Everyone who received the nation’s only single-dose COVID-19 vaccine from Johnson & Johnson should be able to get a booster shot after two months, a federal advisory committee said Friday, a recommendation that’s much much less restrictive than made for Pfizer and Moderna booster shots.
A second shot of the “one and done” Johnson & Johnson vaccine would be available to all previous recipients of the vaccine, who had to be at least 18 years old, as soon as two months after their initial shot if the recommendation is adopted by federal regulators.
“We are encouraged by today’s news,” Utah Department of Health spokesman Tom Hudachko said, advising health care providers to wait for final guidance from federal authorities prior to administering the Johnson & Johnson booster doses.
The single-dose Johnson & Johnson vaccine was much less popular in Utah and the rest of the United States than Pfizer and Moderna. According to the state health department, just over 147,000 of the more than 3.6 million doses of COVID-19 vaccine administered in Utah so far were Johnson & Johnson shots.
All of the vaccines approved for use in the United States are considered effective in preventing hospitalizations or death from COVID-19. But studies have shown the two-dose Pfizer and Moderna vaccines, which use a different technology, offer more protection against the deadly virus.
Use of the Johnson & Johnson vaccine was also briefly paused nationwide in April after initially six women developed rare but serious blood clots following their shots, but it was determined the benefits outweighed the risks.
Many of the Utahns who opted for the single-dose vaccine have concerns, said Han Kim, a professor of public health at Westminster College in Salt Lake City. He said Johnson & Johnson is still “very effective” and people should have plenty of protection for now, although everyone will eventually need booster shots.
“I’m getting a ton of comments from friends who received the Johnson & Johnson,” Kim said. “They got the one-dose vaccine and said that they were done. But a lot of them do feel like they got a less effective vaccine. Now, again, in real life, most people aren’t going to be able to tell. It’s not going to be a big deal.”
A booster dose of the Pfizer vaccine was approved last month, but only for those 65 and older, unless they are deemed to be at a greater risk for COVID-19 because of a medical condition or job. Thursday, the advisory committee proposed the same restrictions for a half-dose booster for those who received the Moderna vaccine.
The third shots would come six months after someone is fully vaccinated with the Pfizer or Moderna vaccine, meaning it’s been two weeks or more since their second dose.
Friday’s unanimous vote by the U.S. Food and Drug Administration’s vaccine advisory committee came after many of the 19 doctors on the advisory committee said Johnson & Johnson should be a two-dose vaccine, like Pfizer and Moderna.
Johnson & Johnson looked at the possibility of offering two doses, but Kim said “there was a lot of pressure to make the distribution of vaccines easier. One dose is always going to be easier,” especially because unlike other COVID-19 vaccines, no special refrigeration is needed.
It’s ultimately up to federal regulators to decide who gets booster shots but they typically agree with the advisory committee. The recommendations on the Moderna and Johnson & Johnson boosters goes next to the FDA, and then to an advisory panel to the Centers for Disease Control and Prevention, and finally, to the head of the CDC.
A final decision could come as soon as next week.
Booster shots must be the same type of vaccine as originally received under the guidelines set by the CDC that are followed by Utah and much of the rest of the United States, although San Francisco as well as other countries allow residents to get a different vaccine as a booster shot.
What’s known as “mixing and matching” vaccines was discussed by the advisory committee Friday, but no vote was taken. A National Institutes of Health study released this week showed Pfizer and especially Moderna booster shots produced more benefits than a second shot of Johnson & Johnson.
Dr. Peter Marks, head of the U.S. Food and Drug Administration’s vaccine office, said before the advisory committee’s vote it was “possible” Johnson & Johnson recipients would be able to get another vaccine as a booster but gave no timeline.
Marks also said the issue of whether Johnson & Johnson should be a two-dose vaccine would be taken under advisement.
Dr. Tamera Sheffield, medical director of preventive medicine for Intermountain Healthcare, said the advisory committee’s discussion “left some items open for decision by the FDA that will not be clear” until revisions are formally issued for the vaccine’s emergency use authorizations.
Sheffield said in addition to raising the possibility of using a different vaccine brand for a booster dose, the advisory committee also expressed interest in lowering the age recommendation for Pfizer and Moderna booster doses to 40 or 50 years old.
The doctor with the region’s largest health care provider said Utahns who got a Johnson & Johnson COVID-19 shot should be ready to roll up their sleeves.
“What is clear is that a second dose of the J&J vaccine provides much higher efficacy at 94% than just one dose, similar to the efficacy of the other two-dose COVID vaccines,” she said. “Those who have received a first dose should receive a second dose of vaccine once the FDA and CDC recommendations are finalized.”