Dr. Sydney Sewall fills a syringe with the COVID-19 vaccine at the Augusta Armory, Tuesday, Dec. 21, 2021, in Augusta. Credit: Robert F. Bukaty / AP

The new federal guidelines on who should get additional COVID-19 shots has raised new questions about when to get another dose.

The recommendations released last week include people over age 50 and anyone over age 12 with a moderate or severely compromised immune system. It is an effort by health officials to boost protection for those most vulnerable to serious illness ahead of a potential surge brought on by a more contagious version of the omicron variant. It also includes new recommendations for people who got the Johnson & Johnson vaccine as their primary immunization.

This change comes with several qualifiers and can be complicated as people assess risk coming out of the winter surge. The Bangor Daily News asked readers last week what kind of questions they have about the additional dose recommendations. We answered some of the most common ones we received below.

What is the risk of not getting another booster?

A booster will not prevent you from getting COVID-19, but it can protect you against serious illness. Both Pfizer and Moderna boosters are highly effective against more severe cases of COVID-19 for about two months. Their efficacy begins to wane after that. The U.S. Centers for Disease Control and Prevention reported in February that the protection against severe illness declined from 87 percent to 66 percent and hospitalizations from 91 percent to 78 percent.

Omicron and the BA.2 variant rising in the U.S. has been called more “mild” because it typically causes less severe symptoms than prior versions. But the chance to become very sick is still possible, as evidenced by the record numbers of hospitalized patients during the omicron surge. That is one of the main reasons health officials are recommending a fourth boost for qualified people while cases remain relatively low.

Who is considered immunocompromised?

A person with a weaker immune system is more likely to need hospitalization or intensive care, including possibly needing a ventilator to help breathe. The federal CDC has a list of conditions that put a person more at risk of severe illness, including cancer, diabetes, certain heart conditions and those who have had organ transplants. People who are pregnant are included in that list. If you are not sure your condition qualifies, talk to a doctor.

When should I get a booster?

In general, a qualified person can get a fourth booster four months after their last dose, as can an adult over 18 who received a Johnson and Johnson primary and booster dose. You should not wait for case counts to increase to do so, said Maine Center for Disease Control and Prevention spokesperson Robert Long, because indicators such as wastewater data and hospitalizations are beginning to show higher levels of the virus, meaning transmission is rising.

If you recently contracted COVID-19 and still want to get a booster, you only need to wait until your symptoms have cleared up and you have isolated for the recommended time period. That period is five days for asymptomatic cases, 10 days for moderate cases and up to 20 days or more for severe cases, according to the federal CDC. People who received monoclonal antibody treatments do not need to wait to get another shot.

Do I need a booster of any kind to travel?

It depends. If you are a non-citizen or an immigrant  coming from outside the U.S., you need to have an initial series of vaccines and show proof of a negative COVID-19 test taken one day before traveling. If you are traveling to another country, it varies.

You should check the guidelines for whichever country you plan to visit. For example, France only allows unvaccinated people from certain countries to visit with a negative test. It considers anyone with a booster shot to be fully vaccinated, so people from approved countries need to show proof of a third shot. COVID Passport, a news site tracking which countries are accepting vaccine passports, updates regularly with countries’ policy changes.

If you are traveling within the U.S., check with your preferred airline for any vaccination requirements.

Where can I get a booster?

Any location currently offering primary doses and boosters should be able to give you a second booster. You can check here for a list of sites or call Maine’s vaccination hotline at 1-888-445-4111.