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The FDA and CDC have approved booster shots for all three COVID-19 vaccines: Pfizer, Moderna, and Johnson & Johnson. The guidelines can be a bit intricate, so let’s clarify who should receive a booster, who is eligible, and whether switching vaccine brands for the booster is advisable. (The recommendations also permit individuals to choose any brand for their booster, regardless of their initial vaccine.)
As always, a reminder: if you have access to a doctor or healthcare provider, they are the most reliable source for personalized advice on what steps you should take.
If you received the Johnson & Johnson vaccine, it’s highly recommended to get a booster.
It’s evident that the J&J vaccine offers less protection compared to the two mRNA vaccines. While it remains a solid option and still provides significant protection, particularly against severe illness and death, there’s room for improvement.
A second dose of the J&J vaccine significantly enhances your immunity against COVID. (Some experts have questioned whether the J&J vaccine should have been a two-dose regimen from the start.) The advice is to receive your booster at least two months after your first dose, which is a shorter interval compared to the other vaccines. So, if your J&J shot was administered two months ago or earlier, now is the time to act.
Another key detail: Everyone who received the J&J vaccine is advised to get a booster. Age or risk factors are not determining factors in this recommendation.
Seems straightforward, right? But there’s an additional consideration. While J&J officials claim their data supports using a J&J booster, and the FDA and CDC generally suggest sticking with the same vaccine type for boosters, a recent NIH study revealed that individuals who initially received J&J had the strongest antibody response when boosted with Moderna.
“There is undeniable evidence of benefit” in choosing an mRNA vaccine (Moderna or Pfizer) as a booster after the J&J vaccine, states Dr. Anthony Harris, a board-certified specialist in occupational and environmental medicine and CEO of HFit. However, a J&J booster remains a viable option if mRNA vaccines are unavailable.
If you received an mRNA vaccine for your primary doses, it’s logical to opt for another mRNA vaccine for your booster (instead of the J&J booster). However, there’s no compelling evidence to favor Moderna over Pfizer or the other way around.
If you were vaccinated with Pfizer or Moderna and are at high risk, it’s advisable to get a booster.
If you remember the earlier guidelines regarding Pfizer boosters, those same rules now extend to the Moderna vaccine. To summarize:
Individuals aged 65 and older should receive a booster.
Those over 50 with underlying health conditions that increase their risk of severe COVID complications should get a booster.
Adults over 18 with high-risk medical conditions may consider a booster.
Adults over 18 working in environments with high COVID exposure risks may opt for a booster.
Boosters for both mRNA vaccines are recommended six months or more after completing the initial vaccine series.
According to Dr. Harris, if you’re not in a high-risk group, you “don’t need to rush for a booster,” but it’s advisable for healthcare workers who frequently interact with COVID-positive patients. Additionally, individuals working in poorly ventilated indoor settings with unmasked colleagues, such as restaurant servers or entertainment industry staff in theaters and concert venues, may also benefit.
Does being “fully vaccinated” still apply without a booster?
The good news is that the definition of “fully vaccinated” remains unchanged. You are still deemed fully vaccinated two weeks after receiving the second dose of a two-dose mRNA vaccine or two weeks after a single dose of J&J.
Even if you qualify for a booster but decide against it, you are still classified as fully vaccinated, as confirmed during the CDC’s advisory panel discussions.
