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How, When and Where Older Adults Can Get COVID-19 Vaccines

Third shots have been recommended for some immunocompromised people, and boosters are likely on the way

En español | More than 176 million Americans — and more than 82 percent of adults 65 and older — have been fully vaccinated against COVID-19, with shots now available to everyone 12 and older. But that's still less than 63 percent of the U.S. population that's eligible to be vaccinated, with over 100 million Americans without a full round of shots.

In much of the country, it's a lot easier to get a shot today than it was a few months ago, with walk-in appointments widely available. But shot distribution looks a lot different than it did earlier this year, when limited vaccine supplies forced states to prioritize some residents over others, followed by the opening of mass vaccination sites.

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Health experts have in recent weeks started to revisit vaccine distribution plans, with booster shots likely coming down the pike to bolster recipients’ immune systems as the highly contagious delta variant spreads. President Joe Biden's administration has said they will likely be recommended to everyone several months after they've completed the initial regimen. The administration is targeting the week of Sept. 20 as a tentative rollout date for booster shots, pending U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) approval.

But there's still uncertainty about when boosters will be available to the general public and whether older adults will be prioritized, as they were during the initial vaccine rollout. Here's what older adults need to know about how to get a vaccine and what to expect from boosters.

Who can get a vaccine?

Pfizer's vaccine is approved for all Americans age 12 and up, and Moderna's and Johnson & Johnson's are available to anyone 18 and older. Pfizer's is currently the only vaccine that the FDA has moved from emergency use authorization status to full approval. All three vaccine manufacturers are investigating how younger populations respond to their shots, with Pfizer and Moderna expanding clinical trials to children between the ages of 5 and 11.

Where can I get a vaccine?

The federal government's website lets you search for locations by zip code, with links to appointments, and many sites permit walk-ins.

Many county health clinics, doctor's offices and pharmacies, including large chains like CVS, Walgreens and Walmart, are taking vaccine appointments, and lots of them offer walk-in vaccinations. Check the pharmacy sites for appointment and walk-in options. Veterans can get vaccinated through Veterans Affairs facilities. For residents and staff at long-term care facilities, vaccines are generally available on-site.

The mass-vaccination sites that popped up across the country in the early days of vaccine distribution have mostly closed.

Are there side effects?

Some people never develop side effects, but many experience injection-site pain, fever, chills, headaches, muscle aches or joint pain, among other symptoms. These reactions are temporary, but experts say you should avoid making big plans in the days following your appointment as a precaution.

More serious aftereffects, including a small number of allergic reactions, are rare. Johnson & Johnson's vaccine has been connected with rare, severe blood clots in a small number of recipients, especially in women 50 and younger.

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If I get a vaccine, can I still get COVID-19?

All three vaccines authorized in the U.S. reduce the risk of COVID-19 infections and are highly effective at preventing severe illness and death from the disease. But breakthrough infections have been documented, albeit rarely, and usually involve mild to moderate symptoms.

Of the more than 173 million fully vaccinated Americans as of Aug. 30, a tiny fraction of 1 percent (0.007 percent) were hospitalized or died from a breakthrough infection, according to the CDC. Adults 65 and older have accounted for 7 in 10 COVID-19 hospitalizations and nearly 9 in 10 deaths of fully vaccinated Americans.

Can my employer require me to get vaccinated?

Technically, yes. The U.S. Equal Employment Opportunity Commission (EEOC) has said federal employment protection laws “do not prevent an employer from requiring all employees physically entering the workplace to be vaccinated for COVID-19." And the Occupational Safety and Health Administration (OSHA) is working on a vaccine mandate for companies with 100 or more workers. Employees at these businesses will need to be vaccinated or tested weekly for COVID-19 before coming into work.

Similarly, vaccine requirements have been announced for all federal workers and contractors and all health care workers in facilities that receive Medicare and Medicaid dollars, including nursing homes. Individual states, including New York and California, have also introduced vaccination mandates for teachers and other workers, requiring those who do not get a vaccine to submit to regular testing, masking and social distancing requirements.

But other federal laws may supersede the EEOC's, so accommodations may be granted to people who don't want to be vaccinated because of valid medical or religious reasons. Those workers may still be required to wear a mask in the office or be told not to come in at all.

Will I need a booster shot?

Booster shots may be available and recommended as early as the week of Sept. 20 for those who are several months past their second shot of the Pfizer and Moderna vaccines, health officials say. Boosters have not yet been authorized by the CDC or the FDA, though Pfizer was the first to ask for approval and is furthest along in the process. Moderna has since requested that regulators approve its boosters, and Johnson & Johnson is expected to do the same in the coming weeks, pending more data.

Officials have suggested that long-term care residents and staff and health care workers will be prioritized in the initial wave of boosters, as they were when vaccines were first made available. But it's unclear whether older adults would also be prioritized and whether individual states and cities would adopt their own distribution plans.

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Older adults wait in line at a COVID vaccination center

Marta Lavandier/The Associated Press

Older Florida residents have their temperatures taken before receiving the second dose of the Pfizer COVID-19 vaccine at Jackson Health System in Miami.

Will I be able to get a booster at the same place I got a vaccine?

It's not yet clear. The White House has said that will eventually direct people to booster appointments at some pharmacies and health centers currently offering vaccines. But you may need to go to a new location if you received your shots from a mass vaccination site, since many have been closed for several months. Gov. Phil Murphy (D) of New Jersey has said his state will “almost certainly” reopen some mass vaccination sites to distribute boosters, but the White House has not yet indicated support for mass vaccination sites nationally.

Residents and staff at long-term care facilities may also go through a different process than they did in the winter, when a series of vaccination clinics were set up through a federal partnership with CVS, Walgreens and other local pharmacies.

Can't immunocompromised people already get boosters?

Not exactly. The CDC recommends that certain immunocompromised people, including those being actively treated for cancer or taking certain immunosuppressing drugs, receive a third dose of Pfizer's or Moderna's vaccine at least 28 days after getting their second dose. These individuals’ immune systems may not respond sufficiently to just two vaccine doses. Only about 3 percent of the U.S. adult population is expected to need a third shot. If you think you may be eligible for one, the CDC recommends talking with your health care provider about your medical condition and whether getting an additional dose makes sense.

Third shots are available at the same locations that offer COVID-19 vaccines. If you received a shot from a mass-vaccination site that has since closed, use to find a vaccine provider near you.

Boosters, on the other hand, will likely be available to anyone who is fully vaccinated but not until months after completing the initial regimen.

If I'm already fully vaccinated, do I really need a booster?

Some health experts say yes. Recent studies from the CDC and the Mayo Clinic suggest that COVID-19 vaccines are very effective in the weeks and months after full inoculation — but that the strength of protection eventually starts to fade.

"Regardless of the vaccine evaluated, all vaccines remain effective in preventing hospitalization and severe disease. But they may be less effective in preventing infection and mild illness recently,” Sara Oliver, M.D., an epidemic intelligence service officer in the CDC's division of viral diseases, said during a CDC advisory panel meeting in late August.

Health officials have noted that the concept of a booster shot isn't new and that many vaccines become less effective over time.

Andrew Soergel covers nursing homes and federal and state policy for AARP. He was previously a senior economics writer at U.S. News & World Report and was awarded an Economics of Aging and Work fellowship through the Associated Press-NORC Center for Public Affairs Research at the University of Chicago.

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