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So what’s the deal with the booster shots?

There has been a lot of controversy about booster shots for the COVID-19 vaccine (just in case you weren’t already tired of hearing the argument over getting the first round of vaccines)

The FDA cleared the Pfizer vaccine booster on September 22nd, stating that it should be taken at least 6 months after the initial completed set. Boosters should be given to immunocompromised people, those at high risk for severe COVID side effects, and those who work or live in high-risk conditions. 

It wasn’t without controversy as the medical community struggles to figure out if another dose is necessary. Some studies noted a decreased level of protection in people who had been vaccinated for over 6 months. However, there isn’t enough data to assume that a booster is necessary to prevent infection since both shots are still considered effective against severe disease. Still, given the low rate of side effects, it isn’t likely to hurt either.

The booster shot is the exact same shot in the exact same amount as the first two Pfizer jabs. Most people noted the same side effects as the original shot: a sore arm, redness/swelling, fatigue, and chills. A few more people indicated some of their lymph nodes in the axilla were more swollen than in the previous rounds, which would make sense since the body has already created antibodies and is more quickly responding to the shot.

If you were excited about getting the vaccine, there appears to be very little evidence against getting the booster shot.

It does get a little more confusing, though. 

On October 12th, the FDA took a neutral stance on the Moderna Vaccine. The Moderna shot has sustained levels of protection longer than Pfizer, though some believe this is due to an initial higher dose and a longer wait between shots. Moderna is asking for a half-dose booster for the same recipient categories as the Pfizer booster. 

The FDA wasn’t so sure, stating that there wasn’t enough evidence in Moderna studies to conclude that there should be a booster at all. 

To further complicate the matter, there is now a third dose option that isn’t considered a booster. 

Wait… what?

The boosters (if Moderna is approved) are given 6 months after the last dose. The goal of the booster is simply to refresh the production of antibodies.

The 3rd dose is for people who may not have made enough antibodies in the first place for the shot to be successful. The third dose is exactly the same as the first two and can be given 28 days after the last dose, following the Moderna schedule. 

So why would the shot not work for someone?

It’s all in the immune system. People who are moderately or severely immunocompromised don’t have the immune system response of a normal person, meaning, on average, they make fewer antibodies in response to the shot, to begin with.  

That means the most vulnerable people may not get the full benefit of vaccination in two doses.

People eligible for a third shot include:

  • Cancer patients undergoing chemo or radiation
  • Organ transplant patients
  • Patients who are taking immunosuppressants or high dose steroids
  • People who are HIV or AIDs positive 

Regardless of if you were team Pfizer or team Moderna, the vaccines are safe and effective. You can lessen your chances of a breakthrough infection via booster or trust the high efficacy rate to keep you safe for now. The important part is making sure you are up-to-date on the information. 

Amanda Ernst, DNP, RN, CEN

Amanda Ernst, DNP, RN, CEN


Amanda is an ER nurse with 10 years of healthcare experience. She currently works as a nurse educator and as an adjunct professor for several schools. She also works as a freelance healthcare writer in her spare time. Amanda thinks the greatest thing about nursing is the endless possibilities and opportunities to learn. What have you learned today?


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