More than 207 million Americans — and more than 87 percent of adults 65 and older — have been fully vaccinated against COVID-19, with shots now available to everyone 5 and older. That's about two-thirds of the eligible U.S. population, with nearly 100 million Americans without a full round of shots.
In much of the country, it's relatively easy to get a shot, and the Centers for Disease Control and Prevention (CDC) now recommends that everyone 16 and older get a booster shot two or five months after their first round of vaccines, depending on which shot they received.
More than 72 million people have already received a Pfizer, Moderna or Johnson & Johnson booster. 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? Who can get a booster?
Pfizer's vaccine is approved for all Americans age 5 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 for people age 16 and up.
The CDC recommends booster shots for all adults. Johnson & Johnson recipients should get a booster shot at least two months after their first shot. Pfizer recipients ages 16 and older should get a booster five months after completing their initial two-shot series. Moderna recipients should also get a booster five months after their initial two-shot series. Pfizer's booster has been recommended for everyone age 16 and older, while Moderna's and Johnson & Johnson's are recommended for everyone 18 and up.
All three vaccine manufacturers are investigating how younger populations respond to their shots. Pfizer’s vaccine for 5- to 11-year-olds is one-third the dose given to people age 12 and up, and is given in two doses, three weeks apart, according to CDC recommendations. Shots for kids are available at doctors’ offices and certain retail pharmacies.
Where can I get a vaccine or booster?
The federal government's Vaccines.gov website lets you search for vaccine and booster providers by zip code, with links to appointments, and many sites permit walk-ins. If you need help finding a COVID-19 vaccine provider, text your zip code to 438829 or call the CDC's vaccine hotline at 800-232-0233 (TTY: 888-720-7489).
Many county health clinics, doctors' offices and pharmacies, including large chains like CVS, Walgreens and Walmart, are taking vaccine appointments, and many also 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. The CDC says the Pfizer and Moderna vaccines are preferable to Johnson & Johnson's because of these reported blood clots.
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, and usually involve mild to moderate symptoms.
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) has issued a vaccine mandate, effective Jan. 4, 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.
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Will I be able to get a booster at the same place I got a vaccine?
Vaccines.gov is directing people to booster appointments at some pharmacies and health centers currently offering initial 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 vaccination clinics were set up through a federal partnership with CVS, Walgreens and other pharmacies.
Am I locked into getting a certain booster based on my initial vaccine?
No, the CDC says it is safe and effective to choose which vaccine you receive as a booster — whether it's the one you got initially or another vaccine.
Weren’t immunocompromised people already able to 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. They may also get a booster — a fourth dose — at least six months after their third shot, according to CDC guidance. 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 vaccines.gov to find a vaccine provider near you.
If I'm already fully vaccinated, do I really need a booster?
Many health experts say yes, if you're an older adult or if your work exposes you to other infected people. 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.