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FDA authorizes booster shot for three COVID-19 vaccines, mixing and matching brands

Virus Outbreak J&J Booster
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More Americans will soon be able to get a COVID-19 booster shot.

A booster is currently available for people who received the Pfizer vaccine at least six months ago. Recipients of the booster must be 65 years or older, have underlying health risks or work in high-risk settings.

The Food and Drug Administration Wednesday authorized boosters for Johnson & Johnson and Moderna vaccine recipients.

“It looks like over time— antibodies against the virus slowly diminish. So your risk of infection over time since your vaccine probably starts to go up, but clearly, it’s most concerning for the people who are at high risk for hospitalization and death to begin with,” said Dr. James Neid, director of infection prevention at the Medical Center of Aurora.

Neid said the need and recommendation for boosters will likely expand as time goes on.

“Your risk over time is going to go up as efficacy starts to wane,” he explained.

The Food and Drug Administration (FDA) authorized mixing and matching vaccine boosters, which is something that wasn’t recommended with the initial doses. For example, people couldn't complete two doses of the Pfizer vaccine and get a third booster shot of another brand, like Moderna.

Experts said this might be especially helpful for people who got the J&J vaccine, since company data shows its single-shot provides less protection.

“If you had the J&J and you get the J&J booster, your antibody levels certainly go up. They’re likely to confer additional protection, but it doesn't look like they go up as high if you get an mRNA booster,” Dr. Neid said.

Pandemic preparedness expert and senior scholar at Johns Hopkins Center for Health Security Dr. Amesh Adalja said mixing and matching vaccines is relatively rare.

“There really isn't mixing and matching with any of our existing vaccines. But it has been something that has been thought about. For example with bird flu, vaccines that are in experimental stages,” he said. “While this isn't something usual, it is something that is highly anticipated because what we’re trying to do is come up with the best types of vaccines and the best vaccine policies to give people the best protection they can get.”

Dr. Neid said for most Americans, getting a booster isn’t necessary at this exact moment.

“It is appropriate to say that most people can start thinking about walking to get their booster, but not running. The cases in vaccinated people in the hospital remain extremely low but over time that may change,” he said.

He said health leaders and doctors like himself are more focused on getting people vaccinated to begin with.

“My sense is that the FDA’s priority is to get the kids ages 5-11 their vaccines approved before they move the age limit down,” Dr. Neid said.