Covid-19 cases are once again seeing a steady rise in the country, with the government urging all citizen to get vaccinated and follow up on their booster shots.

A June 22 meeting of the National Command and Operation Centre (NCOC) had advised all provinces and regions to administer booster doses on a priority basis to further improve protection against Covid transmission.

A booster shot is an additional dose of a coronavirus vaccine given to people who are already fully vaccinated with either the two-dose Sinopharm, Sinovac, Sputnik V, AstraZeneca, Moderna or Pfizer — or the single-dose PakVac.

Boosters are administered to raise people's immunity against Covid-19, which would have waned with time.

Pakistan began rolling out the first booster shots in January, and is now offering second booster jabs to those eligible.

To clear any confusion our readers may have regarding the second booster shot, here are the answers to some of the most common queries:

Who is eligible?

According to the government's guidelines on booster shots dated May 11, citizens aged 18 and above, immunocompromised persons of all eligible age groups, healthcare workers and travellers are eligible for a second booster shot.

How long should the gap be between the first and second booster doses?

The guidelines further recommend that the second booster dose should be administered four months after the first booster shot. "Those who are recovering from a recent Covid-19 infection may wait for 28 days before getting a booster dose," it adds.

Dr Faisal Mahmood, head of infectious diseases at the Aga Khan University Hospital, told Dawn.com that the duration between the first and second booster shots should be at least four months. He added that it can be even longer but not less than four months. Furthermore, the US Centers for Disease Control and Prevention also recommends a duration of four months between the first and second booster shots.

However, despite what's stated on the government's Covid portal, Ministry of National Health Services spokesperson Sajid Shah has said that the four-month duration between booster shots has been significantly cut down. "Those who want to get a second shot of Pfizer can get it after 21 days of the first booster shot. Those who want to get inoculated with Moderna can get a second shot after 28 days."

Shah said that previously, the first booster shot was given after six months of completion of vaccination, but now, people could get it after five months.

Sindh Health Department spokesperson Atif Vighio also said that the gap between the first and second booster shots has been reduced to between 21 and 28 days.

He told Dawn.com that the gap was previously set at four months — as per the May 11 guidelines — but that was because back then, both Chinese and other vaccines were being simultaneously used. “Now, with Pfizer, the gap has been reduced,” he said.

Vighio said that another reason for the four-month gap was because, the authorities had to ensure that there were enough vaccines to cover the entire country at the time — a concern that has since eased.

How much will it cost?

The second booster shot is "absolutely free", said Shah, the spokesperson for the Ministry of National Health Services.

How long will I be protected?

As for how long the second booster provides protection, according to Reuters, a large Israeli study found that a fourth dose of the Pfizer vaccine lowered rates of Covid-19 among the elderly but the protection against infection appeared short-lived.

The second booster's protection against infection dwindled after four weeks. Protection against severe illness did not wane during the six weeks after the dose but more follow-up study was needed to evaluate its longer-term protection, the researchers said.

The study on 1.3 million people aged 60 and older looked at data from the Israeli Ministry of Health database between January 10 and March 2, when the Omicron variant was predominant.

Which vaccines will be administered?

According to the government's Covid-19 portal, Sinopharm, Sinovac, Pfizer, Moderna and AstraZeneca vaccines can be used as boosters in any combination.

The booster interim guidelines said that the shot administered may be the same as the initial vaccine or a different vaccine.

It outlined no specific vaccine for the second booster, saying that vaccine choice should be based on availability or personal preference. "Any available vaccine can be used for a booster dose," the guidelines added.

It further said that boosters for the eligible categories would be offered from the pool of vaccines procured by the government.

Where can I get vaccinated?

Punjab

Primary and Secondary Healthcare Department spokesperson Syed Hammad Raza Bokhari said all district headquarters hospitals (DHQs) and tehsil headquarters hospitals (THQs) were administering second booster doses.

Islamabad

Health ministry spokesperson Sajid Shah told Dawn.com that booster shots of Chinese vaccines were available at all the vaccination centres of the federal capital.

“However, Pfizer vaccine is [only] available at mass vaccination centres such as F-9 Park, Chak Shahzad, Pakistan Institute of Medical Sciences and Tarlai Vaccination Centre,” he said.

Replying to a question, Shah said that the NCOC has also arranged to vaccinate the elderly at their homes. “Moreover, we are willing to send teams to different facilities, including offices and business centres to administer booster shots. We are also considering sending teams door to door for booster shots,” he said.

Azad Jammu and Kashmir

Divisional Monitoring Officer for Covid-19 Vaccination, Shafaq Nadeem, said people could be administered a second booster shot in any vaccination centre at any facility, from the major hospitals to basic health units.

Balochistan

Dr Waseem Baig, media coordinator for Balochistan's health department, said booster shots were being administered across all districts of the province in hospitals, district headquarter hospitals and vaccination centres.

Khyber Pakhtunkhwa

KP Health Secretary Amer Sultan Tareen said booster doses were available and being administered throughout the province.

Sindh

Atif Husain, public relations officer for Sindh's health ministry, said eligible people in the province were being administered their second booster shots. He said that a door-to-door campaign had been launched as well for the administration of booster doses.

Husain said health facilities and hospitals at the district and tehsil levels were being used to provide booster shots.

Additional input by Imtiaz Ali from Karachi, Imran Gabol from Lahore, Sirajuddin from Peshawar, Ghalib Nihad from Balochistan, Ikram Junaidi from Islamabad and Tariq Naqash from Azad Jammu and Kashmir.