The updated boosters are “bivalent.” Bivalent vaccines protect against two different viruses or two strains of the same virus. This type of vaccine is not new. Many common vaccines can protect against even more than two types of viruses or virus strains, like the flu vaccine. The updated COVID-19 boosters target the original COVID-19 strain and the newer omicron variant. Reported side effects seem to be the same as the original vaccine.
An updated booster dose is not recommended for children ages 6 months-4 years who finished their Pfizer 3-dose primary series.
All other patients ages 6 months and older are eligible for the updated booster if:
Please note you are eligible for this updated booster no matter how many previous booster shots you have received.
With the FDA approval of the updated boosters, the original COVID-19 vaccines are no longer approved as boosters. The FDA made this decision because the updated booster is designed to offer more protection from the circulating omicron variant.
People with active COVID-19 infection should not receive a COVID vaccine dose while in isolation (this includes a booster dose). Individuals must have recovered from illness and be out of required isolation prior to receiving the COVID vaccine.
Even if you had COVID, you should still get your booster. There is growing evidence that vaccination following infection increases protection from subsequent infection and hospitalization.
If you have been infected with COVID-19 in the last three months, the following applies:
If you haven’t started your COVID vaccine primary vaccine series, you should get vaccinated. You can find more information about COVID-19 primary vaccination series on the CDC website.
If you have started your primary vaccine series, but have not completed it yet, you will need to wait to get your updated booster. You are eligible for the updated booster at least two months after you have completed your primary vaccine series.
There are many places to get vaccinated in your community. To find an appointment at a pharmacy or other location near you, visit vaccines.gov, vaxfinder.mass.gov or vaccines.nh.gov; text your zip code to 438829; or call 1-800-232-0233.
Mass General Brigham is offering vaccines (primary series and boosters) at many primary care and some specialty offices alongside visits. We will provide information when the updated boosters are available at our locations.
Mass General Brigham will also continue to distribute vaccines from our mobile community vans. Check the schedule to see if the vans will be near you. Check the schedule to see when the vans will be near you.
For booster vaccination, an mRNA vaccine (i.e., Moderna or Pfizer-BioNTech) is recommended. The booster that you receive depends on your age group. The CDC’s website provides guidance for which vaccines and boosters you can receive based on your age group. Read more on the CDC website.
Novavax vaccine may be used in limited situations in people ages 18 years and older who have completed their primary series and have not received any previous booster dose(s):
A booster and an additional primary dose are not the same. An additional primary dose is recommended for people who have compromised immune systems. It is recommended that patients with compromised immune systems receive an additional primary dose to increase their level of protection from the virus. This additional dose completes these patients’ primary vaccine series.
A booster is an extra dose of vaccine meant to boost a patient’s immune system because of decreased immunity over time.
People ages 5 and older who are moderately to severely immunocompromised should get an additional primary dose. These are people who:
The CDC has updated vaccine intervals for people 12 years and older. For non-immunocompromised people 12 years and older, especially males ages 12-39 years, there is more flexibility in timing for the second dose for the Pfizer and Moderna vaccines. An 8-week interval is recommended between first and second doses.
Please note that certain people should continue with the 3-week interval for Pfizer and 4-week interval for Moderna. This includes:
Remember getting vaccinated is the best way to prevent severe illness from COVID-19. Please make sure everyone in your household is vaccinated and up to date with booster recommendations. This is especially important if you or a family member has conditions that put them at high-risk.
While we cannot replace the physical CDC vaccination card, patients who were vaccinated at a Mass General Brigham location can receive their immunization history through Patient Gateway. Patients who received their COVID-19 vaccination(s) through a Mass General Brigham provider can now access their vaccination record digitally or via a QR code through Patient Gateway.
If you are not a current patient registered in Patient Gateway, you can request a hard copy of your vaccination record through Mass General Brigham’s Health Information Management (HIM) Department. You will need to complete an authorization form for release of protected health information. The form can be found here. The completed form may be faxed or mailed, and instructions are included in top right corner of the form.
If you were vaccinated outside of the Mass General Brigham system, you will need request a copy of your vaccination information from the original provider (e.g., CVS, Walgreens).
The Massachusetts Department of Public Health provides additional guidance on how to replace your card here.
What have we learned about COVID-19 over the past two years? What is the best way to prevent the spread of COVID-19? What are serious symptoms associated with the virus? Erica Shenoy, M.D., Ph.D., FIDSA, FSHEA, Associate Chief, Infection Control Unit, Massachusetts General Hospital, discusses recommendations for the prevention, testing, and treatment of COVID-19.
We will not recommend any vaccine that has not been shown to be safe and effective. All COVID-19 vaccines have proven to be effective in preventing severe illness, hospitalization and death from COVID-19. These results were consistent across gender, age, race, and ethnicity. It is important for everyone ages 18 and older to get a booster shot as studies have shown that vaccine effectiveness against infections declines over time. See more information on the CDC website.
The FDA has granted full approval to two COVID vaccines: Pfizer and Moderna.
The Johnson & Johnson COVID-19 vaccine is being used under emergency authorization by the FDA.
Every vaccine goes through a strict regulatory review process. We continually monitor any clinical or safety concerns for all vaccines.
The FDA and the CDC amended information about the Johnson & Johnson (Janssen) COVID-19 vaccine because of a potential safety concern. There have been very rare reports of a type of blood clot called thrombosis with thrombocytopenia syndrome (TTS) among patients that have received the Johnson & Johnson vaccine. Though very rare, the risk of certain blood clots appears to be highest in women aged 30–49.
The Johnson & Johnson vaccine is not an mRNA vaccine. It is an adenovirus vector vaccine. It uses a modified version of the common cold virus called adenovirus 26 to deliver directions to your body to make the spike protein found on the surface of the coronavirus. Your immune system can then make antibodies to these proteins to protect you against COVID-19. You cannot get the cold from the vaccine.
Though mRNA vaccines are a new kind of vaccine, researchers have been studying and working on them for many years. They do not contain live virus and cannot cause COVID-19. Instead, they give our cells directions on how to make the COVID-19 proteins found on the outside layer of the coronavirus. Our immune system can then make antibodies to these proteins and protect us from being infected with COVID-19. The mRNA from the vaccine never enters the nucleus of our cells or gets into our DNA. The CDC has information about mRNA vaccines.
No. The vaccines (Pfizer, Moderna, or Johnson & Johnson) do not contain the whole or live virus and therefore cannot cause COVID-19.
Yes, you should still get vaccinated. There is growing evidence that vaccination following infection increases protection from subsequent infection and hospitalization.
If you have been infected with COVID-19 in the last three months, the following applies:
Read more on the CDC’s website.
Yes, you can be vaccinated. Previously, the CDC recommended delaying vaccination after receiving monoclonal antibody either for prophylaxis after exposure or treatment after infection. The updated guidelines do not recommend any delay in receipt of vaccine. After infection, vaccine can be administered once you have ended your isolation and your acute illness is over; after an exposure, vaccine can be administered when your quarantine period is over.
Some people do get side effects after receiving the vaccine. For most people, mild side effects resolve within a day or so. The most commonly reported symptoms:
Antibody testing is not currently recommended to assess for immunity to COVID-19 following COVID-19 vaccination or to assess the need to vaccination in an unvaccinated person. Antibody testing for the anti-Spike antibody testing is available at MGB through approved clinical research studies and clinical pathways only.
The CDC has updated masking guidance. The CDC recommendations on masking, and other measures, depend on the COVID-19 community level. You can check the COVID-19 community level with the CDC’s tool. Please check your state or town resources for details as rules that govern required masking can vary.
Patients who are at high risk for severe COVID-19 should see the CDC’s detailed guidance about masking and social distancing.
View our mask policy.
Viruses constantly change through mutation. A variant has one or more mutations that make it different from other variants in circulation. As expected, multiple variants of COVID-19 have been documented in the United States and globally throughout this pandemic.
The latest information on variants can be found on the CDC website.
While vaccinated people can still be infected, the good news is the vaccines will give you excellent protection. Infections in vaccinated people — so-called “breakthrough infections” — tend to be mild or with no symptoms. However, infected people, even if they have had the vaccine, can still spread the disease to others.
If you have symptoms of COVID-19 or have been exposed, follow public health guidance regarding isolation, quarantine, and testing.
Vaccination is still the best protection against the virus.
For patients who are hospitalized, there are treatment options (e.g., Remdesivir) available for patients of all ages. For patients 12 and older, the Food and Drug Administration (FDA) has issued emergency use authorizations (EUAs) for several outpatient treatment options to both prevent and treat COVID for certain populations.
There are reports in the media that some people may be using Ivermectin to prevent or treat COVID-19. Ivermectin is a medication used to treat parasites. There is no data that supports using Ivermectin for prevention or treatment of COVID-19. It is not approved by the FDA for prevention or treatment of COVID-19. There are reports of people being harmed when they take Ivermectin to prevent or treat COVID. Please see the FAQ by the FDA and the NIH COVID-19 Treatment Guidelines for more information.
There have been some reports of people having allergic reactions after getting vaccinated. A small number of people had a severe allergic reaction called anaphylaxis. Based on this, the U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) recommend that people with a history of anaphylaxis to any of the ingredients in a COVID-19 vaccine should not get that vaccine. People with other food or medication allergies can be vaccinated.
In general, most patients allergic to one vaccine can receive the other vaccines safely. If you have a history of severe allergic reactions to vaccines, injectable therapies, or any component of the COVID-19 vaccine, you should talk to your primary care provider or allergist (if you have one). Your provider can help you decide if it is safe to get vaccinated.
You can receive a COVID-19 vaccine if you have a food or drug allergy. The Pfizer, Moderna, and Johnson & Johnson COVID-19 vaccines do not contain gelatin, egg, or latex. Nevertheless, if you have a history of anaphylaxis due to any cause (food, oral medications, venom, latex), you might be observed for 30 minutes after receiving the vaccine. In studies, more than 98% of people with a history of severe allergic reactions have been able to get both doses of the COVID vaccine safely.
The Pfizer, Moderna, and Johnson & Johnson COVID-19 vaccines do not contain gelatin, egg, or latex. Also, the vial stoppers are not made with natural rubber latex. Patients who have latex allergies can receive the Pfizer, Moderna, and Johnson & Johnson COVID-19 vaccines.
Both the Pfizer and Moderna COVID-19 vaccines contain polyethylene glycol. Reactions to polyethylene glycol are very rare. Patients with a history of having an allergic reaction to polyethylene glycol should talk to their provider before receiving either the Pfizer or Moderna vaccine.
|Moderna||Johnson & Johnson||Novavax|
|Active||Nucleoside-modified messenger RNA (modRNA) encoding the viral spike (S) glycoprotein of SARS-CoV-2.||Nucleoside-modified mRNA encoding the viral spike (S) glycoprotein of SARS-CoV-2||Recombinant, replication-incompetent adenovirus type 26 expressing the SARS-CoV-2 spike protein||Recombinant spike (rS) protein of SARS-CoV-2 and Matrix-M adjuvant composed of Fraction-A and Fraction-C of saponin extracts from the soapbark tree|
|Inactive - lipids||
2[(polyethylene glycol [PEG])-2000]-N,N-ditetradecylacetamide
SM-102 (Proprietary to Moderna)
Polyethylene glycol (PEG) 2000 dimyristoyl glycerol (DMG)
|Inactive – salts, sugars, buffers||
Potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate
Tromethamine, tromethamine hydrochloride
The diluent, added to the vaccine for administration, is saline (sodium chloride)
Tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate
No diluent needed
Citric acid monohydrate, trisodium citrate dihydrate, 2-hydroxypropyl-β-cyclodextrin (HBCD), polysorbate-80
Potassium dihydrogen phosphate, potassium chloride, disodium hydrogen phosphate dihydrate, disodium hydrogen phosphate heptahydrate, sodium dihydrogen phosphate monohydrate, polysorbate 80
Similar to medication or food allergies, people can be allergic to an ingredient in a vaccine. About half of allergic reactions to vaccines happen in the first 15 minutes after receiving vaccination, and 90% occur within the first 30 minutes. Most vaccine allergic reactions are mild, such as hives.
A severe allergic reaction is called anaphylaxis, which are very rare, occurring in one in a million people for most vaccines. Symptoms of anaphylaxis almost always occur within 4 hours of vaccination, most often within minutes. Symptoms usually include multiple parts of the body: hives on the skin; swelling of mouth, lips, tongue or throat; shortness of breath, wheezing, or chest tightness; or low blood pressure or loss of consciousness.
Because most allergic reactions happen within the first 15–30 minutes, all patients are observed for 15 minutes after getting vaccinated to watch for an allergic reaction. If you have a history of anaphylaxis, you may have a 30-minute observation period after getting vaccinated. If you do have an allergic reaction, medical staff will treat you immediately. All vaccine locations can diagnose and manage allergic reactions and have medications, including epinephrine (“Epi-Pen”), available.
Allergy/immunology consultation may be useful for you if you have the following issues:
Yes, it is very important for you to get vaccinated. People who are immunocompromised are at higher risk of severe, even life-threatening, infection and hospitalization from COVID-19 infection. The COVID-19 vaccines can be safely given to people who are immunocompromised. For questions about allergies related to COVID-19 vaccination, please see the allergy frequently asked questions.
Patients who are immunocompromised include people who:
The CDC recommends that people who are moderately to severely immunocompromised get an additional primary shot of the Pfizer or Moderna COVID-19 vaccine, including those who received the Johnson & Johnson vaccine for their primary vaccine series.
Read more in the COVID-19 vaccine: Primary series, additional primary doses, and boosters section (Do I need an additional primary dose?).
In general, it is typical for people with suppressed immune systems to get less protection from vaccines than people who do not have suppressed immune systems. For transplant recipients, this reduced protection is associated with the immunosuppression medication that is taken following surgery that suppress the immune system so that the body does not reject the donor organ.
The antibody response to the COVID-19 vaccines among people with recent organ transplants is generally weaker than that of the general public, although still significantly more protective than not being vaccinated.
The CDC recommends that people who are moderately to severely immunocompromised should get an additional primary shot of the Pfizer or Moderna COVID-19 vaccine, including those who received the Johnson & Johnson vaccine for their primary vaccine series.
You should not change your immunosuppression medications unless you are told to do so by your provider.
Yes, you can and should get vaccinated. Even though it’s possible that a COVID-19 vaccine may be less effective for you, vaccination is still recommended. There is still a significant benefit in preventing severe infection and hospitalization from COVID-19 infection.
Your transplant provider can help determine the best time to get vaccinated and can tell you if you need transplant labs after vaccination.
Transplant recipients should continue COVID-19 safety measures to protect themselves against the virus. This includes wearing masks in public spaces—both indoor and outdoor (when other people are close by)—and practicing social distancing.
It is important to protect yourself and others by taking preventive measures against COVID-19:
Get more information from the CDC about vaccines and boosters >
Per CDC guidelines, we are not recommending antibody testing at this time. We are still testing the best methods to determine immunity. We do not know what level of antibodies would provide protection in transplant patients. Furthermore, antibody testing does not measure the other type of immune response, which we call cellular immunity. We hope to have more information soon.
Mass General Brigham Maternal-Fetal Medicine Specialist Dr. Ilona Goldfarb answers your questions about pregnancy, fertility, and COVID-19 vaccination.
Vaccinations are considered a safe and routine part of prenatal care. For example, the flu shot is not only offered during pregnancy but recommended.
Based on data that demonstrates that pregnant people are at increased risk of severe illness with COVID-19 and new data that shows that COVID-19 vaccines are safe and effective in pregnancy, the two largest OB/GYN organizations, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal and Fetal Medicine (SMFM), now strongly recommend this vaccine for all pregnant people.
Like many new medications and vaccines, the COVID-19 vaccines were studied in pregnant animals and these studies did not show any complications related to fertility or reproduction from the vaccine exposure.
None of the COVID vaccines contain live virus and they cannot make anyone sick with COVID including pregnant people or their babies.
Many studies of pregnant people have been published and the monitoring of COVID-19 vaccine safety during pregnancy is ongoing. More than 100,000 pregnant individuals have received the vaccine in the U.S. since December 2020 and so far, the CDC is reporting that there are no safety concerns, including infertility, miscarriage, birth defects, or preterm birth.
However, there have been more cases of a rare blood clot in patients who received the Johnson & Johnson COVID-19 vaccine. Therefore on December 16, 2021 the CDC updated their guidance and notes that either the Pfizer or Moderna COVID-19 vaccines are preferred over the Johnson & Johnson vaccine.
Read more about vaccination considerations from the CDC.
Receiving the COVID vaccine prior to pregnancy or as soon as possible during pregnancy is strongly recommended given the risk of severe illness from COVID.
Symptoms including fever, muscle aches, joint pains, fatigue, and headache are common side effects of all three COVID-19 vaccines. Most mild side effects resolve within a day or two and are not believed to be dangerous. If you are worried about side effects from the vaccines and your pregnancy, talk to your OB provider before getting the vaccine.
There have been very rare reports of a type of blood clot called cerebral venous sinus thrombosis among patients that have received the Johnson & Johnson vaccine. Though very rare, the risk of certain blood clots appears to be highest in women aged 18–49. The CDC therefore updated their guidance on December 16, 2021 and notes that either the Pfizer or Moderna COVID-19 vaccines are preferred over the Johnson & Johnson vaccine.
Individuals who have been vaccinated with the Johnson & Johnson vaccine within the last 21 days who experience severe headache, abdominal pain, leg pain, or shortness of breath should seek immediate evaluation.
Yes! Recent studies on pregnant people who received the COVID-19 vaccine during pregnancy demonstrate that immunity is passed to the baby. This immunity may offer protection against COVID-19 to your baby.
The COVID-19 vaccines are currently being offered to breastfeeding individuals. The COVID-19 vaccines are not believed to be a risk for breastfed infants of mothers who were vaccinated as any vaccine component that makes it into the breast milk is likely to be quickly inactivated when the milk is digested by the baby.
In addition, recent studies demonstrate that your COVID-19 immunity can pass to the baby through the breast milk after you receive the vaccine. The Academy of Breastfeeding Medicine recommends that all breastfeeding individuals get a COVID-19 vaccine.
The American College of Obstetricians and Gynecologists has convened an expert panel which recommends completing the vaccine course once it is initiated to receive the most effective and timely immunity.
Yes! This is a great time to get vaccinated. The COVID-19 vaccines are not believed to affect your future fertility. Getting vaccinated before you get pregnant may prevent COVID-19 during pregnancy. It can also avoid the need for vaccination during pregnancy.
Stress, changes in weight and exercise, and other major lifestyle changes can affect periods. All of those changes are common during the COVID-19 pandemic. Studies have also shown that some women who had COVID-19 experienced changes in the duration and flow of their menstrual cycles.
Recently, some people have reported changes in their period after receiving the COVID-19 vaccine. People have reported changes in duration, flow, and symptoms such as pain. The NIH is funding studies to better understand these changes.
This does not mean there is any link to miscarriages. There is now data from many women who have been vaccinated which suggests there is not an increased risk of pregnancy loss.
Studies of mating animals have demonstrated no evidence that COVID vaccines affect fertility. Follow-up data from vaccinated individuals of reproductive age as well as studies on patients before and after vaccination do not show any evidence that the COVID-19 vaccines cause fertility problems (problems trying to get pregnant) in women or men.
Yes. The CDC recommends that everyone ages 18 years and older should get a booster. The booster dose has been shown to provide stronger protection against severe illness from the COVID variants. This additional immunity will help protect you and your baby.
The CDC recommends that patients ages 6 months and older receive the COVID-19 vaccine. The Pfizer and Moderna vaccines are approved and recommended for patients in this age group.
Children older than 6 months old need a consent signed by a parent to receive a vaccine at a Mass General Brigham location.
For most children:
For children who are immunocompromised, the vaccine schedule may differ. Please see the CDC website for details.
The CDC has a tool and vaccine schedule that can help you understand how your child can stay up to date on COVID-19 vaccines. You can also ask your child’s pediatrician.
Booster dose is not recommended for children ages 6 months-4 years who finished their Pfizer 3-dose primary series.
All other patients ages 6 months and older are eligible for the updated booster at least 2 months after completing their primary series or last booster.
See the CDC’s website for more information about vaccine schedules and timelines.
In Massachusetts, you can visit the Mass.gov website to find vaccine appointments near you or dial 2-1-1. In New Hampshire you can visit Vaccines.nh.gov to find a location near you. Or you can search vaccines.gov, text your zip code to 438829 or call 1-800-232-0233 to find a location.
We also have community vans that offer free COVID-19 vaccines on select days and times; no appointment needed. Please view the schedule for when we will be in your neighborhood.
Children should be vaccinated with whichever vaccine is available. If you have questions, please reach out to your child’s pediatrician’s office.
Yes. Anyone older than 6 months must have a written consent form completed and signed by their parent/guardian before receiving the COVID vaccine. Download the consent form here.
We are not able to accept verbal consent by phone. The consent form must be signed by the parent/guardian. One consent form covers both vaccine appointments.
For your child’s first dose, they will get the dose that is given to 5–11-year-olds (10 micrograms). For the second dose, the CDC allows the parent/guardian to choose. However, Mass General Brigham guidelines are to give the 12-year-old dose for the second dose (30 micrograms).
No. The Pfizer and Moderna vaccines do not contain the whole or live virus and therefore cannot cause anyone to contract COVID-19.
Both the Pfizer and the Moderna vaccines work well to prevent severe disease and death from COVID-19. Scientists found that each vaccine for children works just as well as the vaccine used in adults. Both vaccines produced similar antibody responses in children under 5 as do in young adults. Both vaccines reduce the risk of your child having a serious complication from the disease.
Yes. Children who have already had COVID-19 should get vaccinated. People who receive the vaccine after a COVID-19 infection have higher antibody levels. Vaccination after illness provides even better protection than from illness alone.
The most common side effect was pain at the injection site. The most commonly reported symptoms from the Pfizer vaccine study were fatigue, headache, chills, fever, and aches. Like adults and older children, these reactions occurred more frequently after the second dose.
Myocarditis has been reported as a very rare side effect (about 1 in 20,000 people) after the second dose or booster dose, mostly in males ages 12-39 years old. The risk of getting myocarditis from the vaccine is much lower than getting myocarditis from COVID-19. Myocarditis after vaccination is also milder than after getting COVID-19.
In children ages 12 and older who did get myocarditis from the vaccine, cases were mild and got better quickly. This is compared to about 75% (about 3 out of every 4) children who got myocarditis and MIS-C from COVID-19, in which their cases were severe with long-term effects.[SS1] [HM2] [NM3]
It is very important that children get vaccinated. Vaccinating children will protect them, their families, and their communities. Although children are less likely to develop serious illness than other age groups, it can still make children very sick. COVID-19 cases in children can lead to hospitalizations, inflammatory syndromes, and long-term complications, such as "long COVID." Children have died from COVID-19, even those who are otherwise healthy. COVID-19 has caused more deaths in children of all ages than all other currently vaccine-preventable diseases combined. It is the 5th leading cause of death in children 1-4 years of age.
Yes. The CDC has stated that people with cancer may receive the COVID-19 vaccines, as long as they have had no issues with getting vaccines in the past.
If your current treatment includes chemotherapy, immunotherapy, targeted therapies, or radiation therapy, you should talk with your care team in deciding when to get vaccinated.
In making your decision, you should consider your risk of exposure to the virus, what your chances of getting very sick might be if you do get the virus, and when you will finish treatment.
If you are done with treatment, you should get vaccinated. This includes patients who are still being seen as part of post-treatment or are thought of as being in the “survivorship” part of their journey.
No. At this time, there is no evidence to suggest that the vaccines will affect your cancer treatment.
The CDC says that people are considered fully vaccinated if they received all recommended doses of COVID-19 vaccines authorized for emergency use by the World Health Organization (WHO). This includes those who mixed and matched two different vaccines approved by the WHO.
WHO Emergency Use Listing COVID-19 vaccines as of 9/7/2022:
Updated December 12, 2022