Do you need a fourth dose of the COVID-19 vaccine?

key takeaways

  • The COVID-19 vaccine remains effective against severe illness, hospitalization, and death.
  • For people with weakened immune systems, it is recommended to get a booster dose after the three main doses.
  • There is insufficient evidence that no immunocompromised person currently needs a second booster shot.

The study showed that a booster or third dose of the mRNA COVID-19 vaccine could better protect against Omicron infection. However, some evidence suggests that enhanced protection is attenuated by about 15% to 25% after 10 weeks. Does this mean we will need a fourth dose of vaccine soon?

Currently, there is insufficient evidence to support the need for a second booster injection in non-immunocompromised individuals. The Centers for Disease Control and Prevention (CDC) only recommends a booster shot on top of the three main doses for people with weakened immune systems.

However, this situation may soon change.

Will the fourth COVID-19 vaccine prevent Omicron?

How long are boosters valid for?

On Friday, Feb. 11, 2022, the CDC released a study showing that boosters from Pfizer and Moderna lost substantial effect four months after a surge in Omicron.

The researchers found that the booster doses were highly effective against severe and moderate disease about two months after the initial vaccine series. But once the fourth month mark was reached, that effectiveness dropped significantly. This suggests the need for additional boosters in the future, the study said.

The vaccine was 91 percent effective at preventing hospitalizations in the first two months after the boost. But four months later, that had dropped to 78 percent.

Vaccines were also less effective at preventing emergency department and urgent care visits during Omicron. Enhanced protection rose from 87% in the first two months to 66% after four months. Five months later, that number had dropped to 31 percent. However, the researchers said the latter figure was “inaccurate” because there was little data on people who received the booster five months earlier.

These findings come with caveats. The researchers did not assess whether there were differences in protection by age, underlying health conditions, or whether someone was immunocompromised.

“We are still learning about the duration of protection against Omicron with the booster dose,” William Moss, MD, executive director of the Center for International Vaccine Access at the Johns Hopkins Bloomberg School of Public Health, told VigorTip. “A COVID-19 vaccine targeting the Omicron variant is effective. Sexuality depends on the type of vaccine, the outcome of interest, the number of doses received, the vulnerability of the vaccine recipient, and the time since vaccination.”

But we do know that boosters provide important protection.

“In fact, the analysis showed that for those who received the latest vaccines — including two Pfizer and Moderna vaccines plus a booster or a J&J injection plus a booster — hospitalizations and mortality rates were very low during the Omicron wave. to the unvaccinated,” Leslie M. Kantor, MD, MPH, professor and chair of the Department of Urban-Global Public Health at the Rutgers School of Public Health, told VigorTip.

She added that by December 2021, the rate of COVID-19-related hospitalizations was 45 times higher among unvaccinated 50-64-year-olds and 51 times higher among those 65 and older. This shows how important it is to get the recommended dose of the vaccine.

Can mRNA boosters prevent Omicron?

Immunocompromised people should get a fourth shot

The CDC recommends that moderately or severely immunocompromised individuals who received two doses of the mRNA COVID-19 vaccine receive an additional primary dose at least 28 days after completing the second dose.

In addition to the three main doses, they should also receive a booster injection within three months of completing the third dose.

“Some moderately or severely immunocompromised individuals should receive a three-dose primary series and a booster, as many of these individuals do not respond well to two or even three doses of the COVID-19 vaccine and therefore have less protection against the variant, Omicron, for example,” Moss said.

An mRNA COVID-19 vaccine is preferred, Kantor said. This applies to everyone, including immunocompromised individuals and the general population.

what does this mean to you

If you are immunocompromised, you should get a booster dose after the first three doses. There is no evidence that individuals who are not immunocompromised require additional booster shots to be protected.

Do non-immunocompromised people need a second booster dose?

Five months after completing the two-dose mRNA primary vaccine series, individuals aged 12 years and older who are not immunocompromised should receive a booster dose. Currently, there is no evidence that a second booster injection is needed.

“Right now, most people don’t need a second booster dose,” Moss said. “This additional dose may be required if there is evidence that people who received three doses of the vaccine have moderate to severe disease from COVID-19, or if there is a new variant that evades most of our current immunity. ”

A preprint of a study was published in medRxiv The incidence of confirmed infection and serious illness was found to be lower after the fourth dose of vaccine. However, preliminary results from two clinical trials also found that while a second booster dose did increase antibodies, it may not help prevent people from contracting COVID-19.

More research is needed to assess whether a second booster dose is needed. Also, as long as the pandemic continues, the virus will continue to mutate, which will be another factor to consider.

“In the future, people may be advised to get additional boosters,” Kanter said. “There are also efforts to tweak the vaccines to make them more protective against the kind of adaptation observed in the Omicron variants.”

If you have not yet received a booster or a priming series, you can visit or send your zip code to 438829 to find a vaccination provider near you.

“A large percentage of people are late with their recommended boosters, and they should,” Cantor said. “If it’s been five months or more since the second injection, then you should get a booster.”

The information in this article is current as of the date listed, which means that you may have updated information as you read this article. For the latest updates on COVID-19, visit our Coronavirus news page.