F.D.A. to Allow ‘Mix and Match’ Approach for Covid Booster Shots

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“The No. 1 thing I heard from state health secretaries was the need for permissive language around a mix-and-match approach,” said Dr. Nirav D. Shah, Maine’s top health official and the president of the Association of State and Territorial Health Officials.

What to Know About Covid-19 Booster Shots

Who is eligible for a booster shot?

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 before. That group includes: vaccine 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.

Will people who receive Moderna and Johnson & Johnson vaccines be eligible?What underlying medical conditions qualify for a booster shot?

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.

What occupations are eligible for boosters?

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.

Can I get a flu shot at the same time as a Covid vaccine or booster shot?

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.

Dr. Clay Marsh, West Virginia’s Covid-19 czar, said the state had a greater supply of Moderna and Pfizer-BioNTech vaccines than of Johnson & Johnson’s, so officials there might prefer to use them for boosters out of convenience. Others said the option of switching vaccines could streamline the administration of boosters.

“The impetus for states and local health departments was that if they were going to go out to a community site or long-term care facility and start providing boosters, it was a little inefficient to show up somewhere and say, ‘We’re just doing the people who got Pfizer,’” said Dr. Marcus Plescia, the chief medical officer for the Association of State and Territorial Health Officials. “When you have a captive audience, you want to take advantage of that.”

Yet more options could lead to more confusion about booster shots, some experts have said. The Food and Drug Administration this week is expected to authorize boosters for all Johnson & Johnson recipients 18 and older. But the only Moderna recipients who are expected to become eligible for boosters are those who are at least 65 or otherwise considered at high risk, following the same eligibility requirements for recipients of Pfizer-BioNTech’s vaccine.

Jeannette Y. Lee, a biostatistician at the University of Arkansas for Medical Sciences and a member of the F.D.A.’s expert committee, warned on Friday that allowing people to switch from their original vaccine type could be “very, very messy in terms of the messaging.”

It remains unclear what dosage of Moderna’s vaccine might be authorized for use as a booster for recipients of other vaccines. For those who initially received Moderna, regulators are expected to authorize a half-dose as a booster, but the data might support a full-dose booster for people who initially received the other two vaccines.

Dr. Anthony S. Fauci, the government’s top infectious disease expert, publicly suggested on Sunday that the government was headed toward granting greater leeway, at least for Johnson & Johnson recipients. “I believe there’s going to be a degree of flexibility of what a person who got the J.&J. originally can do, either with J.&J. or with the mix-and-match from other products,” he said on “Fox News Sunday.”