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What People With Lupus Should Know About Getting a Second COVID-19 Booster Shot

Posted on August 01, 2022
Medically reviewed by
Robert Hurd, M.D.
Article written by
Manuel Penton, M.D.

  • The Centers for Disease Control and Prevention (CDC) has approved a second COVID-19 booster shot of the messenger RNA (mRNA) vaccines for people over 50 years old and those who are immunocompromised.
  • The Lupus Foundation of America says that booster shots are “particularly important” for people with lupus to prevent the spread of COVID-19.

The CDC and U.S. Food and Drug Administration (FDA) have authorized and recommended a second COVID-19 booster shot for people 50 and over and those with immunocompromising conditions.

The Lupus Foundation of America says, “The virus has changed and it is now easier to catch and transmit, even for people who are vaccinated. The booster shot is particularly important in reducing the chance that you will catch COVID-19.”

The New Recommendations

Some important details about these recommendations include the following:

  • This booster is for people who received their first booster at least four months ago.
  • This fourth shot would be of either the Moderna or Pfizer vaccines, not the Johnson & Johnson vaccine.
  • Even if you were previously vaccinated with the Johnson & Johnson vaccine, it is now recommended that this next dose be a Moderna or Pfizer vaccine only.
  • For those who are immunocompromised and received a three-dose primary vaccination followed by an initial booster, this additional booster counts as a fifth shot.

How Booster Shots Can Protect People With Lupus

If you’re living with lupus, you may be wondering what the experts say about the importance of getting a booster shot to protect against COVID-19. The Lupus Foundation of America says, “Receiving a booster shot reduces the chance that you will catch COVID-19. It also reduces the chance that if you do get it you will get seriously ill or die. Talk to your doctor about the number and timing of COVID-19 vaccine doses that are right for you.”

The CDC’s list of underlying medical conditions doesn’t explicitly list lupus as a condition that may qualify someone for a second booster shot. The list of underlying medical conditions includes, for example, chronic lung disease, diabetes, heart conditions, obesity, smoking or smoking history, and HIV infection.

“I had the Pfizer vaccine and both boosters without any problems,” wrote one MyLupusTeam member. Another said, “I’ve had both shots and two boosters, and I haven’t had any side effects from them.”

Talk with your doctor if you have questions about your eligibility for an additional COVID-19 vaccine dose.

Why Booster Shots Matter

Research indicates that antibody levels are likely to decrease over time, so getting booster doses at recommended intervals is necessary — even for vaccinated people who made antibodies after their initial shots.

Simply making antibodies does not always translate to complete immunity from COVID-19 infection. The findings from recent studies, however, are promising. In one study of immunocompromised people with cancer, researchers tested levels of antibodies (the proteins the immune system makes) to help destroy a target. In this case, the antibodies were to SARS-CoV-2 (the virus that causes COVID-19), made in response to the Moderna COVID-19 vaccine.

On average, antibodies against the coronavirus were identified after the second vaccine dose in about 90 percent of people in the study. These results are considered a good sign that vaccines using mRNA — which include those by Moderna and Pfizer — for COVID-19 can trigger strong responses, even from people with compromised immune systems. It’s evidence that vaccines can protect people at higher risk of severe infections.

One study of 696 people with lupus found that side effects following COVID-19 vaccination didn’t seem to impair daily function and that about 3 percent of participants reported a lupus flare after vaccination. However, the researchers noted that there was no way to tell if those flares resulted from the vaccine or would have occurred even if the participants hadn’t been vaccinated. The study authors wrote, “COVID-19 vaccination appears well tolerated in patients with SLE (systemic lupus erythematosus), with only a minimal risk of flare, if any, including after the mRNA vaccines.”

According to the CDC, getting vaccinated is still the best way to protect yourself and slow the spread of the virus. If you are unvaccinated due to immunodeficiency, an autoimmune disease, cancer treatment, or because you are an organ transplant recipient, this new research should give you confidence to speak with your health care provider about when a COVID-19 vaccine would be right for you.

Find Your Team

On MyLupusTeam, the social support network for people with lupus and their loved ones, more than 213,000 members come together to ask questions, give advice, and share their stories with others who understand.

Are you considering getting a second booster shot? Have you discussed any concerns with your health care provider? Share your insights in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Robert Hurd, M.D. is a professor of endocrinology and health care ethics at Xavier University. Review provided by VeriMed Healthcare Network. Learn more about him here.
Manuel Penton, M.D. is a medical editor at MyHealthTeam. Learn more about him here.

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