FDA Expands COVID Boosters, Approves Mixing Vaccines

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The Food and Drug Administration on Wednesday approved booster shots of the Moderna and Johnson & Johnson COVID-19 vaccines as well as a “mix and match” approach to booster shots.

“The availability of these authorized boosters is important for continued protection against COVID-19 disease,” acting FDA Commissioner Janet Woodcock said in a statement.

The Moderna booster dose is only 50 micrograms, half the size of the two initial 100-microgram doses individuals are given when individuals first receive the vaccine.

The FDA also endorsed mixing different COVID vaccines when it comes to booster shots.

The FDA’s “mix and match” approach means someone can get a booster shot of a different COVID vaccine than the one they initially received when they first got vaccinated.

“A single booster dose of any of the available COVID-19 vaccines may be administered as a heterologous booster dose following completion of primary vaccination with a different available COVID-19 vaccine,” the FDA said in a news release.

For example, all adults 18 and older who received the single-shot Johnson & Johnson vaccine may get a booster dose of either the Johnson & Johnson, the Moderna, or the Pfizer vaccine at least two months after their initial vaccination.

Studies have found that Johnson & Johnson’s vaccine is less effective than the Pfizer and Moderna vaccines.

Similarly, people in high-risk groups who received the Moderna or Pfizer vaccine can get a booster shot of any of the three FDA-approved vaccines at least six months after their original vaccination. The high-risk groups include people age 65 and older, people living in long-term care facilities, and people ages 18 to 64 who are either at high risk of severe illness from COVID or who are at high risk of being exposed to the virus at their jobs.

The Pfizer vaccine booster shot had already been approved in September for certain high-risk groups. On Wednesday, the FDA expanded the use of Pfizer booster shots to all adults who got the Johnson & Johnson vaccine.

Last week, an FDA advisory panel recommended emergency use approval for booster doses of the Moderna and Johnson & Johnson vaccines.

However, some of the committee’s 19 members appeared reluctant to vote for the Moderna booster shot, pointing out that the data on the potential benefits of a booster dose is “not perfect.”

“The data are not perfect but these are extraordinary times and we have to work with imperfect data,” said Dr. Eric Rubin, a professor at the Harvard T.H. Chan School of Public Health who is also editor-in-chief of the New England Journal of Medicine, CNN reported.

The FDA did not recommend one vaccine in particular as a booster shot.

“We do not have preferential recommendations,” Woodcock said. “We feel that if patients have questions, they should consult with perhaps their physician or another provider.”

On Thursday, a Centers for Disease Control and Prevention committee is meeting to discuss booster doses and the mix and match approach.

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