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How bad are COVID booster side effects? And answers to other vaccine booster questions.

The extra dose can help wake up your immune system, but it might come with side effects.
A vaccination sticker seen while the residents and staff at the Toby & Leon Cooperman Sinai Residences in Boca Raton received their Pfizer booster shots in September.
A vaccination sticker seen while the residents and staff at the Toby & Leon Cooperman Sinai Residences in Boca Raton received their Pfizer booster shots in September. [ MIKE STOCKER | South Florida ]
Published Nov. 26, 2021|Updated Dec. 10, 2021

Click here to read this story in Spanish.

UPDATE: U.S. health officials on Dec. 10 issued new recommendations for 16- and 17-year-olds to get their Pfizer booster shots six months after their last dose.

It’s been just over a week since U.S. health officials approved COVID-19 booster shots for people 18 and over. Nearly 2.3 million Floridians have received boosters, and approximately 5.7 million more were eligible as of Nov. 19.

According to guidelines released by the Centers for Disease Control and Prevention, people vaccinated with the two-part Pfizer or Moderna vaccine can receive a booster six months after their second dose. Those who received the Johnson & Johnson vaccine can get a booster two months after their initial shot.

People 18 and over who got the Johnson & Johnson vaccine or 50 and over who got the other vaccines should get a booster shot as soon as possible, the CDC emphasized.

The latest age group encouraged to get boosters are teens ages 16 and 17, who should get the Pfizer booster.

The rapidly changing guidelines have left many Floridians with questions about why boosters are needed and what to expect.

Why do I need a booster shot?

Studies in the U.S. and abroad have shown that the level of COVID antibodies — the cells that attack the virus — decrease over time.

“It’s not uncommon with viruses in general,” said Dr. Laura Arline, chief quality officer for BayCare Health System. “Think about the tetanus shot we have to get every five to 10 years.”

Studies tracking the vaccine’s effectiveness in Israel, the United Kingdom and elsewhere show that they are losing their ability to prevent severe illness and hospitalization. Vaccines still offer better protection than being unvaccinated. Recent data from the CDC shows that unvaccinated people had 5.8 times the risk of infection, are 11.8 times more likely to be hospitalized and had 14 times the risk of dying from COVID.

Related: COVID booster shot protection beats ‘natural immunity,’ study suggests

What side effects should I expect after my booster shot?

Side effects after the boosters appear to be similar to those after the second dose of the Pfizer and Moderna vaccine.

The most commonly reported booster side effects were pain at the injection site, tiredness, headache, muscle and joint pain, chills, nausea and vomiting, and fever, the Food and Drug Administration reported. Additionally, swollen lymph nodes in the underarm of the injection site were observed more frequently following the booster than after the primary two-dose series.

Side effects mean that your immune system is responding to the vaccine, Arline said. “That’s the signal that your immune system is waking up and responding to the foreign intruder.”

But don’t worry if you don’t have serious side effects, she said. “We’ve seen people with very minor side effects still have a wonderful immune response to the vaccine.”

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How do boosters work?

As your immune response to the first round of vaccination wanes, the first things to go are the short-run antibodies that stop the coronavirus from latching on and infecting new cells. The booster shot puts the immune system back on high alert, said Arline, producing short-term antibodies designed to hunt down the coronavirus.

The body will start to increase antibodies within the first few days after the booster, she said, and full immunity takes about two weeks. It’s not clear how long this heightened immunity will last.

Will I need another booster shot?

It’s too soon to tell, said Arline, but probably yes.

“It all has to do with how quickly (the virus) is going to mutate,” she said. “Right now, there are so many unvaccinated people, the virus can continue to mutate quite a bit and pretty frequently.”

At some point, we’ll probably need another dose to address waning immunity, said Arline, or a new formulation of the vaccine to address some yet-unknown variant.

Should I mix-and-match my booster?

You can choose which COVID-19 vaccine you receive as a booster shot, according to the CDC’s latest guidance.

If you initially got the two-part Pfizer or Moderna vaccine, it likely doesn’t make much difference which booster shot you get.

If you initially got the Johnson & Johnson vaccine, there is good reason to try the Pfizer or Moderna vaccine this time. According to one study, subjects who got the Moderna booster had a nearly 10-fold increase in antibodies, compared to those who got another dose of the Johnson & Johnson vaccine.

“Unless there is a medical reason that the patient has to avoid the mRNA vaccine, there is no reason to get the Johnson & Johnson vaccine as a booster,” said Arline.

Ages 16 and 17 can only get the Pfizer booster.

Where can I get a booster shot?

As of Friday, there were booster appointments available at Tampa Bay Publix, CVS and Walgreens locations. No providers were reporting shortages of any booster doses.

Editor’s note: This story was updated with the latest guidance from U.S. health authorities.

Related: A winter COVID wave could come to Florida, but holiday precautions could help prevent one

• • •

How to get vaccinated

The COVID-19 vaccine for ages 5 and up and booster shots for eligible recipients are being administered at doctors’ offices, clinics, pharmacies, grocery stores and public vaccination sites. Many allow appointments to be booked online.

Find a site: Visit vaccines.gov to find vaccination sites in your zip code.

More help: Call the National COVID-19 Vaccination Assistance Hotline.

Phone: 800-232-0233. Help is available in English, Spanish and other languages.

TTY: 888-720-7489

Disability Information and Access Line: Call 888-677-1199 or email DIAL@n4a.org.

• • •

Tampa Bay Times coronavirus coverage

KIDS AND VACCINES: Got questions about vaccinating your kid? Here are some answers.

BOOSTER SHOTS: Confused about which COVID booster to get? This guide will help.

PROTECTING SENIORS: Here’s how seniors can stay safe from the virus.

COVID AND THE FLU: Get a flu shot and the COVID vaccine to avoid a ‘twindemic.’

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A TRIBUTE TO FLORIDIANS TAKEN BY THE CORONAVIRUS: They were parents and retirees, police officers and doctors, imperfect but loved deeply.

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