CDC Backs Rollout of COVID Vaccine Boosters from Moderna and J&J

The Centers for Disease Control and Prevention backed the rollout of Moderna and Johnson & Johnson COVID-19 vaccine boosters, in line with the Food and Drug Administration's authorizations the day before. The committee's actions also support a mix-and-match approach to booster vaccinations.

• How to find a Moderna, Pfizer or Johnson & Johnson booster shot near you

CDC director Rochelle Walensky called the recommendations an "example of our fundamental commitment to protect as many people as possible from COVID-19."

The announcement came just hours after the CDC's vaccine advisory committee voted unanimously in favor of booster doses.

The panel said the Moderna booster should be given to people the same way that the Pfizer-BioNTech booster is administered. That would cover people 65 years and older, and people 18 to 64 who are either at high risk of severe COVID-19 due to certain medical conditions or whose work or institutional setting heightens their exposure. Those who initially received the two-shot Moderna vaccine would need to wait at least six months after the second shot before getting the booster.

For Johnson & Johnson, the panel's advice was simpler: A booster is recommended for people 18 and older at least two months after their initial immunization.

A CDC presentation and draft voting language said that the same vaccine used for initial immunization should be used as a booster dose, but that a mix-and-match approach is OK when the primary vaccine isn't available or a different vaccine is preferred.

During the committee discussions, several members pushed back against this preference for boosting with the same vaccine. They argued that a more permissive approach to mix-and-match would ease the administration of booster doses.

After a brief break late in the deliberations, CDC staff returned with revised voting questions that were neutral on which vaccine should be used as a booster for the J&J and Moderna vaccines. The revised questions don't explicitly mention which vaccine should be used as a booster, which clears the way for mix-and-match boosting without restrictions.

According to the CDC, more than 189 million people in the U.S. are fully vaccinated, about 57% of the population. Hospitalization rates are nine to 15 times higher for unvaccinated people, according to CDC data.

Still, there are reasons to think that boosters could be useful in some groups of people.

There has been a drop in Moderna's effectiveness against infection with the coronavirus over time, and in the face of the delta variant. Protection against hospitalization has remained generally strong, though there have been some declines seen in older people.

For the J&J vaccine, the protection against infection and hospitalization has been pretty steady, the CDC pointed out. But the vaccine has been less effective overall than the Moderna and Pfizer vaccines, so a booster can push protection from the J&J vaccine to a higher level.

The committee wrestled with the trade-off in risks and benefits for administering boosters in some groups. People 65 and older have the most to gain and relatively little increased risk. But for the Moderna vaccine, protection provided by the initial doses has remained pretty strong for younger people, and their risks for heart inflammation are higher, especially in males.

For the J&J vaccine, there have been concerns about rare blood clots following vaccination, which are a higher risk for younger women. But in most cases, the overall benefits of receiving a J&J booster far outweigh those risks because of the increased protection the second dose provides, both federal agencies concluded.

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