Is it a bad idea to get a Covid booster as a young healthy person?

November 14, 2023 1:39 AM

I'm in my twenties. No underlying conditions. I spend a lot of time with my vaccinated 65-year old parents. My last Covid vaccine was in February 2022. AFAIK, I have not had Covid since 2021 (been masking and am cautious around exposure). I was able to get a Covid booster appointment even though I'm not immunocompromised nor older. However, I'm worried I'm doing something wrong for my health and also something unethical by getting the booster while technically being inelegible. Any advice or research I can turn to about this?

I'm anxious about both spreading and contracting Covid, since I had a case in 2021 and it was deeply unpleasant, even though it didn't give me any long-lasting issues. I also want to keep the people around me safe, since I spend a lot of time with my 65 year old parents and have close friends with immunocompromised parents (though I don't spend time with those parents directly). I'm currently jobhunting, and it's looking like I may need to work in high-exposure roles in the future (retail, customer service, etc).

I also just generally want to be up-to-date with any vaccinations, and to not make the pandemic worse, even though I know I can't do much beyond masking in public spaces + potentially vaccination. My last booster was in February 2022, so I've only had 3 shots total and it's been about a year and a half since my last booster.

I talked to my doctor and told him I was worried about getting and spreading Covid since I spend a lot of hours weekly with my higher-risk parents, and he said I could get the Covid booster if I was concerned. So I made an appointment, and have it this week. However, I live in Europe, and am not technically eligible—I'm young, healthy, and my only direct risk is to my parents and to other people. I felt weird about it—my doctor was kind of blasé/flippant about the protocols, so I'm not sure he cares about eligibility and I didn't ask questions—so I started googling, and now I'm not sure I should get the booster.

I found lots of seemingly well-sourced articles say that younger people probably don't need it, that we should save doses for immunocompromised and older people, and that it might do more harm than good to younger healthy people since the benefits of a booster are unknown for that type of group. Or just general confusion around the vaccine, with some experts recommending it and others not knowing if they should. I'm also concerned about jumping my local government's health guidelines that do say I'm inelegible—am I actually making a mistake by ignoring protocol? Am I too anxious and getting treatment I don't need, or affecting someone else's access to vaccines who may need it more? I'm not likely to get in trouble, since it's just a vaccine and I don't have to worry about insurance (we have public healthcare here), but still, it feels iffy.

Any thoughts on this? I know this is a decision I need to ultimately make myself, but any input, research or personal thoughts on what I should think about here would be great. I want the booster to ease my mind and to protect my health and that of others (while masking too, I know the vaccine doesn't guarantee not spreading it to others) but I don't want to get it if it's a bad idea healthwise or unethical generally since I'm inelegible. Thank you!

posted by anonymous to Health & Fitness (21 answers total)

Why do you think you are ineligible? The CDC recommends the booster for everyone, regardless of health status. Uptake has been abysmal this year; you are not stealing anyone else's vaccine or jumping the line. This is not early 2021.

Oh, just saw that you're in Europe. Luckily the European Medical Agency said the same thing. Not to mention your own doctor.

Go forth and be boosted.
posted by basalganglia at 2:15 AM on November 14, 2023 [56 favorites]

The stakes are low here in both directions so the important thing is to take some deep breaths and be okay with your decision whatever it is.

The shot is safe and effective. Concerns about risk tradeoffs for young people did not turn out to be a big deal.

Your doctor having a dose for you is eligibility enough. I know of no supply shortages in Europe. Unless you have recent and specific evidence to the contrary, availability is extremely not an issue.

No need to stress about this. Just get the shot and be happy.
posted by daveliepmann at 2:51 AM on November 14, 2023 [4 favorites]

Response by poster: Oh, right, sorry, I should've specified—I'm in mid-to-southern Europe (sorry, can't be more specific, don't want to doxx myself!) where the current national guidelines are that only 65+ year olds and immunocompromised people get vaccinated with Covid boosters. So, all of my young friends cannot access the vaccine. The only reason I'm able to is because I asked, am lucky that my doctor is ignoring guidelines, and because of the time I spend with my at-risk family members which gives me a tiny bit of validity. So, knowing I'm jumping the national guidelines of my country is part of what's driving my uncertainty. But it makes me feel a little better that the EMA said it's probably fine. Thanks for the answers so far.
posted by Anonymous at 2:54 AM on November 14, 2023 [2 favorites]

..and because of the time I spend with my at-risk family members which gives me a tiny bit of validity.

Here, in the Netherlands at least where they are only recommending the vaccine for those over 60, they also add:

You do not belong to the target groups, but still want to receive a corona vaccination because of a vulnerable family member or on the advice of a treating doctor. Then you can make an appointment at the GGD vaccination location.

posted by vacapinta at 3:04 AM on November 14, 2023 [8 favorites]

You are coming up against macro-decisions that your country/national health board has made largely in response to health economics. There is a cost/benefit calculation at play on the national level. You are not a national administrator, and you are not involved in the production of these guidelines, which are there to guide medical professionals in their actions.

On the micro-level you have good reasons for getting vaccinated. You have acted ethically in discussing these reasons with your GP as you are responsible for your own health and that of your family. The doctor is taking responsibility for administering and delivering the vaccine. You may think they are ignoring guidelines, but they are making local decisions within their power. I think you can assume that if there was not sufficient supply then they would not have prioritised you. I think you can accept the vaccination in good conscience, and if any of your friends comment or question, you can advise them to assess their own situation, and approach their own GP if they feel it is warranted.
posted by einekleine at 3:36 AM on November 14, 2023 [39 favorites]

I can’t think of a more pro social reason to do this than the ones you’ve articulated — do what you can to slow spread, protect vulnerable family members. It’s not like you’re cheating on your taxes here. And you have coverage from your doctor. Go forth and immunize.
posted by eirias at 3:58 AM on November 14, 2023 [10 favorites]

Worrying about taking a dose from someone who needs it is laudable but doesn't seem to be the case since booster uptake is very low, at least in the US.
posted by procrastination at 4:26 AM on November 14, 2023 [5 favorites]

It is not a bad idea for your health - it's a good idea for your health, and the health of people around you, unless you have a specific medical contraindication, which your doctor would have been responsible for flagging for you.

I can see worrying about vaccine access if you live in an area where available vaccine is hard to come by; then there would be a real argument for holding off and letting people who are more directly in need of protection access the limited supply. But it sounds like it wasn't hard for you to make an appointment and there's no dire shortage where you are. So I can't see any concerns about your getting vaccinated. I think you should go forth with a clear conscience!
posted by Stacey at 4:47 AM on November 14, 2023

Like other answerers, I think the key questions are these:

• Is there presently an adequate supply of the vaccine?
• Does the benefit of receiving a dose out-weigh any of the risk factors of getting a dose?

Your doctor is in a good position to know about the first item.

To be blunt about the second item, at least for vaccines available in the US, the evidence that they are safe is pretty clear: serious adverse events after a dose are rare (Minor side effects like headache and myalgia occur quite frequently though). The vaccines available in your area are probably different. If you're in an EU country, the list is here and you can drill down 2 layers to get a very technical PDF such as the one for JCOVDEN to find out what side effects were reported and how frequently, as well as how effective it was by age group.

The safety of JCOVDEN was evaluated in the primary pooled analysis from the double-blind phase of the randomised, placebo-controlled studies COV1001, COV1002, COV2001, COV3001 and COV3009. A total of 38,538 adults aged 18 years and older received at least a single-dose primary vaccination of JCOVDEN. The median age of individuals was 52 years (range 18-100 years)…

Neither of us is probably really qualified to read and understand this document! However, some things are pretty clear

• this vaccine was tested on people in your age range (18-65 are lumped together) though the average age does appear to skew older in the studied groups
• there are no non-rare side effects that were identified in your age range and not other age ranges; the rare side effects of myocarditis and pericarditis was identified as occurring more frequently in under-40s
• while there is variation in vaccine efficacy by age group, there is still substantial efficacy in your age group

The rare myocarditis side effect has been a talking point of vaccine-critical folks. However, according to the CDC, "patients with COVID-19 had nearly 16 times the risk for myocarditis compared with patients who did not have COVID-19"; your excess myocarditis risk from receiving a vaccine (so rare that the prevalance could not actually be estimated in the JCOVDEN studies, not even as "very rare <1/100,000") reduces your risk of having it as a side-effect of a COVID infection so much that it's almost certain to reduce your overall chances of myocarditis.
posted by the antecedent of that pronoun at 5:02 AM on November 14, 2023 [2 favorites]

I am a young and healthy person in a similar situation to you, but in the US where boosters are not restricted and in fact are encouraged for everyone. I got my booster. Make your own decision, but it has been a good decision for me to do so.
posted by branca at 5:09 AM on November 14, 2023

People over 65 and immunocompromised people often have a less-powerful response to vaccines, including COVID vaccines,

and therefore "ring fencing" around the vulnerable person by vaccinating the close friends and close family members of the vulnerable person is often recommended.
posted by chariot pulled by cassowaries at 6:04 AM on November 14, 2023 [14 favorites]

Definitely get vaccinated. The decision to only vaccinate those 65+ is based on bad assumptions and calculations (only accounting for hospitalizations and death, most likely, and not including Long Covid, the cost of being sick and the cost of passing it on to others). Getting vaccinated is the right thing to do for yourself and for those around you.

It is very unlikely that your country will run out of vaccines, they will buy more if needed, so you aren't taking a vaccine from someone else.
posted by ssg at 7:42 AM on November 14, 2023 [3 favorites]

Yeah, the decision to not make the vaccine result available to everyone is an economic decision, not an optimal-public-health one, and given how low vaccine uptake has been pretty much everywhere I really don't think there's an issue of taking a dose away from someone who needs it more.
posted by trig at 8:49 AM on November 14, 2023 [2 favorites]

Unlike most people here, based on what I've read, I don't think it's clear that everyone should get a booster. The benefit for those who are younger, healthy, fully vaccinated, and don't regularly come into contact with vulnerable people is small. But even I think that you clearly should, since you are in regular contact with older people and your doctor approved it.
posted by Mr.Know-it-some at 9:03 AM on November 14, 2023 [3 favorites]

The protection against infection is so short-lived that I think it only makes sense if you want to absolutely maximize protection for your parents. To make that decision it makes sense to think about your risk aversion values in general. Do you always take all available steps to minimize risk? If yes, the get the booster. If no, then you may be irrationally weighting the issue because of the bigger emotional salience of covid.

As for risks to you - I think there is some persuasive evidence of myocarditis risks outweighing the benefits for young men. That would probably tip the scales for me personally.
posted by haptic_avenger at 9:12 AM on November 14, 2023

This is one of the best times to get the months of extra protection a booster supplies, as cases always rise in the winter.
posted by mediareport at 9:32 AM on November 14, 2023 [2 favorites]

The more people who are fully vaccinated the safer it is for immunocompromised people. I got the booster with the eligibility being that I’m a ‘carer’, which is the same level of risk (for eligibility purposes) as regularly being around your parents. Get the vaccine booster if you can, most places theres more vaccines than there is take up.
posted by chives at 9:39 AM on November 14, 2023 [6 favorites]

Some info. on myocarditis and the mRNA covid vaccines, from Akiko Iwasaki at Yale School of Medicine.

OP is in their twenties, and the highest risk group is males between 12 and 17 years of age. And in that highest risk group, the myocarditis risk after the second vaccine dose, which is the highest, is 35.9 per 100,000 people. In comparison, the risk of post-covid myocarditis infection in that same group is 64.9 per 100,000.

What would you like to say to those concerned about getting vaccinated due to myocarditis risk?

Iwasaki: First of all, myocarditis after vaccination for the most part appears to be transient, and these patients recover. In comparison, getting COVID could lead to more severe, more prolonged myocarditis. Secondly, there are ways to reduce the risk for myocarditis, like spacing apart the first and second dose. And now that we have seen enough of these cases, doctors are learning how to treat these events when they do occur. And it’s also important to emphasize that instances of myocarditis have not been seen after the booster doses. So it’s mostly confined to the second dose of the primary series, and we shouldn’t be expecting these things to occur for future booster doses. And if the COVID boosters become like an annual flu vaccine, we wouldn’t expect myocarditis to occur because they are spaced so far apart.
posted by gudrun at 11:14 AM on November 14, 2023 [8 favorites]

Your doctor has OK'd you to get the vaccine based on the laws and guidelines of your own country. Unless you bribed him to do so, or otherwise acted unethically or duplicitously, I don't see how you don't qualify.

Your doctor agreed it was a good idea to get a booster. It seems legal for you to get it. The booster benefits your parents and it benefits you. Win win.
posted by muddgirl at 11:41 AM on November 14, 2023 [2 favorites]

Your doctor said it was okay. Go forth and get boosted. You have the internet's permission too.
posted by bluedaisy at 12:34 PM on November 14, 2023

Response by poster: Thank you so much for the clear & useful answers, everyone, I feel much steadier in my decision now. I'll go ahead with the appointment and get the booster.
posted by Anonymous at 4:27 PM on November 14, 2023 [10 favorites]