Covid-19 vaccination: answers to common questions about the 4th vaccine dose


Q: Who may receive the 4th vaccine? (3rd vaccine in the case of Johnson & Johnson being the 1st – see the final question for info specific to those who received J&J initially)

A: Adults ages 50 and older may receive a 4th dose of Pfizer or Moderna vaccine, at least 4 months after their 3rd dose. Adults ages 18 – 49 with certain serious underlying health conditions may receive a 4th dose of either Pfizer or Moderna vaccine. Children ages 12 – 17 with certain serious underlying health conditions may receive a 4th dose of the Pfizer vaccine.

Q: What is considered a serious underlying health condition, in relation to individuals ages 12 – 49 qualifying for a 4th vaccine dose?

A: If you have:

  • Been receiving active cancer treatment for tumors or cancers of the blood
  • Received an organ transplant and are taking medicine to suppress the immune system
  • Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
  • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids or other drugs that may suppress their immune response

Q: May I receive my 4th vaccine at my Evergreen/Junction/Charlotte/Alder Brook Primary Care office?

A: Only Evergreen in Williston and Evergreen Junction in Essex Junction have the Covid vaccine. The Charlotte and Alder Brook offices do not have Covid vaccines. Williston and Junction patients who already have an appointment with a provider for a different reason, may receive a 4th vaccination during the visit. These two offices have the Pfizer vaccine. We are not currently scheduling appointments solely for receiving Covid vaccination. You may schedule a Covid vaccination appointment at a pharmacy.

Q: Can I receive a Pfizer vaccine as a 4th dose if my previous 3 vaccines included a Moderna vaccine? Can I receive a Moderna vaccine if my previous 3 vaccines included a Pfizer vaccine?

A: Yes for both questions.

Q: What if I received a Johnson & Johnson vaccine initially?

A: If you are age 18 and older and you received two J&J vaccines you may receive a Pfizer or Moderna booster. If you are 50 and older and your 1st and 2nd doses were either both J&J or a J&J followed by either a Pfizer or Moderna vaccine, you may receive another Pfizer or Moderna vaccine.

The following is information from the CDC:

“Data continue to show the importance of vaccination and booster doses to protect individuals both from infection and severe outcomes of COVID-19. For adults and adolescents eligible for a first booster dose, these shots are safe and provide substantial benefit. During the recent Omicron surge, those who were boosted were 21-times less likely to die from COVID-19 compared to those who were unvaccinated, and 7-times less likely to be hospitalized. CDC continues to recommend that all eligible adults, adolescents, and children 5 and older be up to date on their COVID-19 vaccines, which includes getting an initial booster when eligible.

Following FDA’s regulatory action today (3/29/22), CDC is updating its recommendations to allow certain immunocompromised individuals and people over the age of 50 who received an initial booster dose at least 4 months ago to be eligible for another mRNA booster to increase their protection against severe disease from COVID-19. Separately and in addition, based on newly published data, adults who received a primary vaccine and booster dose of Johnson & Johnson’s Janssen COVID-19 vaccine at least 4 months ago may now receive a second booster dose using an mRNA COVID-19 vaccine.

These updated recommendations acknowledge the increased risk of severe disease in certain populations including those who are elderly or over the age of 50 with multiple underlying conditions, along with the currently available data on vaccine and booster effectiveness.”