Late last week, an independent advisory committee to the FDA voted in favor of booster shots of Moderna and Janssen (Johnson & Johnson) COVID-19 vaccines for some groups. If you got the Moderna or J&J COVID-19 vaccine, is it time to schedule your booster dose?
First, it’s going to take a bit more time before Moderna and J&J boosters are available – give it a week, give or take. Although the advisory committee voted in favor of boosters for both vaccines, they ultimately will need to be authorized or approved by the FDA. Additionally, the CDC’s own independent advisory committee – the Advisory Committee on Immunization Practices (ACIP) will need to issue recommendations for how these boosters can be given. The ACIP has a 2-day meeting scheduled for this Wednesday and Thursday, and the draft agenda indicates that Thursday’s session will focus on COVID-19 vaccines. I suspect it’s likely that the ACIP will recommend Moderna and J&J boosters on Thursday, but that still remains to be seen.
The bigger question, though, is whether you need a booster dose of Moderna or J&J vaccine once they are available – and that depends on which vaccine you received, how long ago you received it, and your individual risks and benefits.
First, the FDA’s advisory committee voted in favor of J&J boosters 2 months after the first dose for everyone age 18 and older who received a first dose of J&J vaccine. Assuming the FDA authorization and CDC recommendations mirror this vote, then yes, if you received a dose of J&J vaccine at least 2 months ago, then you should get a second dose once it becomes available. (Although, considering that all of the other COVID-19 vaccines authorized by either the FDA or the World Health Organization have 2-dose series, I do wonder whether this dose is a booster dose or the second dose of a 2-dose series. I hope the FDA and/or CDC will clarify this.)
In contrast to the J&J recommendation, the FDA’s advisory committee voted in favor of booster doses for Moderna 6 months after the second dose, but only for the same high-risk groups recommended for booster doses of Pfizer vaccine. As I mentioned in my earlier post on Pfizer boosters, this includes some groups that “may” benefit from a booster, based on individual assessments of their risks and benefits. In other words, not everyone in the groups that “may receive” a booster dose actually needs one.
To further complicate things, immediately after the vote on Moderna boosters, FDA scientists asked the advisory committee whether they should extend the booster dose authorizations for both Pfizer and Moderna vaccines to include all adults age 18 years and up. However, the vaccine experts on the advisory committee all agreed that there isn’t enough evidence to show that all adults need a booster dose.
In other words, if you got 1 dose of J&J COVID-19 vaccine at least 2 months ago, then you need a second dose to complete what may ultimately be considered a 2-dose series. But not everyone who got a 2-dose series of Pfizer or Moderna vaccine needs a booster. People over 65, people with moderate-to-severe immunocompromise and people age 50-64 years with certain high risk conditions should get a booster. For the rest of us, talk with your healthcare provider about any chronic health conditions you may have and whether they put you at high risk of severe COVID-19, and consider any reactions you may have had to previous doses of COVID-19 vaccine, whether you live or work in risky settings, how much COVID-19 is spreading in your area and your ability and willingness to wear a mask and social distance.
The answer to the “do I need a COVID-19 booster” question is not straightforward for most adults – I wish it was! But the important thing to remember is that 2 doses of COVID-19 vaccines are still highly effective for most people. If you’re still hesitant about getting your first or second dose of a COVID-19 vaccine, then I urge you to get your COVID-19 shot – and your flu shot too! Getting your COVID and flu shots are some of the best steps you can take to protect yourself and your loved ones this fall and winter.
💉 Dr. B