FDA clears Moderna, J&J booster shots: Which one is right for you?

The US Food and Drug Administration has given the green light to Moderna and Johnson & Johnson’s COVID-19 booster shots for eligible populations amid reports of waning immunity and breakthrough infections.

Switching to a different vaccine for the booster – a heterologous approach otherwise called mix-and-match boosting – was also authorized by the agency, which means people eligible for an additional jab can get to choose the booster brand they like.

However, acting FDA Commissioner Dr Janet Woodcock clarified the agency will not make any “preferential recommendations” on booster brands and would expect many people to take the same vaccine they had taken before.

The booster shots will be given at the same recommended interval (after 6 months if Moderna or Pfizer was the primary vaccine, or after 2 months if Johnson & Johnson). Moderna’s booster dose will be 50 micrograms, which is half the strength of the original jabs.

Earlier in September,  the agency gave its nod to a booster dose of the Pfizer-BioNTech COVID-19 vaccine for people 65 years and older, those at high risk, or at jobs that left them at risk, paving the way for an early US roll-out of the jabs.

“The availability of these authorized boosters is important for continued protection against COVID-19 infection,” said Woodcock.

Consult with your HCPs

As it stands, Dr Peter Marks, FDA Director for the Center for Biologics Evaluation and Research said individuals should still consult with their healthcare providers (HCPs) should they have queries about which booster to take.

“There are situations where there may be issues with [booster] availability, or there are certain medical considerations that a certain individual may be recommended a certain booster,” he explained.

Some individuals may have also experienced certain adverse reactions to the primary vaccine series that they may opt to take a different vaccine as a booster. “We wanted to provide a lot of flexibility as some people don’t know which vaccine they got,” Woodcock said during a media briefing.

Marks also hinted at lowering the age of people eligible for boosters in the future as “there is evidence to suggest it.”

Who’s eligible for which vaccine

People who are fully vaccinated with the Pfizer-BioNTech or Moderna vaccines are eligible for a booster if they are 65 years or older, or between 18 and 64, and either at high risk of severe COVID-19 complications due to underlying medical conditions or work-related or institutional exposure.

The FDA clarified Pfizer’s booster emergency use authorization (EUA) for the 18–64 age group at high risk of COVID-19 due to workplace exposure to closely align with Moderna’s booster EUA. Both vaccines are developed using synthetic messenger ribonucleic acid (mRNA) ingenious technology.

Johnson & Johnson’s booster shot is approved for individuals 18 years and older at least 2 months after completion of the single-dose primary regimen.

The US Centers for Disease Control and Prevention is expected to issue clinical guidance for healthcare professionals to help people decide safely on which booster to get. Regardless, people should not lose sight of the fact that COVID-19 vaccines are life-saving, particularly for the elderly and the immunocompromised.