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November 19, 2021

Johnson & Johnson COVID Booster Gets a Green Light from CDC

Johnson & Johnson COVID Booster Gets a Green Light from CDC

Americans eligible for a COVID booster now have three options available to them, including the Johnson & Johnson (J&J) vaccine. The Centers for Disease Control and Prevention (CDC) approved the FDA’s decision to authorize a booster for all J&J recipients ages 18 and older who got the jab at least 2 months ago. So, as of October 21, nearly 15 million people who got the J&J shot can roll up their sleeves for an additional shot.

The CDC’s decision follows the recommendation of its Advisory Committee on Immunization Practices (ACIP) as well as a unanimous vote in favor of an additional J&J dose by the FDA’s Vaccine and Related Biological Products Advisory Committee on October 15.

J&J is now one of three COVID boosters authorized for emergency use in the United States. U.S. regulatory officials also authorized boosters for the Pfizer and Moderna COVID-19 vaccines, noting that fully vaccinated people who are eligible for an additional shot can “mix and match,” or choose which vaccine they’d like to receive.

So, those who got the Johnson & Johnson shot can choose to receive another dose of that same vaccine—or they can opt for a booster dose of either the Pfizer or the Moderna mRNA vaccine. 

What the latest research on boosters shows
The FDA decision to authorize a booster dose of the Pfizer vaccine for certain high-risk groups was based on recent data published in The Lancet, which found that the Pfizer vaccine remained 90 percent effective in preventing hospitalization due to COVID-19 for up to six months. But the effectiveness of the vaccine declined from 88 percent one month after injection to 47 percent five months later.

The data Moderna submitted to federal regulators presented a similar picture, suggesting that people’s immunity declines six months after their second dose and that receiving a half-dose booster increases protection against COVID—including the Delta variant, which is not only more contagious but also associated with more severe infections.  

Unlike the two-dose Pfizer and Moderna mRNA vaccines, studies show the efficacy of the single-shot J&J vaccine hasn’t waned. An October 2021 study published in the New England Journal of Medicine compared immune responses from the J&J vaccine with the Pfizer and Moderna vaccines. The study found that although the J&J vaccine produces a lower immune response, it’s more stable over time. Among those who got the J&J shot, antibody and memory cells were still robust up to eight months after vaccination.

But real-world evidence and Phase 3 trial data show the J&J vaccine is 79 percent effective 28 days after immunization—well below the initial 94 to 95 percent efficacy rates of Pfizer or Moderna.

Ongoing research shows that a booster shot given six months after the first J&J dose results in a 9- to 12-fold increase in antibody levels. J&J trial data also shows that a booster helps bolster protection against the Delta variant.

So, which booster is best?
Being able to mix and match COVID-19 vaccines will now offer people more flexibility in getting boosters, depending on what’s available to them in their local area.

Previously, the CDC advised people that COVID-19 vaccines aren’t interchangeable, and that the second dose in a two-shot series should come from the same manufacturer as the first one did. But as scientists gather more data on the safety and effectiveness of mixing different COVID-19 vaccine types, they’ve agreed that the benefits of mixing and matching likely outweigh the risks. 

Still, “mix-and-match” studies were designed to answer questions about safety and effectiveness—not which booster combination offers the most protection against COVID-19. 

So, right now, one vaccine isn’t recommended over another. Research on that is ongoing. What is clear, however, is that no matter which type of vaccine people got initially or which they get as a booster, antibody levels increase.
Looking ahead, large, randomized controlled trials are needed to determine which of the nine mix-and-match combinations provided the greatest protection for various age and risk groups. More research is also needed to examine how long immunity following boosters lasts over time. Federal officials will continue to scrutinize the data as it becomes available. 

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