Where Things Stand on Boosters for Three Vaccines in the U.S.

Confused about who can get a booster shot of which vaccine, and what the F.D.A.’s advisers on vaccines are voting on this week? This scorecard may help.,

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Here’s a snapshot of where things stand on boosters for the three vaccines in use in the U.S.

A nurse’s cold storage bag with three vaccine options at a vaccination event in July in New York City: Moderna is red, Pfizer-BioNTech is purple and Johnson & Johnson is blue.Credit…James Estrin/The New York Times

Oct. 14, 2021, 12:23 p.m. ET

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

The Food and Drug Administration’s panel of expert advisers is scheduled to vote this week on whether to recommend booster shots for two of the three vaccines in use in the United States, those from Moderna and Johnson & Johnson, for each vaccine’s recipients.

The agency has already authorized booster shots of the third, from Pfizer-BioNTech, for certain groups who got that vaccine initially, including adults 65 and older and residents of long-term care facilities. 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 F.D.A. 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 win 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.: Awaiting authorization as a booster for the same population groups who are now eligible for a Pfizer booster. (Some immunocompromised people can receive a full third dose a month after their second.)

Where it stands elsewhere: Some countries are 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 F.D.A. staff report took a neutral stance on Moderna’s booster-shot application.

What to Know About Covid-19 Booster Shots

The F.D.A. authorized booster shots for a select group of people who received their second doses of the Pfizer-BioNTech vaccine at least six months ago. That group includes: Pfizer recipients who are 65 or older or who live in long-term care facilities; adults who are at high risk of severe Covid-19 because of an underlying medical condition; health care workers and others whose jobs put them at risk. People with weakened immune systems are eligible for a third dose of either Pfizer or Moderna four weeks after the second shot.

Regulators have not authorized booster shots for recipients of the Moderna and Johnson & Johnson vaccines yet, but an F.D.A. panel is scheduled to meet to weigh booster shots for adult recipients of the Moderna and Johnson & Johnson vaccines.

The C.D.C. has said the conditions that qualify a person for a booster shot include: hypertension and heart disease; diabetes or obesity; cancer or blood disorders; weakened immune system; chronic lung, kidney or liver disease; dementia and certain disabilities. Pregnant women and current and former smokers are also eligible.

The F.D.A. authorized boosters for workers whose jobs put them at high risk of exposure to potentially infectious people. The C.D.C. says that group includes: emergency medical workers; education workers; food and agriculture workers; manufacturing workers; corrections workers; U.S. Postal Service workers; public transit workers; grocery store workers.

It is not recommended. For now, Pfizer vaccine recipients are advised to get a Pfizer booster shot, and Moderna and Johnson & Johnson recipients should wait until booster doses from those manufacturers are approved.

Yes. The C.D.C. says the Covid vaccine may be administered without regard to the timing of other vaccines, and many pharmacy sites are allowing people to schedule a flu shot at the same time as a booster dose.

Johnson & Johnson

What you would get: A second dose, probably six months after the initial dose.

Where it stands in the U.S.: Awaiting authorization. An F.D.A. staff report found significant shortcomings in the data that the company submitted with its application, but it was not clear whether that would delay a decision.

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

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

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