COVID-19 booster shots: Who needs them and who can get one?

As U.S. health officials press for more Americans to get vaccinated to fight the current COVID-19 surge, they also are preparing to offer booster shots to those already inoculated.

The vaccines authorized in the U.S. continue to be highly effective in reducing the risk of severe disease, hospitalization and death, even against the more infectious delta variant of the new coronavirus. But some data suggests that the shots’ effectiveness has begun to wane, especially against mild to moderate infection and that an extra dose pumps up protection.

Here are some commonly asked questions about where things stand on booster shots.

Who can get a booster shot now?

This month, the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention approved a third dose of messenger RNA vaccine — either Moderna or Pfizer-BioNTech — for people with severely or moderately compromised immune systems. The CDC recommended the third shot for recipients of organ or stem cell transplants, those with advanced or untreated HIV infections or who are receiving cancer treatment, and for people taking medications that weaken the immune system.

The third shot was recommended based on data that the first two shots did not trigger a sufficient immune system response in some people with such conditions. A third shot was shown to help rev up the response for many.

A third shot can be given 28 days or more after the second dose. Health officials recommend that, when possible, the third dose should be the same vaccine as the first two doses.

I have a compromised immune system. How do I get the extra dose?

A person with a weakened immune system should be able to get a third shot wherever mRNA vaccines are being administered, including clinics and pharmacies.

There is no requirement that individuals document the condition that makes them eligible. The honor system applies here, as it did earlier in the vaccination rollout in Nevada, when priority was given to people with underlying health conditions.

Patients will be asked to attest to having a condition making them eligible for a third shot.

“To help ensure there are no barriers for this vulnerable population, individuals can self attest and receive the additional dose wherever the mRNA vaccines are offered,” said Candice McDaniel with the Nevada Department of Health and Human Services during a COVID-19 media briefing on Thursday.

There continues to be no out-of-pocket cost for shots, which are subsidized by the federal government.

Who else needs a booster shot?

Most people eventually will need a booster shot, according to U.S. health officials who have been analyzing scientific data from the U.S. and around the world to understand how long protection from the vaccine will last.

“The available data make very clear that protection against SARS-CoV-2 infection begins to decrease over time following the initial doses of vaccination, and in association with the dominance of the delta variant, we are starting to see evidence of reduced protection against mild and moderate disease,” top U.S. health officials, including the the CDC’s Dr. Rochelle Walensky, the FDA’s Dr. Janet Woodcock and U.S. Surgeon General Dr. Vivek Murthy, among others, said in an Aug. 18 statement.

“Based on our latest assessment, the current protection against severe disease, hospitalization and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout,” the statement continued. “For that reason, we conclude that a booster shot will be needed to maximize vaccine-induced protection and prolong its durability.”

What else does the data show?

A study in U.S. nursing homes found the effectiveness of the Pfizer and Moderna vaccines against infection fell from about 74 percent in the spring to 53 percent in June and July.

Another study didn’t see a big change in how well the vaccines protected against hospitalization. It found that the vaccines were 86 percent effective at two to 12 weeks after the second dose and 85 percent at 13 to 24 weeks after.

New York state data showed steady vaccine protection against hospitalizations at about 95 percent over the nearly three months examined. But vaccine effectiveness against new lab-confirmed infections fell from about 92 percent in early May to about 80 percent in late July in that study.

And Mayo Clinic patient data from Minnesota showed that in July, when the delta variant was prevalent, Moderna’s vaccine was 76 percent effective against infection and Pfizer’s 42 percent.

Makes of all three vaccines authorized in the U.S. point to studies indicating that an extra dose of vaccine provides additional protection against the virus.

Real-world data from Israel, among the first countries to authorize a third shot for the elderly, shows that a booster shot reduced the the risk of infection in the 60-plus age group by 86 percent and against severe infection by 92 percent, The Wall Street Journal recently reported.

When can the public get a booster shot?

Next month, some members of the public are expected to become eligible to receive a third dose of mRNA vaccine. Exactly who is yet to be determined.

U.S. health officials have said that those who got their shots eight months ago will be first in line.

On Sept. 20, “the individuals who were fully vaccinated earliest in the vaccination rollout, including many health care providers, nursing home residents, and other seniors, will likely be eligible for a booster,” the officials said in their Aug. 18 statement.

But President Joe Biden said on Friday that U.S. health officials are considering offering a booster just five months after a second dose. Later in the day, White House spokeswoman Jen Psaki clarified the president’s comments by saying that he would rely on CDC and FDA officials to make any changes to the guidance on time frame.

I got the Johnson & Johnson vaccine. Do I need a booster shot?

Federal health officials have said that they anticipate that booster shots also will be needed for those who received the Johnson & Johnson vaccine.

This past week, Johnson & Johnson said new data indicates that a second dose of its one-dose vaccine dramatically increases antibodies to fend off COVID-19.

Company officials said they hope that the new data will lead to the inclusion of the J&J vaccine in the initial distribution of booster shots in September.

The Associated Press contributed to this report.

This is a developing story. Check back for updates.

Contact Mary Hynes at mhynes@reviewjournal.com or 702-383-0336. Follow @MaryHynes1 on Twitter.