How do I get a second COVID booster shot if I'm under 65?
March 25, 2022 12:22 PM   Subscribe

I'm vaxxed & boosted (Pfizer) but it's been about 6 months. I'm not 65 yet, but I'm not young either. Not immunocompromised. I asked my doctor if he could prescribe a second booster shot, and he said he couldn't, but he added that I could probably get one if I just walked in somewhere. How do I go about this?

When I got the first three shots, they wanted to see my ID, and they asked to see my vax card for the last two shots. I assume that if I try got a second booster, and they ask for my vax card or ID, they're going to say no dice because you're already boosted.

Is that accurate? How can I get another booster? If I walk in off the street with no appointment and say I have no vax card or ID, will they give me the shot anyway? Any tips on how to do that? I'm in the SF Bay Area, and I'd prefer the Moderna shot if I can get it. I had no issues at all with the first three shots (mild fatigue after the second shot, and a sore arm, that's it).

(Adding: I've looked at the science on this, and I've got a technical/science background, so I think I'm making a fairly informed decision about it. I'm not seeking advice on whether this is advisable from a medical standpoint.)

Thanks in advance.
posted by mikeand1 to Health & Fitness (17 answers total) 2 users marked this as a favorite
"If I walk in off the street with no appointment and say I have no vax card or ID, will they give me the shot anyway?"

posted by sandmanwv at 12:24 PM on March 25, 2022 [4 favorites]

Response by poster: > Yes.

Will I get the "right" shot if I do that? Is there any difference between the 1st, 2nd, or booster shot in terms of dosage/composition, or are they all the same thing regardless of whether it's Pfizer/Moderna?
posted by mikeand1 at 12:30 PM on March 25, 2022

Best answer: I got a second booster (Pfizer) at my local Target/CVS. All I did was make an appointment online and then show up. They signed my card without blinking.

(Note: I did have to tick "yes" when the website asked if I'm immunocompromised, which I'm not, really, but I had no qualms about doing this because there is no longer a shortage of COVID-19 shots in the United States. Your moral calculations may vary.)
posted by Faint of Butt at 12:37 PM on March 25, 2022 [4 favorites]

If it works the same where you are as it does where I am, a Pfizer booster is the same dose as for the first two shots but a Moderna booster is half the initial Moderna doses.
posted by flabdablet at 12:38 PM on March 25, 2022

I did the same as Faint of Butt. I'm not really immunocompromised either, but I do spend a lot of time with someone who is (he's been double boosted too but I'd just rather be safe). Was this a lie? Yeah, I guess, but it was one I felt comfortable making. They asked me no additional questions and still filled out my vax card. I also imagine you could just walk in somewhere with your vax card and they're not going to question you (but I don't know).

And I was literally the only person there to get a Covid vaccine (unlike when I got my first booster and there were several people) so I didn't feel like I was taking it away from someone else who needed it.

It was Pfizer, though.
posted by edencosmic at 12:44 PM on March 25, 2022 [2 favorites]

At least in Canada, according to the pharmacy tech that gave me my booster, the Moderna booster is "half strength". I haven't gone to the trouble of validating that statement but might be something you might want to validate yourself.
posted by cgg at 12:48 PM on March 25, 2022 [1 favorite]

My husband is late 40s but works in a high-risk setting (hospital) and has some health issues, so when he went for his first booster they gave him the full Moderna dose -- my Moderna booster was half-dose (I had Pfizer for my first two but wanted Moderna for my third, he had Moderna for all three). He just talked to the pharmacist and they said he could have the full dose so he took it. This was at the pharmacy of a regional grocery store in the midwest.
posted by jabes at 1:07 PM on March 25, 2022 [2 favorites]

For 3rd doses:
Moderna booster shots for non-immuno-compromised people are 1/2 dose.
Moderna booster shots for people who ARE immuno-compromised are a full dose.

Since Moderna second boosters are not yet approved we don't know what the dose recommended would be.

Please keep in mind that the pharmacist or nurse administering this puts their license at risk. The pharmacy where I administered vaccines is vigilant - the Health Department told him that if they find cases of unauthorized vaccination they will cut him off from receiving vaccine. I personally refused to administer adult vaccine to children, though I was asked more than once. I was asked to vaccinate 4 year olds a number of times. I refused. My malpractice insurance does not cover incidents that I perform against official guidelines - it's not clear to me that my not checking the state database for your vaccine history or your willfully holding back information would be sufficient defense to a sharp lawyer. If you develop anaphylaxis from an unauthorized 4th shot I may be liable and my malpractice will certainly refuse to defend me. I think this issue goes well beyond how you can contrive to have someone give you a 4th shot.
posted by citygirl at 1:17 PM on March 25, 2022 [15 favorites]

The federal government will no longer be paying for the shots of uninsured people. Depending on your state, starting April 5, you may need to present ID and insurance. This may affect your ability to get the shot.
posted by quadrilaterals at 1:41 PM on March 25, 2022 [2 favorites]

Response by poster: > If you develop anaphylaxis from an unauthorized 4th shot I may be liable and my malpractice will certainly refuse to defend me. I think this issue goes well beyond how you can contrive to have someone give you a 4th shot.

Just so you know, I'm absolutely not the kind of person who would file a malpractice lawsuit in this situation. I understand that you can't know that about me, but I'm posting this question solely from the standpoint of my personal perspective. I don't intend for this to be a guide/advice to anyone else, although obviously I can't control what anyone else does with this information.
posted by mikeand1 at 1:44 PM on March 25, 2022

Different states track vaccinations differently but in California, and I presume elsewhere, you could easily make up a name or state that you are immune compromised to receive a 4th shot.

It is completely fine to mix and match products but the algorithm is a bit complicated because the Moderna booster is a half dose of the same product, while Pfizer and J&J boosters are same dose as original vaccination. Also, if you started with J&J, then you'd get that one initial shot, then a full dose 2 months later of any product, then a booster of a full dose Pfizer or J&J or half dose Moderna. Or if you started with an MRNA product, you'd get 3 full doses of that, then 1 half dose (if your booster is Moderna) or a full dose if it's J&J or Pfizer. Also, J&J is the inferior product so not recommended as a preferred option.

Confusing, I know.
posted by latkes at 3:11 PM on March 25, 2022

Response by poster: ^^

The thing about the CDC guidelines is that they are formulated in response to all kinds of public health and policy considerations that are irrelevant to me at a personal level. As just one example, the first round of booster shots was slow to be approved because the CDC was concerned that isolated incidents of bad reactions to the shots would let antivaxxers exaggerate the downsides of the shots, resulting in a broader public backlash.

I'm not necessarily dinging the CDC for their particular decision-making--they have an extraordinarily complex set of factors to contend with, as well as all the practical and political constraints imposed on any large bureaucratic agency. I'm just saying that for me personally, the calculus is completely different, and it includes my own personal willingness to accept a certain level of risk (which I perceive to be be very low, when balanced against the potential benefits).
posted by mikeand1 at 4:59 PM on March 25, 2022

I don't think your characterization of why boosters were slow to approve is accurate. Not to say the CDC has done a great job through this, but there was initially limited evidence for the efficacy of boosters. We now have plenty of evidence that they are very valuable, but we did not then. The CDC does not, nor should it, just automatically recommend treatments that have no demonstrated value.

There is no magical calculation of how many shots you as an individual should have or what timing is best. We have research on various scenarios, not on your body, and you have already made up your mind that you want 4 shots anyway. The research and guidance that exists on having four shots is based on immune compromised people and is listed in those CDC links. I'm not sure what exactly you want in terms of advice.
posted by latkes at 5:17 PM on March 25, 2022 [1 favorite]

Best answer: Just noticed you are in the Bay. I don't know SF but I personally administer vaccines in Alameda County (here's a calendar of drop in sites) and if someone tells me they are immune compromised I administer 4 doses without question.

If you want Moderna for this one, the recommendation for boosters is a half dose of the same Moderna product that is given for the initial vaccination.
posted by latkes at 5:21 PM on March 25, 2022

Response by poster: >I don't think your characterization of why boosters were slow to approve is accurate.

Going back and looking, I see now that at the time it was FDA, not CDC decision-making I'm talking about (the vaccines were still under FDA emergency authorization at the time, in the Summer of 2021). Several FDA officials signed a Lancet pub that set forth their concerns for how the public might negatively respond to adverse reactions if boosters were more broadly recommended.

Perhaps I put too much of my own gloss on it above, so to quote: "The message that boosting might soon be needed, if not justified by robust data and analysis, could adversely affect confidence in vaccines and undermine messaging about the value of primary vaccination," and, "If unnecessary boosting causes significant adverse reactions, there could be implications for vaccine acceptance that go beyond COVID-19 vaccines."

Again, not trying to ding anyone in those agencies for what is an extremely difficult set of decisions to implement. But the reality is that they do not develop these guidelines based strictly on how a vaccine performs in clinical trials, or on strictly medical factors. Broader issues of public policy necessarily come into play. Those include cost and equity issues as well.

>There is no magical calculation of how many shots you as an individual should have or what timing is best.

I understand that. I wouldn't call myself an epidemiologist, but I was in a closely related field and my graduate training included epidemiology, clinical trials, and biostatistics. I commonly used large epidemiological datasets, including an extensive statistical analysis of several epidemiology datasets for my dissertation. I think I have the judgment required to appreciate the ambiguities and imperfections inherent in scientific studies of these kinds, and I also have plenty of information about my personal circumstances that were never a consideration in any agency's guidelines or recommendations.

So yes, I have made up my own mind about it, and I also made it clear I wasn't asking for advice on whether or not to get it.
posted by mikeand1 at 7:15 PM on March 25, 2022

Best answer: I'm not 65 yet, but I'm not young either.

Are you over 50? The Times is reporting that second booster shots will be offered to anyone over 50, potentially starting next week.
posted by Dip Flash at 7:33 PM on March 25, 2022 [4 favorites]

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