, if recommended," he added.


Those eligible for a Moderna booster will receive a half-dose, administered at least six months after the second vaccine.

“Research has shown that a half-dose gives an excellent antibody response, so it appears a full dose is not necessary as a third booster for Moderna,” Bregier said.

Johnson & Johnson

The CDC also recommends J&J's booster dose at least two months after immunization. Anyone who got the one-dose vaccine qualifies.

Evidence has suggested that J&J recipients are more vulnerable to infection than people who got vaccines from competitors Pfizer or Moderna — and that most got their single dose many months ago.

Pfizer-BioNTech (Comirnaty)

    Those eligible for a Pfizer booster can receive it at least six months following the second dose in the primary series.

    Pfizer’s vaccine, FDA-approved for people 16 and older, already carries EUA for adolescents ages 12 to 15, and kids ages 5 to 11. 2- to 5-year-olds could become eligible for the two-dose vaccine series in early 2022, according to news reports.