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The Food and Drug Administration and Centers for Disease Control and Prevention have made booster recommendations for all three COVID-19 vaccines available in the U.S., including authorizing a mix-and-match option for booster shots from Johnson & Johnson (J&J), Moderna or Pfizer.
For people who received Moderna or Pfizer vaccines, booster vaccinations are recommended 6 months or more after finishing the initial two-dose series for those age 65 and older and for younger adults 18 and older who work or live in high-risk settings or have underlying medical conditions that increase their COVID-19 risk.
For people who got the J&J COVID-19 vaccine, booster vaccinations are recommended for those 18 and older and who were vaccinated two or more months ago.
"What mix-and-match means is that regardless of what you got for your primary series, you could get any of the other three vaccines available for use in the U.S. as your booster if you're eligible for a booster," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group.
So how do you know which booster vaccination to choose?
"All of the boosters will dramatically boost your antibody response," says Dr. Poland. "I would make the decision about a booster based on how did you respond to whatever you got originally? And are there any unique risk factors that you have?"
People who responded well to the first vaccine with minimal side effects can choose to get the same brand for their booster vaccination. But there are reasons someone might choose a different vaccine. For example, a younger man who initially got the Moderna or Pfizer vaccine might want a J&J booster, because the mRNA vaccines are linked with a slight risk of heart inflammation called myocarditis. And a woman under age 50 might prefer to get a Moderna or Pfizer booster, because the J&J vaccine is linked with a slightly higher risk of a rare blood clotting condition in younger women.
In this Mayo Clinic Q&A podcast, Dr. Poland walks through the recent booster recommendations and the likely timeline for COVID-19 vaccine approval for kids ages 5 — 11.
To practice safe social distancing during the COVID-19 pandemic, this interview was conducted using video conferencing. The sound and video quality are representative of the technology used. For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was recorded prior to COVID-19 or recorded in an area not designated for patient care, where social distancing and other safety protocols were followed.
Research disclosures for Dr. Gregory Poland.
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Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.
For more information and all your COVID-19 coverage, go to the Mayo Clinic News Network and mayoclinic.org.
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I've heard the J&J elicits a B Cell response and the mRNA vaccines elicit a T Cell response. I've heard this is because these vaccines work in different ways. Therefore, should I 'start over' with a 2 shot regiment of an mRNA since it's a different type of vaccine?
Wondering if it might be better to check antibodies before getting the Covid vaccine booster?
I have gotten the Pfizer (2-shot), am 76 years old and in average health but have bronchiectasis and mycobacterium avian complex--both currently well controlled. I just don't see the need to inject more into my body than necessary.
@alexsneedmiller and @fdixon63, good questions. I have submitted them to Dr. Poland for a future podcast.
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1 ReactionYou could check, but the reason for the recommendation is that even healthy older people (mainly defined as over 65) have a less robust immune system, and antibodies decline faster. In addition, those of us with lung issues and/or underlying infection are at risk of becoming much sicker from Covid and other viruses.
My docs came down firmly on the side of getting the booster - side effects are milder than Covid.
PS My fully vaccinated daughter and "extra" daughter currently both have contracted Covid - they were not yet eligible for the booster, having not gotten their 2nd vaccine dose until May.
Sue
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1 ReactionThanks Sue. I had not seen or read about antibodies declining faster and not being as robust in older folks. Appreciate the additional information. These guidelines are what I needed to know moving forward. Looks like I'll be getting the booster. Faye
@colleenyoung just curious if my question was discussed. I haven't heard it asked, but maybe I missed it. With all the news about how important boosters are, how does the "J&J + 1 Phizer booster" hold up to Omicron?
Should those of us in the J&J + mRNA booster category advocate to get a 2nd mRNA to 'catch up'?
Thanks for the nudge, Alex.
Dr Poland addressed your question (sort of) in this podcast.
Excerpt
Dr. Halena Gazelka 10:26
Excellent. All right, our next listener asks. They state that they are one of the immune compromised individuals in the moderately to severely immunocompromised category who got a third dose of Pfizer back in August when it was authorized. It wasn't called a booster, it was called a third dose. So, does that mean that they get to then have a booster as a booster dose I guess? So, a fourth dose it would be.
Dr. Gregory Poland 11:05
Yes, and this is something that is, you know, you talk about public health messaging, it's something that is very confusing. So, let me go over it carefully. This is only pertaining to people who are moderately to severely immunocompromised. Okay. If you got an mRNA vaccine, you would have gotten two doses, the recommendation was that 28 or more days later, you get a late dose or a third dose, as you mentioned, Halena. Excuse me. And then six months later, you get your booster, i.e., your fourth dose. If you started with the J&J vaccine, then you get your first dose, and then two months later you get your second dose, stop that's the end. So, with J&J, it's a total of two doses with the mRNA vaccines to a total of four doses. A little confusing, I recognize.
He also talks about boosters and the J&J vaccine in this next podcast