The FDA has expanded the emergency use authorization of the Pfizer and Moderna COVID-19 vaccines to allow adults 50 and older to get a second booster. The shot can be administered as early as four months after the first booster of any COVID-19 vaccine. Immunocompromised individuals will also be eligible.

The expanded eligibility means that otherwise healthy older adults will be able to get three-dose primary series of the vaccine and two boosters, for a total of five shots. Previously anyone 12 or older who was severely immunocompromised could get additional shots.

The CDC is updating its vaccine pages to reflect the expanded eligibility.

“Current evidence suggests some waning of protection over time against serious outcomes from COVID-19 in older and immunocompromised individuals,” said Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, in a news release. “Based on an analysis of emerging data, a second booster dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccine could help increase protection levels for these higher-risk individuals.”

The news release urged people to get their initial booster if they have not done so, as it can greatly protect against severe outcomes from COVID-19. The FDA says potential benefits outweigh any risks associated with the booster for older adults.

For those who got the Johnson & Johnson vaccine and booster, it’s ok to get an additional booster of the Pfizer or Moderna vaccines. “Boosters are safe, and people over the age of 50 can now get an additional booster 4 months after their prior dose to increase their protection further,” CDC Director Dr. Rochelle Walensky said in the statement. “This is especially important for those 65 and older and those 50 and older with underlying medical conditions that increase their risk for severe disease from COVID-19 as they are the most likely to benefit from receiving an additional booster dose at this time.”

Yet, the data on whether a fourth shot is effective is not yet conclusive, so the CDC has stepped back on making a recommendation for older adults to get the shot and has stated instead that it is available to them. In the end, individuals will have to make the decision for themselves on whether a fourth shot is warranted.

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