Can we get a second booster next year?

Q. “My husband and I both had a mild case of COVID-19 in January 2021, then got the first shot of Moderna in March, followed by the second in April. I plan to get my booster in the next few days. How long will immunity last with this third shot?

Also, this may be too soon to ask, but my husband and I plan to take my dream trip to Italy the end of June 2022 immediately followed by a trip to England to visit family. That’s seven months from now, so we’ll need to renew our COVID-19 vaccines prior to our trip, right?” — Linda, Boca Raton

A. Immunity wanes approximately six months after you’ve gotten two shots of Pfizer or Moderna or one shot of the Johnson & Johnson vaccine, said Dr. Jorge Perez, founder of KIDZ Medical Services, which has offices throughout South Florida. That’s why boosters are now encouraged, although recommendations continue to evolve.

“Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, recently said that the stance on boosters could change in the future as more data on their efficacy becomes available,” Perez said. “Overall, I recommend that my patients — and my family — follow the CDC recommendations in effect four to six weeks before their scheduled travel date.”

There are no recommendations for a second booster, or a fourth shot, at the moment, although that could change as omicron and other variants continue to emerge in the coming months.

“At that time, they also need to reconsider traveling to a country that is in the middle of a surge, as several in Europe are experiencing right now,” Perez said.

Q. “I am a Type 2 diabetic. I received the Pfizer vaccine. Six months from my last dose would be Dec. 28. I’m planning a Christmas trip. Should I get my booster two weeks before my trip, so that I have increased resistance before I travel?” — Robert

A. Go for it, said Dr. Andrea Klemes, chief medical officer at MDVIP, a physicians’ network with headquarters in Boca Raton.

“The Centers for Disease Control and Prevention recommends six months between your second dose and your booster, but I think it makes sense to get it two weeks early to ensure you are protected on your trip,” Klemes said. “Personally, that is what I would do.”

Q. “I had to get a tetanus shot about a month ago. Walgreens only had DTaP. Can I get a COVID booster now or is it too soon? Will the tetanus shot fight the COVID antibodies?” — Krista, Fort Lauderdale

A. DTaP is a triple-whammy vaccine that prevents diphtheria, tetanus and pertussis. Your DTaP shot will get along just fine with a COVID booster, said Dr. Hila Beckerman, a Delray Beach pediatrician with extensive vaccine experience.

“This is a very common question,” Beckerman said. “Each vaccine works by making antibodies to a specific protein found on that virus or bacteria. When you get the COVID vaccine, your body makes antibodies specifically against the spike protein on the outside of the COVID virus. Those antibodies don’t affect a different virus or bacteria. So if you get a DTaP vaccine, the antibodies you make as a result of that vaccine don’t affect other viruses or bacteria. Therefore, you can receive the COVID vaccine regardless of any other vaccine.”

Q. “I may be a rare case, but I received my first Moderna vaccination in late January and my second in late February. Then this summer, I caught COVID and became quite ill with it. Do I have any extra protection? Can I get it again? I work with someone in a small office who refuses to get vaccinated and wears a mask only sporadically. That’s troubling.” — Susan

A. It’s true that you’re in the minority, but vaccinated people do get COVID and can get it more than once. According to the Centers for Disease Control and Prevention, there were 91 cases per 100,000 vaccinated people in the United States who had COVID as of Oct. 2, compared with 452 cases per 100,000 among the unvaccinated.

Now that you’ve recovered, you have extra protection, but how much and for how long is unknown, said Dr. Andrea Klemes, chief medical officer at MDVIP, a physicians’ network with headquarters in Boca Raton.

“You can get COVID after being vaccinated and you can also get COVID again after having had it before,” she said. “I would discuss your particular case with your doctor, but you may consider a booster shot if it has been more than three months since you had COVID and you meet the criteria.”

Q. “I received my COVID-19 vaccinations in January and February and then went for the monoclonal antibody injection in August. Do I still need to get the COVID booster?” — Deb

A. Monoclonal antibodies are proteins that fight the virus and have been successful in treating mild to moderate COVID. According to the University of Pittsburgh Medical Center: “If you receive monoclonal antibod(ies), it remains important to be vaccinated to prevent serious illness in the future.”

The Centers for Disease Control and Prevention recommends that you wait 90 days after treatment with monoclonal antibodies before getting a COVID shot. Depending when in August you got your monoclonal injection, you can head over to a pharmacy now or in the coming weeks to get your booster.

Q. “I am an over-70 survivor of open heart surgery and living with well-controlled Type 2 diabetes. I have had all three Pfizer vaccinations. What is your advice on attending a family gathering with vaccinated adults but several children under 11 still unvaccinated?” — Patricia

A. Don’t cancel Christmas! There are several things you can do to create a safe gathering. Here are some recommendations from the Centers for Disease Control and Prevention:

Stay outdoors as much as possible

Make sure indoor spaces have good air circulation and are not too crowded.

Don’t go if you’re sick.

I would add you should get tested for COVID-19 before you go and ask others who are attending to get tested, too. The Binax Now home tests are about $25 and known for their accuracy.

Since you have some pre-existing conditions, there’s extra advice from Dr. Joanna Drowos, an associate professor of family medicine at Florida Atlantic University in Boca Raton.

“As someone who is at higher risk of becoming ill from a COVID19 infection, the recommendation would be to mask when indoors, and ask others to mask around you as well,” she said. “You can still enjoy an event with your family, but make sure to spend time outdoors, keep your distance and wash your hands.”

Q. “Do you know of anywhere that would give a Pfizer booster in the thigh for someone diagnosed with breast cancer in both breasts?” — Survivor

A. You do have to ask around when you want your shot anywhere beside your arm. One possibility is a doctor’s office, said Dr. Hila Beckerman, a pediatrician with extensive vaccine experience.

“When administering the Pfizer vaccine, the most important aspect is to give it in the muscle,” she said. “The upper arm is more easily accessible and has less fatty tissue covering the deltoid muscle, which is why it is most commonly administered there. The anterolateral thigh can absolutely be used as an alternative location. However, it is imperative to ensure that the vaccine is placed inside the muscle. Therefore, those receiving a vaccine in the thigh may need to use a longer needle (commonly 1.5 inch, as opposed to a 1 inch needle in the deltoid). This will obviously depend on your body type and weight.”

I asked a CVS pharmacist and she said they weren’t allowed to do this. But some Publix pharmacists do have the training and the right needles; you just need to confirm this before you go, Publix spokeswoman Maria Brous said.

“There is additional training that accompanies administering a vaccine at an alternative site, such as the thigh,” said Brous, who added that the customer would have to prove a medical need. “We would want to ensure that our pharmacist has the training to make it a seamless process for our customer.”