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The FDA and CDC have now authorized booster doses for all three of the COVID-19 vaccines: Pfizer, Moderna, and Johnson & Johnson. The details get a little bit complicated, so let’s break down who should get a booster, who can get a booster, and whether you should get a different brand than the one you got in the first place. (The recommendations also allow people to get any brand of booster, so you don’t have to stick with the same kind you got originally.)
A caveat, as always: if you have a physician or other medical provider who you can have a conversation with, they are your best source of information on what you, personally, should do.
If you got Johnson & Johnson, definitely get a booster
It’s now pretty clear that the J&J vaccine doesn’t provide as much protection as the two mRNA vaccines. It’s still a good vaccine, and still provides a lot of protection, especially against severe disease and death. But it could be better.
A second J&J shot does a lot to improve your protection from COVID. (Many experts have asked whether perhaps the J&J should have been a two-dose vaccine from the beginning.) The recommendation is to get your booster at least two months after your initial shot. This is a shorter timeframe than for the other vaccines’ boosters. So if you got your J&J shot two months ago or more, it’s time.
Another important point: Everybody who got a J&J shot is recommended to get a booster. You don’t have to be a particular age or be in a high-risk group.
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Easy decision, right? But there’s one more detail. While J&J executives say that their data supports giving people a J&J booster, and the FDA and CDC generally recommend getting the same type of booster as your initial vaccination, a recent NIH study found that people who got J&J as their initial dose had the highest antibody levels if they got Moderna for their booster.
“There is clear evidence of benefit” for an mRNA vaccine (Moderna or Pfizer) as your booster after a J&J vaccine, says Dr. Anthony Harris, who is board certified in occupational and environmental medicine and is the CEO of HFit. A J&J booster would still be a fine choice if that’s all that’s available.
If you got an mRNA vaccine for your initial series, it makes sense to get another mRNA vaccine for your booster (rather than the J&J booster). That said, there’s no strong evidence to support a choice of Moderna over Pfizer or vice versa.
If you got Pfizer or Moderna and you’re high risk, get a booster
If you recall the recommendations about Pfizer boosters from a few weeks ago, those same guidelines now apply to the Moderna vaccine as well. In short:People who are over 65 should get a booster.People who are over 50 and have underlying medical conditions that put them at high risk for severe disease from COVID should get a booster.People who are over 18 and have high risk medical conditions may get a booster.People who are over 18 and work in a setting where they’re at high risk for exposure to COVID may get a booster.
Boosters for both mRNA vaccines are intended to be given six months or more after the initial series of doses.
Dr. Harris’s advice is that if you’re not in a high risk category, you “don’t have to run out and get a booster,” but that it’s probably a good idea if you work in healthcare and interact with COVID-positive patients. Another group of workers who could benefit are those who work indoors with people who aren’t necessarily masked and where you aren’t sure the ventilation is good. People who fall into that category include many servers at indoor restaurants, and people in the entertainment industry who spend time in theaters and concert venues.
Am I still “fully vaccinated” without a booster?
Good news: The definition of “fully vaccinated” hasn’t changed. You are still considered fully vaccinated two weeks after the second dose of a two-dose mRNA vaccine, or two weeks after a single dose of J&J.
If you’re eligible for a booster but choose not to get one, you are still considered fully vaccinated, according to information discussed at the CDC’s advisory panel meeting.