Maryland expanded COVID booster shot eligibility to some people. Here’s what you need to know.

On Wednesday, Maryland Gov. Larry Hogan announced his administration would begin administering COVID vaccine boosters to older adults in congregate settings. The move goes beyond the FDA’s approval, which allows for third doses of the Pfizer-BioNTech and Moderna vaccines for the immunocompromised.

Hogan, a Republican, said the state moved ahead because there hasn’t been clear guidance on boosters from the federal government, something he continues to advocate for publicly.


Here’s what you need to know:

Who is eligible to receive a booster shot in Maryland?

Hogan announced Wednesday that Maryland will allow booster shots for those age 65 and older in nursing homes, assisted living centers, residential treatment centers and group homes for people with disabilities. Previously, only immunocompromised people were eligible for extra shots.


Wednesday, Hogan also clarified that his administration is directing vaccination sites to administer booster shots to “anyone who considers themselves to be immunocompromised.” No doctor’s note or prescription is required, Hogan said.

Early research shows that people with minimal protection against COVID-19 after two doses of the vaccines due to immune system issues may have an improved response after a third dose. So far, the side effects for third doses have mirrored those accompanying the two-dose series, including pain at the injection site and fatigue.

Where does the federal government stand?

So far, the Food and Drug Administration has only authorized the administration of a third Pfizer-BioNTech or Moderna vaccine to individuals “who have undergone solid organ transplantation, or who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise,” so long as the patient is at least 28 days from their second dose of the vaccine.

Hogan’s spokesman said Wednesday that his administration is “interpreting that view to deem the seniors in congregate care settings as immunocompromised.” The FDA declined to comment direcly on Maryland’s decision.

On Sept. 17, FDA officials will be meeting with a panel of outside experts to review data about Pfizer booster shots. The Pfizer vaccine is the only one to receive full-fledged approval from the FDA, which is likely to ease the administration of those boosters. The other two vaccinations on offer in the United States — Moderna and Johnson & Johnson — are still being administered via emergency use authorizations.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has said that Moderna’s booster authorization could come behind Pfizer’s since the company hadn’t yet submitted required data for approval. The FDA recommends that individuals get the third dose of the same vaccine they received previously “unless the mRNA vaccine product given for the first two doses is not available or is unknown.”

Making more people eligible for boosters would require sign-off from the FDA and a Centers for Disease Control committee.

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Previously, the Biden administration had announced that boosters would be available starting Sept. 20 for all recipients at least eight months out from their second shot, but regulatory approval has lagged.


What about recipients of the Johnson & Johnson vaccine?

There isn’t yet guidance on booster shots for the single-shot Johnson & Johnson vaccine, which was approved later than the double-dose varieties. The FDA does not recommend that recipients of the Johnson & Johnson vaccine get a booster of the Pfizer or Moderna variety.

Where can Marylanders get their shots?

Although there are no longer mass vaccination sites at stadiums and other venues, Hogan has maintained that a rollout featuring pharmacies and clinics will suffice. Previously many congregate living facilities for older adults offered clinics on-site.

The Maryland Department of Health still operates a digital map of vaccination sites at

Because the booster shots are no different from previous doses, Marylanders can visit any provider for their boosters.

Are any other states allowing boosters for older adults congregate living settings?

Maryland is the first state to offer boosters to this group, according to a report from Forbes. Other countries, such as Israel and Singapore, have begun the process of offering third doses to people 60 and over.