The U.S. Food and Drug Administration (FDA) authorized a second COVID-19 booster dose of either the Pfizer-BioNTech or the Moderna COVID-19 vaccines for older people and certain immunocompromised individuals in March. The FDA previously authorized a single booster dose for certain immunocompromised individuals following completion of a three-dose primary vaccination series. This action will make a second booster dose of these vaccines available to other populations at higher risk for severe illness, hospitalization and death. According to the FDA, “Emerging evidence suggests that a second booster dose of an mRNA COVID-19 vaccine improves protection against severe COVID-19 and is not associated with new safety concerns.”

As COVID-19 and its emerging variants continue to spread around the globe and threaten public health, it is important for long-term care providers to know and prepare for all available options to protect their residents and staff. Vaccination effectively reduces the risk of severe illness, hospitalization and death, even against the Delta and Omicron variants.

Nationwide, deadly cases among residents have declined significantly since before the COVID-19 vaccine rollout. This month, the reported COVID-19 death rate among residents is 0.1 percent for the week ending April 17. That is down from a peak of 5.6 percent for the week ending December 20, 2020. Deaths have decreased among nursing home staff as well. During 2020, there were 70 staff deaths reported for the week ending June 21, 2020 compared to eight reported for the week ending April 17, 2022.

Who is eligible for a second COVID-19 booster?

Research has found that like many vaccines, there may be a decrease in the COVID-19 vaccines’ protection over time. This is especially true for people who live in long-term care settings. A “booster dose” or booster shot refers to another dose of a vaccine that is given to someone who has built enough protection after their original vaccination series, but that protection decreased over time. This booster dose is different than the additional dose recommended for those with a weakened immune system.

Booster shots help to maximize a vaccine’s protection against infection and potential serious illness. The FDA emergency use authorization for second COVID-19 boosters is as follows: 

• A second booster dose of the Pfizer-BioNTech COVID-19 Vaccine (marketed as Comirnaty) or Moderna COVID-19 Vaccine (marketed as Spikevax) may be administered to individuals 50 years of age and older at least 4 months after receipt of a first booster dose of any authorized or approved COVID-19 vaccine.
• A second booster dose of the Pfizer-BioNTech COVID-19 Vaccine may be administered to individuals 12 years of age and older with certain kinds of immunocompromise at least 4 months after receipt of a first booster dose of any authorized or approved COVID-19 vaccine. These are people who have undergone solid organ transplantation, or who are living with conditions that are considered to have an equivalent level of immunocompromise.
• A second booster dose of the Moderna COVID-19 Vaccine may be administered at least 4 months after the first booster dose of any authorized or approved COVID-19 vaccine to individuals 18 years of age and older with the same certain kinds of immunocompromise.

Long-term care preparation for COVID-19 boosters

The FDA’s amended authorization only covers the mRNA vaccines developed by Pfizer-BioNTech and Moderna. Long-term care facilities can prepare for residents’ COVID-19 booster shots by keeping a close watch on resident vaccination records and the dates of their last dose. They can ease the logistics of booster shots for multiple residents at different times by ensuring documentation can be easily accessed by their vaccine provider. For example, they can put vaccination information in their electronic medication administration (eMAR) system.

We can help

Turenne PharMedCo Pharmacy Services is a vaccine provider through the Federal Long Term Care Pharmacy Program. We are happy to help long-term care facilities learn more about preparing for second COVID-19 booster shots for residents and staff. Our COVID-19 vaccination clinics are available for long-term healthcare customers in Alabama and Tennessee. Our immunization-certified pharmacists and nurses will inoculate previously vaccinated and unvaccinated residents and staff on-site.

Click here to learn more about our vaccination service in Alabama and to complete a vaccine clinic request form. For convenience, a consent form for vaccine recipients and vaccine fact sheets from the FDA are also available on our website for download. To request a clinic in Tennessee, call 1-866-720-7626.