The First American To Take A COVID Vaccine Just Got A Booster. Here’s How To Get Yours.

Last December, nurse Sandra Lindsay became the first New Yorker — and American — to take a dose of a COVID-19 vaccine outside of a clinical trial. Over the nearly 300 days that followed, she would be joined by 216 million people in the U.S. in a battle to beat back the pandemic.

As director of nursing for critical care at Northwell Health's Long Island Jewish Medical Center, she has been on the frontlines during every COVID surge, including the recent one propelled by the delta variant.

And on Wednesday, Lindsay — who also has a doctorate — and two other early vaccine recipients took their booster shots.

"I'm feeling great. I am up and out. Just like I responded to the first two shots,” said Dr. Lindsay.

Now, people across the country are getting supplemental shots of the Pfizer-BioNTech vaccine, which is the only shot currently eligible for a third dose. Recipients of the Johnson & Johnson and Moderna vaccines will have to wait for now.

It’s one of many guidelines New Yorkers should know before heading to a pharmacy for an extra shot. Here are some others.

Why do I need a booster shot, anyway?

The COVID vaccines are great at preventing severe disease, hospitalization, and death. And they reduce your risk of infection, too. (Reminder: Pfizer and Moderna vaccines were initially authorized to require two shots, while Johnson & Johnson came with a single dose.)

But studies suggest the Pfizer vaccine’s protection — against infection and hospitalization — can wane over time. Despite also being an mRNA vaccine, the Moderna shot appears to be holding up better than Pfizer’s drug at the moment.

"I would not be surprised if recommendations for Moderna recipients to be boosted are a bit narrower than what they were for Pfizer," Dr. Céline Gounder, an infectious disease specialist and epidemiologist at New York University and Bellevue Hospital, told Science Friday this week.

Waning appears to be more common in older adults, people who are immunocompromised and health care workers.

Frontline workers are also experiencing this decline in vaccine effectiveness against catching the virus around the six-month mark.

The delta variant is blamed for this drop in this effectiveness, though it could partially be due to the economy reopening and daily exposure rising.

“We are worried about a possible winter surge. Myself and the nurses, we’re exhausted," Dr. Lindsay said. "We’re saddened by how many people we have lost. They're our friends, our neighbors, our colleagues, Americans.”

Combined with natural decreases in immunity over time, it means some of us could use a boost.

OK, so who needs a booster?

Right now, the Centers for Disease Control and Prevention recommend the booster shot for people over the age of 65, people older than 50 with health conditions that put them at risk of severe disease and adult residents of long-term care facilities.

Younger adults with certain pre-existing conditions are also eligible, although the official word from the CDC is that people in these groups should decide based on their individual exposure and risk of severe disease.

“That’s the question mark group,” Dr. David Buchholz, a primary care specialist at Columbia University, said of these young people. “But if you have any questions, you can just talk to your primary care provider.”

Frontline workers in high-risk settings — like jails, schools and hospitals — and people living in similar environs are also eligible, with the same caveats.

When will boosters be ready for the other vaccines?

Recipients of the Johnson & Johnson and Moderna vaccines will have to hang tight for now, even if they’re eligible. The CDC says they’ll share guidance on boosters for this group as soon as the federal agencies get the data they need.

Johnson & Johnson announced earlier this week that it was in the process of sharing that information with the Food and Drug Administration. The New Jersey-based company said it had found a second shot could improve its vaccine efficacy, from 79% to more than 90%, bringing it in line with its authorized competitors.

An FDA advisory committee is scheduled to meet on October 14th and 15th to consider boosters shots for Moderna and Johnson & Johnson. At the moment, it's unclear if Pfizer recipients would be allowed to take boosters shots from another brand or vice versa--but the National Institutes of Health are looking into it.

"The NIH is currently studying every possible combination of Pfizer, Moderna and J&J — which one did you get first and which should you get as a booster — to see what combo is the best," Dr. Gounder said on Science Friday. "We should have data on all of those mix-and-match regimens by mid-to-late October."

Regardless, these people are still reaping the benefits of their first full course of vaccines, noted Dr. Chloe Teasdale, assistant professor of epidemiology and biostatistics at the CUNY Graduate School of Public Health.

“The effectiveness of the vaccines is staying high,” she said. “People should continue to feel protected even without the boosters.”

Let’s say I’m eligible. When should I get a booster?

If it’s been six months or more since your second Pfizer shot, you’re good to go, according to the CDC. For simplicity’s sake, Dr. Buccholz suggests simply choosing the six-month anniversary of your second dose.

The one exception is if you were immunocompromised when you got your first two doses — due to causes such as chemotherapy or immunosuppressant drugs. In that case, you’re eligible for an additional dose of COVID vaccine 28 days after your second shot. This isn’t technically a booster—more like a supplemental dose to get immunocompromised people’s immunity up to par with the rest of the vaccinated population.

It’s also fine to get your booster at the same time as your flu shot.

OK, I’m eligible. It’s been six months. Do I go back to the Javits Center for a shot or what?

Some of New York’s mass vaccination sites, including the Javits Center, have been closed, while others have been scaled down. So your best bet is your local pharmacy, your primary care physician or a community clinic. The New York City, state and federal governments all offer vaccine finder tools, which allow you to filter by manufacturer, so you can be sure you’re visiting a site with the Pfizer vaccine. The city also has a handy online scheduler, where you can sign up for an appointment at one of the city’s vaccine hubs.

The city offers free transit to vaccine appointments for disabled New Yorkers and older adults; you can arrange a ride by calling 877-VAX-4NYC (877-829-4692). The city’s COVID-19 and Flu Vaccine Finder also allows users to choose accessible vaccination sites. And you can sign up for a vaccine appointment in your own home by going online or calling the hotline above.

New Jersey residents, meanwhile, can use their state's Vaccine Appointment Finder or call 1-855-568-0545 to schedule a booster shot.

What can I expect in terms of side effects?

Probably about what you experienced after your second dose of Pfizer, Dr. Buccholz says. He had a sore arm and some fatigue after both his second shot and his booster shot. Dr. Lindsay also reported some pain at the injection site.

I still need more information.

The New York State Department of Health has set up an entire booster webpage with lots of information and resources on the follow-up shots. The CDC also goes into greater detail about eligibility, and slides and meeting minutes from its Advisory Committee on Immunization Practices are available online.