White House: Most Americans Will Need Booster Shot 8 Months After Vaccination

U.S. health officials announced today that fully vaccinated Americans aged 18 and above will need a booster shot eight months after their second dose of Pfizer-BioNTech or Moderna vaccine.

The first boosters are expected to be administered starting September 20, according to a joint statement by the Health and Human Services, Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC) and others.

The recommendation comes as new data from the CDC indicates that the vaccine protection against COVID-19 wanes over time. But officials say that the authorized vaccines are still highly effective at preventing serious disease, hospitalization, and death from the virus.

“Here’s what you need to know: if you are fully vaccinated, you still have a high degree of protection from the worst outcomes of COVID-19,” Vivek Murthy, U.S. Surgeon General, said at a White House briefing. “We are not recommending that you go out and get a booster today.”

For boosters to be administered, the FDA still needs to complete an independent review of a third dose of the vaccines by Moderna and Pfizer. A CDC advisory panel also needs to review the data and go through a final vote.

What Will the Booster Rollout Look Like?

Like the original vaccine rollout, boosters will first go to healthcare workers, emergency workers, residents of long-term care facilities, and other seniors.

Healthcare workers and other people who received the vaccines in January and February will soon reach the eight-month mark for their booster shots.

A CDC panel said last week that people should try to get a booster shot that matches their previous doses, but mixing the mRNA vaccines would be fine if their original one is unavailable. Research indicates that getting three doses of an mRNA vaccine, such as Moderna and Pfizer, is more effective than mixing mRNA and adenovirus vector vaccines, like Johnson & Johnson.

No Boosters for Johnson & Johnson  

Currently, there is no peer-reviewed data on the safety and efficacy of a second dose of Johnson & Johnson’s vaccine, which was authorized as a single-dose regimen. Health officials are expecting the results of the company’s two-dose clinical trial in late August, prior to making an official recommendation.

“Administration of the J&J vaccine did not begin in the U.S. until March 2021, and we expect more data on J&J in the next few weeks. With those data in hand, we will keep the public informed with a timely plan for J&J booster shots as well,” the statement said.

Why Booster Shots May Be Necessary

The CDC today released three studies that suggested booster shots would be necessary for all Americans in coming months.

In one of the studies, the CDC analyzed data from nearly 4,000 nursing homes before the emergence of the Delta variant in the U.S., and nearly 15,000 nursing homes after it became the dominant variant.

The study found that vaccine efficacies at preventing infections went from about 75% to 53% during that time period. It did not assess how well the vaccines protected against severe illness.

Murthy explained that the health authorities decided on an eight-month period for the booster from another CDC study that found increases in mild to moderate infections among vaccinated people around the six-month mark.

"We know that the most important purpose of the vaccine is to keep us out of the hospital and to save our life. It’s to prevent against hospitalizations and death," he said. "And fortunately, we’re seeing that still holding at a high level, which is good news."

The highly contagious Delta variant is driving a surge in COVID-19 cases in the U.S., especially among unvaccinated people.

In July, the CDC said that Americans did not need booster shots. Even with new data about waning vaccine efficacy over time, the Biden administration appeared hesitant to highlight this fact, for fear that it will dissuade people from getting the shot.

Even with reduced efficacy, the COVID-19 vaccines are still highly effective at preventing serious disease and death, which is what they were designed to do, Kate Mullane, DO, PharmD, a professor of medicine and infectious disease specialist at the University of Chicago, tells Verywell.

Scientists do not yet know the exact levels of antibodies that would mount an effective immune response against the COVID-19 virus. They rely instead on data, like that from Israel, to observe when infections increase among vaccinated individuals and determine a timeline for booster shots from there. The Biden administration currently recommends people wait eight months before receiving a booster shot, though Mullane says that timeline may change. 

Mullane explains that booster shots will likely become part of an annual vaccination, like the flu shot, to support the immune system against new variants.

“As long as people travel and as long as human beings don't protect themselves and don't practice social distancing, we're going to see the spread of the newer variants,” Mullane says. “With each change in the variant, our worry is that our vaccine will lose efficacy.”

Is it too Soon for the U.S. to Administer Boosters?

Some experts have raised questions about the ethics of distributing booster shots in the U.S. while less than a tenth of the population in some countries is vaccinated.

The World Health Organization (WHO) called on wealthier nations to hold off on administering booster shots until after September or later, saying that distributing vaccines overseas would be more effective at quelling the pandemic in the long-run. Increasing vaccination rates globally could also slow the development and spread of more contagious or evasive viral variants in the future.

The U.S. has so far committed to donating 600 million doses of COVID-19 vaccine to other countries, and officials said they plan to increase this allocation. To vaccinate 70% of the global population and end the pandemic, 11 billion vaccine doses are needed, according to WHO Director-General Tedros Adhanom Ghebreyesus.

Variants and Hospitalizations Increase Urgency of Boosters

“This plan to administer booster doses does not change our commitment to vaccinating those who are not yet vaccinated, here in the U.S. and around the world," Murthy said at the press conference today. "The overwhelming cases of severe disease, hospitalization, and death continue to occur among the unvaccinated. We will continue to ramp up efforts to increase vaccinations here at home and to ensure people have accurate information about vaccines and access to vaccinations."

In the U.S., the rate of children and young adults who are hospitalized for COVID-19 have increased dramatically. Mehul Suthar, PhD, assistant professor at the Emory Vaccine Center, tells Verywell that as vaccine efficacy wanes, elderly and immunocompromised people are still disproportionately vulnerable to the virus.

"This Delta variant sort of shifted the focus a bit more towards the younger children as well as healthy young adults," Suthar says. "But the elderly are still going to be the vulnerable population."

Last week, the FDA authorized a booster shot for immunocompromised individuals, which was followed by an official CDC recommendation. But the CDC at the time said the general public would not yet need a booster shot.

Nearly 60% of Americans 12 and older are fully vaccinated against COVID-19. No vaccine has been authorized for children under the age of 12 yet. At least 1 million Americans have received an additional dose of the vaccine on their own before it was recommended, according to the CDC.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.