• 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.
• The Spondylitis Association of America advises individuals with spondylitis to talk with their health care providers about whether to receive a booster shot to protect against COVID-19.

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

The Spondylitis Association of America (SAA) recommends that people with spondylitis share the decision-making with their rheumatology teams about whether to get a booster shot against COVID-19, while taking their current medication regimens into consideration.

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 would be of either the Moderna or Pfizer vaccines, 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 a fifth shot.

How Booster Shots Affect People With Spondylitis

If you already had your first booster shot, you may be wondering what health experts have to say about whether additional boosters are effective for people with spondylitis. The SAA notes that individuals who are taking medications such as methotrexate and tumor necrosis factor (TNF)-alpha inhibitors may mount a lower immune response to vaccinations. Therefore, it’s important to speak with your rheumatologist about whether to time your vaccination appointment around your medications, the SAA recommends.

The CDC’s list of underlying medical conditions doesn’t explicitly list spondylitis as a condition that may qualify someone for a second booster shot. The list of underlying medical conditions includes, for example, chronic lung disease, diabetes, heart conditions, obesity, smoking or smoking history, and HIV infection.

“Got the second booster in March — sore arm, no other effects,” wrote one MySpondylitisTeam member. Another said, “I’m going to get my booster soon!”

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 a person’s levels of antibodies against the coronavirus are likely to decrease over time. Antibodies are proteins the immune system makes to help destroy a target. Therefore, 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. 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, researchers identified antibodies 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.

A survey of 2,860 adults with rheumatic disease — including 256 people with spondyloarthritis — found that participants experienced adverse events that were very similar to side effects seen in the general population. “This study presents encouraging data regarding communication between people with systemic rheumatic diseases and their physicians and to the overall safety of COVID-19 vaccination in this patient population,” the study authors wrote.

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 MySpondylitisTeam, the social support network for people with spondylitis 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.