Following approval from the Food and Drug Administration, kids ages 5 to 11 are one step closer to becoming booster-eligible. If the Centers for Disease Control and Prevention signs off, children in this age group could receive Pfizer's COVID booster at least five months after their primary vaccine series.

The CDC's independent advisory committee is expected to meet soon and, rest assured, Healthy Headlines will update parents if and/or when the shots become available. Here are the groups currently approved for an extra dose:

  • Everyone 12 and up (either two months after receiving a one-dose Johnson & Johnson vaccine or five months after the primary vaccine series from Pfizer or Moderna).
  • Additionally, some immunocompromised children ages 5 to 11 are encouraged to get a third Pfizer shot (considered an additional vaccine in its primary series) 28 days after their second dose.

While Pfizer is the only COVID vaccine series approved for U.S. children ages 5 and above, a “mix and match” approach gives booster-eligible adults the ability to choose between manufacturers. Some people may prefer the vaccine type they received originally, while others may opt for a different one.


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 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.

“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," he added.


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Which one should I get?

The simple answer is the one that’s most readily available. Getting any of the vaccines now is better than waiting, doctors agree.

“It’s important to remember no matter what product you get, you will have a boost in immune response,” Priest said.

Evidence shows all three vaccines are highly effective in reducing the risk of severe disease, hospitalization and death. Getting vaccinated is the best way to protect yourself and reduce the spread of the virus.

But if you have a choice, here’s what to keep in mind:

  • If you had an mRNA vaccine — Pfizer or Moderna — Priest advised people to stick with the same product. “I don't think there's much benefit in mixing and matching Moderna and Pfizer right now,” he said. But if one is not available when you go for your booster, then go ahead and get the other mRNA option, he added.
  • There is a benefit in getting an mRNA booster if you received the J&J vaccine, Priest said. Studies have shown that Pfizer and Moderna boosters induced higher levels of antibodies in J&J recipients than a second J&J dose.
  • If you had an adverse reaction to one type of vaccine, “you could boost with another. Talk with your medical provider as you decide,” said Aliza Hekman, a Novant Health physician assistant who specializes in infectious disease.

Pfizer and Moderna vaccines recommended over J&J

In line with the CDC’s recommendation to use mRNA vaccines over Johnson & Johnson, Novant Health is exclusively offering Moderna and Pfizer COVID immunizations for the primary series. People who experienced an allergic reaction to an mRNA vaccine can, however, opt to receive a J&J booster at Novant Health.

The updated guidance cited the risk of blood clots linked to J&J’s vaccine.

“I would emphasize that the adverse events the CDC includes in their latest report are incredibly rare and involve blood clotting. However, COVID-19 itself creates much higher risk of blood clots than the vaccine does. Despite these changes, J&J has been important tool and protected millions of people around the world from getting COVID,” Priest said.

Individuals who prefer or are only eligible for the J&J vaccine are encouraged to check NCDHHS or a retail pharmacy for availability.


I've had a breakthrough case. When can I get a booster?

The answer is when your symptoms are improved AND you are out of the quarantine period (typically 10 days), Hekman said.

Don't I have natural immunity?

Aliza Hekman
Aliza Hekman

“While it’s true you will have some antibodies from COVID itself, it’s been proven that vaccination offers a more durable immunity. And with different variants circulating, I recommend getting a booster as soon as you’re eligible,” Hekman said.

“Early on in the pandemic, when vaccines were not widely available, there was some thinking that people with COVID could wait to get vaccinated because they already had some immunity. But this was meant to save vaccine doses for people who had none. With vaccines widely available, that’s not really the case anymore,” she added.

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

Dr. Charles Bregier
Dr. Charles Bregier

Under CDC recommendations, some immunocompromised patients are eligible for a fourth dose of the COVID vaccine. It is recommended for the moderately or severely immunocompromised five months after a third dose of the Pfizer or Moderna vaccine.

"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 it's recommended," he added.

immunocompromised fourth COVID vaccine dose

These patients may see a message similar to the photo on the right in MyChart.

Who is considered to be immunocompromised?

People are considered to be moderately or severely immunocompromised if they have:

  • Been receiving active cancer treatment for tumors or blood cancers.
  • 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.
  • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome).
  • Advanced or untreated HIV infection.
  • Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response.

Boosters are free. Find a location near you.

Keep in mind, all COVID-19 vaccines and boosters are free for everyone — even people without insurance. Find a convenient location near you.

For people seeking a COVID-19 test, please read this advice before driving to an emergency room or testing location.