Without a scorecard, it can be difficult to track developments in the coronavirus vaccine booster area.
This week, a panel of FDA advisory experts is to vote on whether to recommend booster shots for two of the three vaccines used in the United States, from Moderna and Johnson & Johnson, for each vaccine recipient.
The agency has already authorized the revaccination of a third vaccine from Pfizer-BioNTech for specific populations that initially received the vaccine, including adults aged 65 and over and residents of long-term care facilities. Third doses of Pfizer-BioNTech and Moderna vaccines are also approved for some people with weaker immune systems who may not have received full protection from the initial two doses.
All three vaccines initially provide very reliable protection against infection, serious illness and death from Covid-19. The boost for boosters comes from research suggesting that while this defense remains strong against serious illness and death, it may diminish somewhat over time and could lead to more breakthrough infections, especially the highly contagious Delta variant. The decline is usually most noticeable in the elderly and people with certain underlying medical conditions.
Here is a summary of the booster situation for three vaccines available in the United States.
What would you get: Third full dose at least six months after the second.
Where is it located in the USA: Available now to many people. The FDA has approved third shots for people over 65, people with certain medical conditions, and certain other individuals who are at high risk because of where they work or live. (Some immunocompromised people may receive their third shot a month after the second.) The agency has postponed a decision on whether to allow boosters for other people.
Where does it stand elsewhere: Pfizer-BioNTech booster vaccines are widely used in Israel and some other countries.
What science says: The Pfizer-BioNTech vaccine was the first vaccine to receive full US approval (for children 16 years and older), the first approved for some children (ages 12 to 15), and the first approved for revaccination; the available data on its safety and efficacy are particularly reliable. Some studies show that the effectiveness of the vaccine may decrease slightly more over time than the Moderna vaccine.
What would you get: Half dose at least six months after the second full dose.
Where is it located in the USA: Pending authorization as a booster for the same populations now eligible for the Pfizer booster. (Some immunocompromised people may receive a full third dose one month after the second.)
Where does it stand elsewhere: Some countries are proposing or planning to do so in the near future.
What science says: Some studies show that the effectiveness of the Moderna vaccine decreases less than the effectiveness of the other two vaccines available in the United States. This could mean that Moderna recipients need less booster packs. With this in mind, the FDA staff report took a neutral position on the use of the Moderna booster injection.
What you need to know about COVID-19 vaccinations
The FDA has approved the vaccination of a select group of people who received a second dose of Pfizer-BioNTech vaccine at least six months ago. This group includes: Pfizer beneficiaries 65 years of age or older or living in long-term care facilities; adults who are at high risk for severe Covid-19 due to an underlying medical condition; health workers and others whose work puts them at risk. People with weakened immune systems are eligible for a third dose of Pfizer or Moderna four weeks after the second shot.
Regulators have yet to authorize boosters for Moderna and Johnson & Johnson vaccine recipients, but the FDA team plans to hold a meeting to weigh up boosters for adults who received Moderna and Johnson & Johnson vaccines.
The CDC stated that conditions under which a person can be given a booster vaccination include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; a weakened immune system; chronic diseases of the lungs, kidneys, or liver; dementia and certain disorders. Pregnant women and current and former smokers are also eligible for assistance.
The FDA has approved boosters for workers whose work puts them at high risk of contact with potentially infectious people. The CDC reports that this group includes: emergency medical workers; educators; workers in the food industry and agriculture; workers in production; correctional workers; United States Postal Service workers; public transport workers; Grocery store workers.
Not recommended. At this time, Pfizer recipients are advised to receive a Pfizer booster vaccine, while Moderna and Johnson & Johnson recipients should await approval of booster doses from those manufacturers.
Yes. The CDC says the Covid vaccine can be administered without considering the timing of other vaccines, and many pharmacies allow people to schedule a flu shot at the same time as the booster dose.
Johnson and Johnson
What would you get: The second dose is probably six months after the first.
Where is it located in the USA: Awaiting authorization. The FDA staff report found significant flaws in the data the company provided with its application, but it was unclear if this would delay the decision.
Where does it stand elsewhere: No country has yet recommended a second dose of Johnson & Johnson vaccine.
What science says: The Johnson & Johnson vaccine provides strong initial protection after one dose, although not as strong as the two-dose Pfizer or Moderna vaccines, which is why Johnson & Johnson recipients have long been interested in boosters.