National News

An Extra Shot? Where Things Stand on Boosters for 3 Vaccines in the US

Posted October 16, 2021 8:32 p.m. EDT
Updated October 17, 2021 4:15 p.m. EDT

FILE — A vial of the COVID-19 vaccine in New York on June 23, 2021. In documents released Tuesday morning, Oct. 12, 2021, Moderna argued that the Food and Drug Administration should authorize a half-dose of its coronavirus vaccine as a booster shot for recipients at least six months after the second dose, citing evidence that the vaccine’s potency against infection wanes over time. (Bess Adler/The New York Times)

It can be hard to keep track of developments on coronavirus vaccine boosters without a score card.

The Food and Drug Administration’s panel of expert advisers voted Thursday to recommend booster shots for many recipients of the Moderna coronavirus vaccine, and on Friday to recommend boosters for recipients of Johnson & Johnson’s vaccine who are ages 18 and older, at least two months after receiving the first dose.

The agency has already authorized booster shots of the other vaccine in use in the United States, from Pfizer-BioNTech, for certain groups who got that vaccine initially. Third doses of the Pfizer-BioNTech and Moderna vaccines also have been authorized for some people with weaker immune systems, who may not have gotten full protection from the original two doses.

All three vaccines initially provide very strong protection against infection, serious illness and death from COVID-19. The impetus for boosters comes from studies suggesting that while that protection remains strong against serious illness and death, it may decline somewhat over time and could allow more breakthrough infections, especially of the highly contagious delta variant. The decline tends to be most pronounced in older people and those with certain underlying medical conditions.

Here is a rundown of the booster shot situation for the three vaccines available in the United States.

PFIZER-BIONTECH

What you would get: A third full dose, at least six months after your second.

Where it stands in the U.S.: Available now for many people. The FDA has authorized third shots for people over 65, people with certain medical conditions and some others who are at high risk because of where they work or live. (Some immunocompromised people can get a third shot a month after their second.) The agency has put off a decision on whether to authorize boosters for other people.

Where it stands elsewhere: Israel and some other countries are administering Pfizer-BioNTech booster shots widely.

What the science says: The Pfizer-BioNTech vaccine was the first to receive full approval in the United States (for those 16 and older), the first to be authorized for some children (those 12 to 15) and the first to be authorized for boosters; the available data on its safety and effectiveness is especially robust. Some studies suggest that the vaccine may decline in effectiveness over time a bit more than the Moderna vaccine.

MODERNA

What you would get: A half-dose, at least six months after your second full dose.

Where it stands in the U.S.: An FDA advisory panel voted Thursday to recommend Moderna boosters for the same population groups now eligible for a Pfizer booster. The panel’s vote is nonbinding, but its recommendations are generally followed by the FDA. (Some immunocompromised people can receive a full third dose a month after their second.)

Where it stands elsewhere: Some countries are already offering Moderna booster shots or planning to do so soon.

What the science says: Some studies suggest that the Moderna vaccine’s effectiveness declines less than the other two vaccines available in the United States do. That may mean there is less need for Moderna recipients to get boosters. Taking that into account, an FDA staff report took a neutral stance on Moderna’s booster shot application.

JOHNSON & JOHNSON

What you would get: A second dose, at least two months after the initial dose.

Where it stands in the U.S.: The FDA advisory panel unanimously voted Friday to recommend boosters, even though an FDA staff report found significant shortcomings in the data that the company submitted with its application. The FDA is not required to follow the panel’s suggestions, but it usually does.

Where it stands elsewhere: No country has yet authorized administering second doses of the Johnson & Johnson vaccine.

What the science says: The Johnson & Johnson vaccine gives strong initial protection after one dose, although not as strong as the Pfizer or Moderna two-dose vaccines, so there has long been interest in boosters for Johnson & Johnson recipients. This article originally appeared in The New York Times.

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