FDA Authorizes Second Booster Shot for Immunocompromised and those over 50 years

Older adults can get second booster shots of the Pfizer-BioNTech and Moderna coronavirus vaccines, federal agencies announced Tuesday as they expanded access to additional shots to help shore up protection against severe illness.

The Food and Drug Administration authorized a second booster shot of the Pfizer-BioNTech and Moderna coronavirus vaccines for people 50 and older at least four months after their first booster. The FDA also updated its authorization of additional doses for people 12 and older who are immunocompromised, saying they are eligible for another booster shot — the fifth inoculation for people at heightened peril from the virus.

The FDA action was followed within hours by a statement from the Centers for Disease Control and Prevention updating its booster guidance.

The second booster for adults 50 and older and for people 12 and older who are immunocompromised is expected to begin immediately now that the CDC has updated its guidance allowing those individuals to get it.

“This is especially important for those 65 and older and those 50 and older with underlying medical conditions that increase their risk for severe disease from COVID-19 as they are the most likely to benefit from receiving an additional booster dose at this time,” CDC Director Rochelle Walensky said in a statement.

There are about 118 million people age 50 and older in the United States. But because not all of the people in that age range have received the initial series of shots or boosters, only a fraction are immediately eligible for a fourth shot.

Booster uptake in the United States has been slower than desired, particularly among older Americans who are at higher risk of severe illness. About 15 million people age 65 and older — a third of people in the age group — are fully vaccinated but have yet to receive a first booster. Only about 40 percent of people between 50 and 64 have received a first booster.

“I’ve been getting multiple inquiries from lay friends over the past few days: ‘What does this mean, and what should I do?’ ” said John P. Moore, a professor of microbiology and immunology at Weill Cornell Medicine in New York. “I find it increasingly difficult to tell friends what they should do. It’s becoming really problematic.”

The primary benefit of a fourth shot is thought to be protection against severe illness, and that risk can vary dramatically among people 50 and older. Not all experts are convinced the benefits are clear, and some have debated about whether the age cutoff should be 60 or older.A matrix of factors — including underlying health conditions, age, and time since last booster dose or infection — could play a role in what a person should consider in risk vs. benefit.

A 70-year-old with diabetes and high blood pressure, for example, who received a booster dose in October probably would be at dramatically different risk from covid-19 than a 50-year-old with no underlying health conditions. Tens of millions of people were infected with the omicron variant during the winter surge, and those people’s immune systems have been effectively boosted — so they may not need another shot now.

Timing the shots’ peak protection to the time of greatest risk from the virus is tricky. No one knows when future variants will emerge, and scientists are uncertain even about known threats. Infections from the BA.2 version of the omicron variant are ticking upward in the United States, but some health officials have said they don’t expect BA.2 to cause a surge. Some experts predict a surge next winter.

In terms of giving a second booster, Moore said, “Should you do it now — and in the fall? Or in the fall — and not now? This is where it gets head-spinning. What is the long-term intent, and what is the long-term policy?”

Text your zip code to 438829 or call 1-800-232-0233 to find locations near you or call 1-877-VAX-4NYC (1-877-829-4692)

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