Things You Should Do After Getting Your COVID-19 Booster Shot

If you're reading this, then perhaps you're basking in the afterglow of having received your COVID-19 booster shot — and knowing you've taken action to help reduce the spread of COVID-19 and increase your odds that you won't contract a severe form of this persnickety and mercurial virus. Or maybe you've made your appointment and are wondering what's going to happen after the needle stick. In either case, we'd like to take the opportunity to say, "go best friend," because if you're getting boosted, you're one of the more than 70 million Americans who are following official public health recommendations aimed toward stopping the pandemic and getting "normal" life — whatever that is now — back on track. 

More to the point, however, you're doing the right thing in figuring out what you'll need to be doing after you get your COVID-19 booster, including everything that you'll need to be doing from moment the kind healthcare worker with the hypodermic needle (gently) puts that little adhesive bandage on your arm. Of course, you'll also want to make sure you know the things you shouldn't do after getting your COVID-19 booster. For the moment, though, let's keep our focus on the things you should be doing after your COVID-19 booster shot. 

The technology behind the Pfizer and Moderna COVID-19 vaccines/boosters isn't new; it's been in development for more than 15 years, per the CDC. And all the COVID-19 vaccines/boosters that are subject to emergency use authorization (EUA) in the United States have been clinically proven effective at mitigating the spread of COVID-19 and reducing the risk of contracting a severe form of the illness. At the same time, they have also been found to be safe. Just to be clear on what that means, the CDC states that all of the COVID-19 vaccines subject to EUA "were evaluated in tens of thousands of participants in clinical trials" and "met the Food and Drug Administration's (FDA's) rigorous scientific standards for safety, effectiveness, and manufacturing quality." Further, "millions of people in the United States have received COVID-19 vaccines under the most intense safety monitoring in U.S. history." 

Part of that monitoring has involved asking that vaccine/booster recipients remain at the vaccine center for "observation" for anywhere from 15 to 30 minutes after injection (via the CDC).

In late December, the U.K. temporarily suspended the observation requirement, due to logistical issues that don't necessarily apply to your vaccine center or in the U.S. at all (via Times of India). However, the U.K.'s decision was not meant to suggest that the observation period is optional. As noted above, the observation period is critical to the scientific evaluation of adverse events in connection with the COVID-19 vaccines and boosters.

What clinicians are most concerned about during the observation period after injection of a COVID-19 vaccine is anaphylaxis, according to the CDC. Anaphylaxis, which is rare to begin with, is an "acute and potentially life-threatening allergic reaction" (via the Mayo Clinic). The Mayo Clinic notes the most common triggers for anaphylaxis are foods, although it also may occur in connection with taking medication (as well as insect stings and exposure to latex). Anaphylaxis has been observed in only rare cases following an EUA COVID-19 vaccine/booster (via the University of Michigan). For example, the CDC says that safety monitoring of the Pfizer vaccine against COVID-19 (in the United States from December 14-23, 2020) has detected just 21 cases of anaphylaxis in 1,893,360 doses (11.1 cases per million doses). The CDC noted that "71% of these occurred within 15 minutes of vaccination."

If you have no allergies to medications, have never experienced anaphylaxis, and especially, if you didn't experience a severe immediate reaction in connection with your initial COVID-19 vaccine or vaccine series, then the risk that you will experience anaphylaxis from your COVID-19 booster shot becomes even smaller.  However, all vaccine sites are required by the FDA to be ready to deploy immediate emergency care in the event a vaccine recipient experiences signs of anaphylaxis.

Here is how you can tell if you are having an allergic reaction and what anyone with known allergies should know in advance of getting their COVID-19 booster shot.

According to the CDC, the systems that have been put in place to monitor the safety of COVID-19 vaccines have found four types of serious side effects, which they refer to as adverse events. The first is anaphylaxis, which is rare, according to the Mayo Clinic. Anaphylaxis tends to present immediately after exposure, which, in the case of COVID-19 booster shots, means within 15 to 30 minutes after shot administration — so while you are still being observed after having received your injection. 

The next side effect is heart inflammation, which is also rare and can present as either myocarditis (inflammation of heart muscle) or pericarditis (inflammation of the heart's lining), according to the CDC. The third is Guillain-Barré Syndrome, another rarity, and which causes neurological symptoms (via the Mayo Clinic). 

Thrombosis with thrombocytopenia syndrome (TTS) is the fourth side effect, which is not only rare but seen primarily in those who received the vaccine manufactured by Johnson & Johnson (via Hematology). Because of this, and because of concerns that the Johnson & Johnson COVID-19 vaccine may not be as effective as the Pfizer or Moderna vaccines against COVID-19, the CDC has taken steps to narrow use of the Johnson & Johnson vaccine, according to NPR.

In the unlikely scenario that you experience serious side effects from your COVID-19 booster shot — and you seek medical assistance — your healthcare provider is expected to make a record of the occurrence of an adverse reaction and notify the CDC of the same. If your side effects are minor such that they don't require you to see a medical professional, then ideally, you will report your side effects to the CDC. Doing so is as easy as logging in to the V-Safe app provided by the CDC.

V-safe is a "smartphone-based tool that uses text messaging and web surveys to give personalized health check-ins after you receive a COVID-19 vaccine," the CDC explains. This app was designed to make it easy and fast to notify public health authorities that you have experienced side effects after receiving a COVID-19 vaccine. Although this information is private under HIPAA (via the CDC), it is very important in the name of public health because it helps the CDC, and theoretically, other public health authorities, monitor the vaccine/booster's safety in "near real time." 

The United States has not yet legislated that those entering the country must present evidence of having had a booster shot against COVID-19. However, eight countries have. These include Croatia, Kuwait, The Netherlands, Israel, Austria, Greece, Switzerland, and France, according to Time of India. The rule is already in effect in Kuwait, France, Croatia (which specifically requires proof of the booster within 365 days of entry to the country), Israel (which requires the final vaccine dose to be within 180 days of one's entry into the country), and Austria (which has now enacted vaccine mandates for all citizens), Greece (which has made vaccine passports mandatory in many indoor spaces, and to get a vaccine passport, one must have received a booster). 

The Netherlands has given people until February 2022 to comply with the booster-shot mandate. Switzerland, like Croatia, now requires proof of vaccination within the last 365 days before traveling. However, one can enter the country without a Swiss vaccine passport but won't be allowed to enter many of Switzerland's indoor spaces (no word yet on whether that includes hotels!). 

As with vaccine mandates, the United States as a whole is not in agreement as to whether masking should be required and under what circumstances. According to the AARP, as of January 3, 2022 eight states require masks in indoor public places, regardless of vaccination status. These are California, Hawaii, Illinois, Nevada, New Mexico, New York, Oregon, and Washington (Washington requires masking even at outdoor events that are attended by 500 or more people). In addition, Washington, D.C., along with the territory of Puerto Rico have imposed similar orders. 

Connecticut, by contrast — which dropped its state-mandated mask requirement early on in the pandemic and then reimposed it only to drop it again — has now re-reimposed a masking mandate applicable only to the unvaccinated, noted AARP. Other states such as Rhode Island, for example, require masking at large venues but allow smaller businesses to decide for themselves based on the vaccination status of those seeking to enter those businesses. And within states that do not impose masking mandates, there can be great variation among the various municipalities, and again, among private businesses. What is absolutely certain, however, is that the CDC recommends masking, regardless of vaccine status, "in health care and long-term care facilities, prisons, homeless shelters, on public transit, and in transportation hubs like airports and bus and train stations," with most states making efforts to follow along (via AARP).