CDC green-lights 4th dose boosters for most Americans over 50

Frank Mallone, 71, receiving his Pfizer COVID-19 vaccine booster shot from Dr. Tiffany Taliaferro at the Safeway on Capitol Hill in Washington, D.C., on Monday, October 4, 2021.
71-year-old Frank Mallone receives a Pfizer COVID-19 booster shot. 
Tom Williams/CQ-Roll Call Inc. via Getty Images
  • The CDC recommended additional booster shots for older adults in the US on Monday, hours after the FDA authorized the same.
  • The CDC said people over 50 with underlying medical conditions, and everyone over 65, may get a second boost.
  • Second boosts can be given with Moderna or Pfizer’s vaccine, at least four months after a first booster.

The Centers for Disease Control and Prevention has given the final OK for additional boosters to be administered to older adults in pharmacies and doctor’s offices across the US.

On Tuesday afternoon, the CDC said it was updating its booster shot recommendations to allow:

  • people over 50 with underlying medical conditions that increase their COVID risk
  • and everyone over 65

to get a 4th dose of an mRNA vaccine, from either Pfizer or Moderna, at least four months after their first boost. Adults who received a primary vaccine and booster dose of Johnson & Johnson’s vaccine at least four months ago can also get a second booster, but only with Pfizer or Moderna product.

Before Tuesday, only certain immunocompromised patients could get an additional booster shot. The new CDC recommendations now allow those immunocompromised people to potentially have another booster — for many of them, that would be their fifth injection.

“Boosters are safe, and people over the age of 50 can now get an additional booster four months after their prior dose to increase their protection further,” CDC Director Rochelle Walensky said in a statement. “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.”

Research suggests boosters are not as useful at this juncture for younger people, whose immune systems respond better to vaccines of all kinds, and therefore need less frequent boosting in general.

The CDC’s new advice, expected to be quickly adopted at pharmacies, clinics, and vaccination sites across the county in the coming hours and days, comes after the US Food and Drug Administration authorized the same COVID-19 vaccine booster shots from Pfizer and Moderna on Tuesday morning.

“Current evidence suggests some waning of protection over time against serious outcomes from COVID-19 in older and immunocompromised individuals,” Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said in a statement, adding that “an initial booster dose is critical in helping to protect all adults from the potentially severe outcomes of COVID-19. So, those who have not received their initial booster dose are strongly encouraged to do so.”

Data suggests that overwhelmingly, it has been white, upper class Americans who’ve recieved their first booster shots so far.

“We’ve gotta do better when it comes to boosters,” Dr. Anthony Fauci, the president’s chief medical advisor, said during a White House briefing last week, stressing that racial booster equity is not as good as it was for primary vaccinations (first and second shots.) “We’re trying everything we can to get the message out of why it is so important. Because when you look at the data of what boosters do, particularly in the era of Omicron, boosters are extremely important.”

5th shot boosts are allowed now for immunocompromised patients

In addition to the second boosts for older adults, the CDC told Insider it is also allowing for additional booster doses in immunocompromised patients. A fifth shot is now on offer for:

  • immunocompromised patients ages 12 to 18, who can have Pfizer’s vaccine
  • immunocompromised patients 18 and up, with either Moderna or Pfizer.

Immunocompromised adults who got J&J can now have a total of four shots, but their new boosts should only be Pfizer or Moderna product, the CDC said. Eligible immunocompromised patients include those who have undergone solid organ transplantation, and those with other similarly immune-compromising medical conditions.

Boosters are only a temporary fix. We ‘need to figure out our next move’ against the virus.

Experts stress that even in highly vulnerable populations, additional boosters with the exact same vaccine recipes we’ve had all along can only be a short-term virus-fighting strategy. In the long run, better vaccines, either tailored to circulating variants, or that protect against multiple viral strains at the same time, need to be part of the solution.

“We really need to figure out our next move,” epidemiology expert Katelyn Jetelina, who teaches public health at the University of Texas, said in a recent newsletter.


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