Moderna and Johnson & Johnson coronavirus boosters will soon be making their way into arms after the Centers for Disease Control and Prevention authorized the shots and also cleared a mix and match booster strategy.
Moderna boosters are cleared in the same population as Pfizer boosters plus one additional group — people living in long-term care facilities. In addition to that group, people who are 65-plus, have certain medical conditions or face workplace exposure will be eligible for a Moderna booster, which is half the size of a regular dose.
Anyone age 18 and older will be eligible to get a Johnson & Johnson booster dose.
It has also been authorized that booster doses can be mixed and matched with the primary doses.
Although it is expected and recommended that people will get the same booster shot as their original vaccine, Johnson & Johnson recipients could stick with the J&J or get an mRNA booster two months after their first shot.
Moderna or Pfizer recipients could get another mRNA shot or a J&J booster six months after their second dose.
The mix and match strategy might be used in instances of limited supplies or individual risk factors.
A recent National Institutes of Health study showed mixing booster shots yielded similar or improved antibody responses, especially for Johnson & Johnson recipients who got an mRNA booster.
The boosters and the mix and match policy became official Wednesday night. The Advisory Committee on Immunization Practices made the recommendation, which CDC Director Dr. Rochelle Walensky endorsed. Walensky added the new eligibility group of people in long-term care settings.
About 99 million Americans now become eligible for a Moderna or J&J booster shot this month. People are still considered fully vaccinated if they have not yet gotten a booster shot.
Recommending the boosters didn’t come without concerns and questions among members of the CDC’s Advisory Committee on Immunization Practice, which met virtually on Wednesday and Thursday.
ACIP member Dr. Sarah Long noted the lack of evidence that boosters are needed for young adults.
“I can’t say that I am comfortable that anybody under 50, otherwise healthy individuals, need a booster vaccine at this time with either Moderna or Pfizer,” Long said.
The shots also come with rare but serious risks.
Moderna shots carry a risk of myocarditis, inflammation of the heart, in young males. There have been 39 cases for every one million doses given.
Johnson & Johnson has risks of a rare blood clotting issue, and there have been 10 cases per one million doses. Also with J&J comes the risk of Guillain-Barre syndrome, a rare disorder that impacts the nervous system. There have been 16 cases per one million doses.
