Logan Reed
Boosters are common for many vaccines, such as the tetanus vaccine, which requires a booster every 10 years for adults. Scientists have found that with some vaccines, a person's protection decreases over time, and a booster helps them stay protected. The COVID-19 booster works in the same way, and it may also provide broader protection against new variants. While the CDC does not recommend mixing products for the primary series of COVID-19 vaccines, the FDA and CDC have approved a mix-and-match approach for COVID-19 booster shots for people aged 5 years and older. However, children under 5 years old should generally stick to the same vaccine brand as their primary series.
| Characteristics | Values |
|---|---|
| Is it necessary to receive the same vaccine for a booster? | The FDA and CDC have approved a "mix-and-match" approach for COVID-19 boosters, allowing eligible individuals to choose their vaccine type regardless of their initial vaccine. However, children under five years old should generally stick to the same vaccine as their primary series. |
| Who is eligible for a COVID-19 booster? | The CDC recommends that adults and children aged six months and older receive an updated 2024-2025 COVID-19 vaccine. People aged six months and older can receive Pfizer or Moderna, while those aged 12 and older can receive Novavax. Adults aged 65 and older are eligible for a second booster dose six months after their first. |
| Are there advantages to receiving a booster? | Boosters help maintain protection against COVID-19 as vaccine protection wanes over time. They can also broaden protection against new variants, reducing the risk of severe illness, hospitalization, and death. |
| Are boosters safe? | Boosters have the same ingredients as the original vaccines, which have been proven safe for hundreds of millions of people. Most individuals experience mild and similar side effects to their second shot, and serious side effects are rare. |
| Are there specific considerations for additional doses? | Yes, additional doses are recommended for immunocompromised individuals to help them build the same level of immunity as those who are not immunocompromised. |
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What You'll Learn
COVID-19 boosters for children under 5
The US Food and Drug Administration (FDA) has approved the use of bivalent COVID-19 vaccines for children under 5. The vaccines, developed by Moderna and Pfizer-BioNTech, offer protection against both the original strain of COVID-19 and the Omicron variant. The CDC has also recommended their use for this age group.
The Moderna vaccine is the only option available for children under 5, as the FDA revoked the emergency use authorization for Pfizer's vaccine for this age group. Moderna's vaccine is a three-dose primary series, with the first two doses being the original vaccine and the third dose being the bivalent booster.
The FDA and CDC have stated that it is safe to mix and match booster shots for adults. However, there is no strong benefit to doing so unless you have an allergy to a specific vaccine component. It is important to note that the recommendation to mix and match booster shots does not currently apply to children under 5, as they are only authorized to receive the Moderna vaccine.
The CDC recommends that parents of children aged 6 months to 17 years discuss the benefits of vaccination with a healthcare provider. The COVID-19 vaccine helps protect against severe illness, hospitalization, and death, especially in those who are at high risk or have never been vaccinated. The 2024-2025 COVID-19 vaccines are updated to provide better protection against the Omicron variant and its subvariants.
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Mixing and matching COVID-19 boosters
The US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) have approved mixing and matching COVID-19 boosters for people aged five and above. This means that regardless of the vaccine that you received first, you can choose the vaccine you want for your next dose. For example, if you received a Pfizer COVID vaccine in the past, you could choose to get a Moderna or Novavax vaccine for your next dose.
The FDA and CDC do not recommend one shot over another, and they note that using the same vaccine for the booster when possible is preferable. However, if it is not easy to get the same vaccine you previously had, mixing and matching won't hurt. What's most important is that you get the booster shot.
There is no data that mixing is better than matching. However, there is plenty of data showing that either way works well and achieves the goal of increasing antibody levels. A study by the National Institutes of Health (NIH) found that people who received the Johnson & Johnson vaccine produced higher antibody levels after they got the Moderna or Pfizer booster, compared to another Johnson & Johnson booster.
Booster shots are important because the protection offered by the initial series of vaccines wanes over time, increasing the chance of breakthrough infections. By getting a booster shot, you are increasing your immunity against the virus and helping to prevent severe illness or death, particularly among older adults and people with pre-existing medical conditions.
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Booster eligibility
The eligibility criteria for a COVID-19 booster shot depend on several factors, including age, health status, and the type of vaccine initially received. Here is some information regarding booster eligibility:
Age and Health Status:
For individuals aged 6 months and older, the CDC recommends receiving an updated 2024-2025 COVID-19 vaccine. Specifically, people aged 6 months and older can receive the Pfizer or Moderna vaccine, while those aged 12 and older can opt for Novavax. Additionally, adults aged 65 and older are eligible for a second 2024-2025 COVID-19 vaccine dose six months after their first vaccination. Similarly, younger individuals who are moderately or severely immunocompromised are also advised to receive this updated booster dose.
Previous Vaccination History:
The eligibility for a booster shot also depends on the type of vaccine initially received and the number of doses. For individuals who received the Pfizer-BioNTech or Moderna COVID-19 vaccine series, a third dose of the same mRNA vaccine is generally recommended. However, if the original mRNA vaccine is not available or unknown, another mRNA vaccine (Pfizer or Moderna) may be administered as a booster. It is important to note that individuals should not receive more than three mRNA vaccine doses in total.
For those who received the Johnson & Johnson (J&J) vaccine, the eligibility criteria are different. Anyone aged 18 years or older who has received at least one dose of the J&J vaccine at least two months ago is eligible for a COVID-19 booster shot. These individuals have the option to receive either a second J&J dose or a booster from a different vaccine, such as Pfizer or Moderna.
Timing and Intervals:
The timing of booster shots is crucial. For most individuals, a booster shot is recommended a few months after the final dose of the initial vaccination series to ensure continued protection against COVID-19. However, the specific interval may vary depending on the vaccine received and individual circumstances. For example, individuals with moderately to severely compromised immune systems may require additional doses at specific intervals to maintain adequate protection.
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Booster safety
Booster shots are an essential part of maintaining one's protection against COVID-19. The protection offered by the initial vaccine doses can wane over time, leaving individuals vulnerable to new variants of the virus. A COVID-19 booster shot is a safe supplementary dose that reminds the body's immune system about the virus, improving protection.
The CDC and FDA have approved a "mix-and-match" approach for booster shots, allowing individuals to choose any authorized vaccine as their booster, regardless of which vaccine they initially received. This flexibility in vaccine selection is rooted in safety and efficacy, assuring individuals that they can confidently select the first available booster option to promptly enhance their protection.
For individuals who received the Pfizer or Moderna vaccines, a booster is recommended after at least five or six months, respectively, from completing the primary vaccination series. If you received the Johnson & Johnson vaccine, you are eligible for a booster after at least two months. It is important to note that the Johnson & Johnson booster is not an mRNA vaccine like the Pfizer and Moderna boosters and is more similar to the primary dose.
While the "mix-and-match" approach is generally safe and approved, there are some considerations. If you have already received an mRNA vaccine (Pfizer or Moderna), there is no strong benefit to mixing and matching. Staying with the same vaccine type for your booster may be preferable if it is easily accessible. However, if it is not convenient to obtain the same vaccine, mixing and matching is a safe option.
For children under the age of 5, it is generally recommended to stick to the same vaccine brand for their primary series and booster. Children aged 6 months to 4 years with weakened immune systems may receive additional doses (1, 2, or 3) of Pfizer or Moderna vaccines as recommended by their paediatrician. Children aged 5 and above can make the choice to switch vaccine types for their booster, in alignment with the "mix-and-match" approach.
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Booster effectiveness
COVID-19 vaccines are designed to train your immune system to fight off a COVID-19 infection. Studies suggest that the vaccines are most effective in the first few months following your shot. That's why health experts recommend boosters or updated doses three to four months after your last COVID shot.
The effectiveness of a booster shot depends on several factors, including the timing of the shot, the type of vaccine, and individual health history. According to a study by researchers at Yale School of Public Health and the University of North Carolina at Charlotte, the best time to get a booster varies based on where a person lives and their personal infection history. The study suggests that administering boosters in September or October can offer up to four times more protection against infection compared to later in the year.
Additionally, the type of vaccine chosen for the booster shot can impact its effectiveness. The Pfizer, Moderna, and Novavax vaccines have been tested and proven safe, and updated versions of these vaccines are available to target specific Omicron subvariants. The CDC and FDA have approved a "mix-and-match" approach for booster shots, allowing individuals to choose a different vaccine from their original dose. However, for those who have received the mRNA vaccine, there is no significant benefit to mixing and matching, and it is recommended to stick to the same vaccine if possible.
The booster shot's effectiveness also depends on individual health history. Breakthrough infections can impact the timing of subsequent boosters, as natural infections temporarily enhance immunity. Delaying the booster shot after an infection can help extend immunity and improve protection.
Overall, the COVID-19 booster shot plays a crucial role in improving protection against current versions of the SARS-CoV-2 virus. Staying up to date with vaccinations is essential, as vaccine effectiveness can wane over time and in response to emerging variants. For instance, during a COVID surge in 2025, the COVID positivity rate hit 9%, partly due to the new highly contagious "Stratus" variant.
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Frequently asked questions
The FDA and CDC have approved a "mix-and-match" approach for COVID-19 booster shots for people age 5 years and older. However, children under 5 years old should generally stick to the same vaccine as their primary series.
There is no strong benefit to mixing and matching. However, if you received the original vaccine with no issues, you already know how you will feel after the booster, so it may be preferred.
No, mixing and matching is safe and effective. However, vaccine recommendations are complex and frequently changing, so sticking with the same vaccine may be a safer option.
The CDC recommends that adults and children age 6 months and older receive an updated 2024-2025 COVID-19 vaccine. Adults age 65 and older and younger people with compromised immune systems are eligible for a second booster six months after their first.
