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Here's When You Need Your Second Booster, Say Virus Experts

A fourth COVID-19 shot is on the horizon.
FACT CHECKED BY Emilia Paluszek

The FDA just approved a second booster for adults 50 and up, saying they can get one as early as four months after their last booster. With studies showing how vaccine effectiveness wanes over time, a fourth COVID-19 shot might help protect against the virus and its variants. "The potential future requirement for an additional boost—a fourth shot for mRNA, or a third shot for Johnson & Johnson—is being very carefully monitored in real time," says Dr. Anthony Fauci. Here is when you might need your fourth shot, according to experts. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.


Older People Will Get Priority

Senior woman in consultation with her female doctor or therapist

When the fourth shot becomes available, people most at risk—for example, the elderly—will be given priority. As we said, those over 50 get the first chance. "Variant specific shots are being studied right now by the NIH and by a number of companies," says Dr. Anthony Fauci. "I don't think there's any doubt that sooner or later, particularly among the elderly, who have less of a robust immune response than a normal younger population, that they will need a boost of a fourth shot. In fact, the FDA is soon considering data from companies, particularly Pfizer, about the safety and the efficacy of a fourth dose boost. Right now, we know that after four or five months, the protection against hospitalization, and individuals who are given a third shot, diminishes somewhat. It's holding pretty strong at around 78% efficacy against hospitalization. But if it goes any significantly lower than that, you certainly would consider the possibility of a fourth dose boost, particularly among elderly and those with underlying diseases."


Fourth Shot Important For Immunocompromised

Woman in her 30s sits by her living room window with a cup of tea and looks out contemplatively. She is a cancer survivor and is wearing a headscarf.

"For those who are immune-compromised, those who are older adults, over the age of 50 or at least 65, we want to strongly recommend and encourage [a fourth shot], the same way we do with flu vaccines," says Moderna President Stephen Hoge. "For those who have cancer, COVID can actually be a life-threatening disease, even post-vaccination. I don't think you want to mess around with that."


Get the Fourth Shot Before Flu Season

Young woman taking a vaccine from her doctor.

Experts believe COVID-19 will pick up in the fall season, so taking a fourth dose around that time would be beneficial. "Barring any surprises from new variants, maybe the best thing is to think about our booster strategy in conjunction with the influenza vaccine next fall, and get as many people as possible boosted then," says Peter Marks, M.D., Ph.D., director of the Center for Biologics Evaluation and Research (CBER) at the Food and Drug Administration.


People With Underlying Health Conditions

Nurse holding syringe

People who already have serious health conditions should take the fourth shot, experts say. "These people will likely be the first group to require another booster," says Yale University immunologist Akiko Iwasaki, Ph.D. "Their immune response is not as robust as a healthy young person. It depends on how fast the immunity is waning. So we'll have to wait and see."


Protection Against New Variants

Infected patient in quarantine lying in bed in hospital

With new variants like BA.2 spreading across the globe, a fourth shot could provide added protection. "While current research and real-world data show that boosters continue to provide a high level of protection against severe disease and hospitalization with Omicron, we recognize the need to be prepared in the event this protection wanes over time and to potentially help address Omicron and new variants in the future," says Kathrin Jansen, senior vice president and head of vaccine research and development at Pfizer.


How to Stay Safe Out There

Brunette woman wearing a KN95 FPP2 mask.

Follow the public health fundamentals and help end this pandemic, no matter where you live—get vaccinated or boosted ASAP; if you live in an area with low vaccination rates, wear an N95 face mask, don't travel, social distance, avoid large crowds, don't go indoors with people you're not sheltering with (especially in bars), practice good hand hygiene, and to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

Ferozan Mast
Ferozan Mast is a science, health and wellness writer with a passion for making science and research-backed information accessible to a general audience. Read more about Ferozan