Since the Center for Disease Control and Prevention, last week approved sweeping changes to booster recommendations for Pfizer, Moderna, and Johnson & Johnson vaccine recipients, up to 99 million Americans are now eligible for a COVID-19 vaccine booster shot.
Following the Food and Drug Administration (FDA)’s update, boosters for all three vaccines are now permissible under emergency use authorizations.
In addition, the FDA has also authorized eligible Americans to mix-and-match their booster shots, meaning you can get any of the three brands to be received as an additional dose.
“I was personally not going to recommend a booster dose of the same product as Janssen, so I’m glad that we have included the mix-and-match,” Dr. Pablo Sanchez, CDC’s vaccine adviser, said last week at the booster shot committee meeting.
Corid-19 Vaccine: Johnson & Johnson recipients
In the United States, the CDC has now recommended adult vaccinations with Johnson & Johnson’s COVID-19 vaccine at least two months after the initial dose.
This update is coming after FDA announced that even the highest estimations of the single-shot vaccine’s protection were “consistently less” than the mRNA-based vaccines from Pfizer or Moderna.
A Johnson & Johnson report shown to the FDA’s outside vaccine advisers explains the effectiveness of the vaccine against symptomatic COVID-19 climbed to 94% in the U.S. after a booster shot.
In addition, CDC vaccine advisers concluded that repeated doses of the vaccine would not lead to any increased risks of rare or serious side effects.
A few of the agency’s outside vaccine advisers, however, said they would probably recommend a dose of Pfizer or Moderna instead of the Janssen vaccine to patients at higher risk for a rare blood clotting side effect.
In the United States, the CDC and FDA have confirmed close to 50 cases of thrombosis with thrombocytopenia syndrome among the more than 15 million recipients of Johnson & Johnson’s vaccine. Most of those affected were women under the age of 50.
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Corid-19 Vaccine: Pfizer and Moderna recipients
Currently, everyone 65 years of age and older who has received the COVID-19 vaccine from Pfizer or Moderna is recommended to get a booster shot six months after their initial vaccination.
The CDC also expanded eligibility for adults ages 18 and up who were vaccinated six months ago e.g. for individuals who are exposed to hazardous risks on their job e.g. teachers and school support staff, grocery clerks, postal workers, factory employees, public transit crews, police officers, air traffic controllers, etc. can qualify as well.
Regardless, many pharmacies and providers do not require proof of eligibility, but only “self-attestation” for additional booster shots for immunocompromised recipients, similar to an earlier booster shot recommendations.
As authorities gather more data on the need and possible risks for booster shots, the FDA and CDC said there could be expanded eligibility for booster shots further.
“There is evidence to suggest potentially that lowering the age of those eligible for boosters may make sense in the future. Something we’re looking at closely,” Dr. Peter Marks, FDA’s top vaccine official, said to reporters last week.
These risks include severe heart conditions such as myocarditis and pericarditis, which suggest that it has originally affected young males from mRNA-based vaccines manufactured by Pfizer and Moderna.
The majority of these cases, according to federal health officials, are mild and usually resolve within a day, though hospitalization is required in many cases.
Last week, the CDC’s outside vaccine advisers reported that Moderna’s first two doses might cause “slightly more myocarditis” among adults under 30 than Pfizer’s vaccine.
The decision by Moderna to reduce the booster dose in half could however cut the risk of myocarditis following the booster, according to some experts.
The FDA’s vaccine advisors were also presented with data from Pfizer’s booster rollout in Israel, which suggests a lower risk of myocarditis after the third dose while reducing the severity of COVID-19 outbreaks there.
“We may well get there. It’s a matter of having the data, and ensuring that when we make that decision, the benefits clearly outweigh the risks throughout the population,” Marks said.
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Corid-19 Vaccine: Mix-and-match boosters
Based on early data from the National Institutes of Health, the FDA’s decision to allow mixing and matching booster shots is part of a trend indicating that all blends of so-called “heterologous” boosting are safe and effective.
Additionally, officials from the Department of Health and Human Services labeled circumstances such as when made matching booster shots brands could become difficult.
For example, like when people who don’t remember which vaccinations they had first received experienced adverse reactions after the initial vaccination, or are unable to get the same brand at their local pharmacy.
The FDA’s scientists released their conclusions about the NIH trial, concluding there was not enough information to select a “preferred strategy” for boosting.
Scientists cautioned against comparing the immune response triggered by different booster combinations as their study was not designed to compare directly.
“We will not articulate a preference. My understanding is that most people will have done largely well with the initial vaccine that they got and may express a preference, very much, for the original vaccine series they got, having done very well,” CDC Director Rochelle Walensky asserted last week.
“There may be some people who might prefer another vaccine over the one that they received, and the current CDC recommendations now make that possible.”
