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All fully vaccinated Americans ages 12 and over can now access an additional dose of the COVID-19 vaccines.
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  • The FDA and CDC are allowing all Americans ages 12 and over to be eligible for a COVID-19 booster shot.
  • While the vaccines continue to provide protection from serious disease and hospitalization, the effectiveness of the vaccines against breakthrough or mild infections is lower in the face of the Omicron variant.
  • To get the pandemic under control, experts agree that more unvaccinated people still need to get their first shots.

With the rapid spread of the highly contagious Omicron variant of the coronavirus, the Centers for Disease Control and Prevention (CDC) now says that all fully vaccinated people ages 12 and older in the United States should get a booster dose as soon as they are eligible.

Those who are 12 years and over who received the Pfizer-BioNTech vaccine or Moderna vaccine are eligible for a booster 5 months after their second dose.

The CDC recommends that adults receive either the Pfizer-BioNTech or Moderna vaccine in most situations. Children ages 12 to 17 can only receive Pfizer-BioNTech for their booster.

People 18 years or older who received the one-dose Johnson & Johnson vaccine are eligible for a booster at least 2 months after their dose. The CDC recommends they receive one of the mRNA vaccines in most situations.

In addition, moderately or severely immunocompromised 5- to 11-year-olds can receive an additional primary dose of a COVID-19 vaccine 28 days after their second shot.

The Omicron variant appears to be more transmissible, which is why it is causing another surge of coronavirus cases. Data shows that one or two doses of a COVID-19 vaccine offer little protection against infection by Omicron, although they continue to offer protection against severe illness.

The booster doses can shore up protection against infection and strengthen protection against severe illness and hospitalization.

The CDC and Food and Drug Administration (FDA) previously authorized mix-and-match boosters, so people eligible for a booster are free to choose any of the vaccines approved or authorized as a booster for their age group.

Although all adults are now eligible for a booster, which people should seek one out as soon as they are eligible?

Dr. Albert A. Rizzo, the chief medical officer of the American Lung Association, said the decision of the CDC and FDA — and certain state and local authorities — to open up boosters to all adults “boils down to mitigating risk, as well as trying to stem what seems to be a surge [of the coronavirus] in different parts of the country.”

Public health officials are also responding to research showing that the protection against infection offered by the mRNA vaccines wanes during the months after the second dose.

In spite of that waning, “vaccines have been effective, as far as keeping people from getting critically ill and needing hospitalization,” said Rizzo.

Many of the people who may benefit the most from boosters are people who were already eligible for them.

Adults who received one dose of the Johnson & Johnson vaccine were already eligible for a booster because the protection offered by one dose of this vaccine is lower than two doses of the mRNA vaccines.

In addition, Rizzo said the CDC and FDA, in their earlier decisions on mRNA boosters, “really did open up boosters to the people who are at highest risk [of COVID-19] — the elderly and people who have compromising comorbidities.”

Fully vaccinated people with underlying medical conditions are more likely to have severe COVID-19 if they do develop the infection.

In addition, older adults may generate less of an immune response to the initial vaccine series, so a drop in protection in the months after their second dose can put them at even more risk.

The CDC’s list of underlying medical conditions includes:

  • cancer
  • chronic kidney disease
  • chronic liver disease
  • chronic lung diseases
  • dementia or other neurological conditions
  • diabetes, type 1 or type 2
  • Down syndrome
  • heart conditions
  • HIV infection
  • immunocompromised state (people in this group are already eligible for an additional dose, but the CDC does not currently recommend a booster dose after that additional dose)
  • mental health conditions, including anxiety, depression, schizophrenia
  • overweight and obesity
  • pregnancy
  • sickle cell disease or thalassemia
  • smoking, current or former
  • solid organ or blood stem cell transplant
  • stroke or cerebrovascular disease
  • substance use disorders
  • tuberculosis

Other conditions not listed may also increase a person’s risk of severe COVID-19. If unsure about their risk, people should talk with their doctor to see if they would benefit from a booster.

Dr. Brandi Freeman, a pediatrician at Children’s Hospital of Colorado and the associate vice chair for diversity, equity, and inclusion at the University of Colorado Medicine, said people who frequently come into contact with others should also consider getting a booster.

This frequent exposure increases the chance that a person will contract the coronavirus, as well as transmit the virus onto others if they themselves have an infection.

Previously, the CDC approved boosters for people living in long-term care settings, as well as people who work as:

  • first responders, such as healthcare workers, firefighters, and police
  • long-term care staff
  • education staff, such as teachers, support staff and daycare workers
  • food and agriculture workers
  • manufacturing workers
  • corrections workers
  • postal workers
  • public transit workers
  • grocery store workers

“All of these people continue to put themselves out into a public area where it’s difficult to prevent the spread of [COVID-19],” Rizzo said.

Some of these workers, such as people at long-term care facilities, also come into contact with people who are at higher risk of severe COVID-19 — which is another reason for workers in those settings to consider getting a booster.

Other people not on this list who are around vulnerable or unvaccinated people may also want to get boosted.

This includes people caring for parents or other family members, including younger children.

“COVID-19 vaccination for 5- to 11-year-olds was just opened up, but there is the entire under-5 population that are not vaccinated,” Freeman said. “So, people who are around them may want to consider getting a booster.”

Even with a wider rollout of COVID-19 boosters, Rizzo said the country still needs to get more unvaccinated people vaccinated.

Around 16 percent of people ages 12 and older in the United States have not had even a single dose, reports the CDC.

Although fully vaccinated people can end up in the hospital with COVID-19, unvaccinated people have a much higher risk.

This is putting strain on emergency departments and hospitals in some parts of the country, as COVID-19 hospitalizations increase.

“That not only puts the healthcare system in jeopardy,” Rizzo said, “but it also puts people who have non-COVID related illnesses who need hospital services — such as someone who had a heart attack — in jeopardy.”