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Adults 50 and older can now roll up their sleeves for a second COVID-19 booster, as can younger individuals with certain immune-compromising conditions.

The Food and Drug Administration (FDA) authorized the extra shot March 29, and the Centers for Disease Control and Prevention (CDC) agreed to add it to its coronavirus vaccine

recommendations. But health officials stopped short of urging everyone in the eligible population to run out and get it, leaving many to wonder if they should.

“There’s not a simple answer to this,” says William Moss, M.D., executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health. Other

experts agree: A few factors can shape your decision.

Here’s what to think about when thinking about a second booster shot.

of either the Pfizer-BioNTech or the Moderna vaccine at least four months after their first booster.Individuals 12 and older who have certain immunocompromising conditions can get a second

Pfizer booster at least four months after their first booster.People 18 and older who have certain immunocompromising conditions can get a second Moderna booster at least four months after

their first booster.Adults who received a primary vaccine and booster dose of Johnson & Johnson’s (Janssen) vaccine at least four months ago can get a second booster dose using an mRNA

COVID-19 vaccine.

Source: FDA, CDC

The biggest risk factor for getting a severe case of COVID-19 is age, says Carlos del Rio, M.D., professor of medicine in the Division of Infectious Diseases at Emory University School of

Medicine. This is largely because the immune system starts to lose some of its oomph as one gets older.

Data from the CDC shows that Americans 85 and older account for the largest share of deaths from COVID-19, followed by 75- to 84-year-olds and 65- to 74-year-olds. All together, people

50-plus account for more than 93 percent of the roughly 1 million deaths from COVID-19 in the U.S.

But underlying health conditions like diabetes, obesity and heart disease can also complicate a coronavirus infection. So it’s important to assess your risk based on these key factors.

(Think about it this way: A 50-year-old who doesn’t have any health conditions is in a different risk category than an 85-year-old who is managing several.)

The FDA’s decision to authorize the second booster was based on data from Israel that suggests a second booster dose given at least four months after the first booster can reduce the risk

of hospitalization and death in adults 60 and older and other high-risk individuals. The reason U.S. health officials decided to extend the eligible age range to 50 is because “we know that

people in the age range from about 50 to 65, about a third of them have significant medical comorbidities,” meaning the presence of two or more underlying health conditions, Peter Marks,

M.D., director of the FDA’s Center for Biologics Evaluation and Research, explained in a news briefing. “So by choosing age 50 and up … we felt like we would capture the population that

might most benefit from this fourth booster dose.”

Ashley Drews, M.D., an infectious disease physician and epidemiologist at Houston Methodist, says immunocompromised folks and people who are 65 and older (some experts suggest 60 and older)

should go ahead and get the second booster now. The same goes for anyone in their 50s who has an underlying health condition that puts them at high risk for severe illness. “But if you are

50 to 60 and don’t have any underlying health conditions that place you at increased risk of severe COVID, then it’s not as urgent for you to get the second booster right now,” Drews says.