• 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.
• Recent studies found that most people who were immunocompromised had a strong immune response to mRNA vaccines for COVID-19.
• The American Heart Association (AHA) advises individuals with heart disease to talk with their health care providers about whether to receive a second booster shot to protect against COVID-19.

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

The American Heart Association recommends that people with heart disease share the decision-making with their doctors about whether to get a second booster shot against COVID-19. The AHA has shared insights from medical experts who generally agree that after talking with your doctor, you should get a second booster if you are eligible under the CDC’s new recommendations.

The New Recommendations

Some important details about these recommendations include the following:

• This additional booster is for people who received their first booster shot at least four months ago.
• This fourth shot will be of either the Moderna or Pfizer vaccine, 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 your fifth shot.

How Booster Shots Can Protect People With Heart Disease

If you already had your first booster shot, you may be wondering what experts say about whether additional boosters are effective for people with heart disease. The American Heart Association advises individuals with heart disease to speak with their providers about whether to get a second booster shot.

The CDC’s list of underlying medical conditions explicitly lists several cardiac diseases among the conditions that put people at higher risk of severe illness if they get COVID-19. These conditions include:

• Heart failure
• Coronary artery disease
• Cardiomyopathies
• In some cases, high blood pressure (hypertension)

“Just took my second booster shot,” wrote one MyHeartDiseaseTeam member. Another said, “My husband was vaxxed and double boosted!”

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 the study’s 515 participants. 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 in people with compromised immune systems. It’s evidence that vaccines can protect people at higher risk of severe infections.

Although some people diagnosed with heart disease have expressed concern about experiencing myocarditis or pericarditis — which can cause inflammation in cardiac tissue — this side effect is very rare after an initial dose of the vaccine and even more unlikely to occur following a booster dose. In addition, heart issues are more common among those who actually come down with COVID-19 compared with people who experience side effects from the vaccinations, researchers say.

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, or 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 MyHeartDiseaseTeam, the social support network for people with heart disease and their loved ones, 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.