If you got a double dose of the Moderna COVID-19 vaccine or the single shot made by Johnson&Johnson (J&J) earlier this year, you're likely on edge these days, wondering when it will be your turn to get a booster. It's been a month since the U.S. Food and Drug Administration's (FDA) advisory committee voted unanimously to recommend the emergency use authorization (EUA) of a booster dose from Pfizer, which was the first of the three COVID-19 vaccines in the U.S. to submit its necessary paperwork. Less than a week later, the Centers for Disease Control and Prevention's (CDC) advisory committee met and then it only took a day for CDC director Rochelle Walensky, MD, to endorse the recommendation. Ever since, eligible Pfizer recipients have been lining up to get their boosters, but the message has been clear to those who got one of the other two COVID-19 vaccines—don't try to wiggle your way into the queue for a Pfizer booster; wait your turn to boost with the original vaccine you received. Now, however, we finally have a solid idea of what the booster timeline looks like for those who got Moderna or Johnson&Johnson. Read on to find out when it'll finally be your turn!
Moderna and Johnson&Johnson recipients will likely be able to get boosters by the end of October.
Reuters reports CDC's Advisory Committee on Immunization Practices (ACIP) will meet on Oct. 20 and Oct. 21 to make recommendations on booster doses of the Moderna and Johnson&Johnson COVID-19 vaccines. That's a week after the FDA committee will meet to discuss the need for boosters of the two vaccines, on Oct. 14 and Oct. 15.
It's similar to the schedule with the Pfizer booster's EUA: the FDA board met on Sept. 17 to review Pfizer's data, then the CDC's ACIP met on Sept. 23 to provide its guidance, and the next day, on Sept. 24, Walensky endorsed the committee's guidance, but added two other eligible categories of people who could get a Pfizer booster. That means, if all goes similarly with Moderna and Johnson&Johnson, the CDC director could endorse boosters by Oct. 22.
"So Oct. 14, the FDA advisory committee will start considering Moderna boosters," Allison Arwady, MD, MPH, Chicago Department of Public Health Commissioner, told a local NBC News outlet. "A week or two after that we should have guidance for people who got Moderna as their first series and similarly J&J probably. … Before the end of October, I would expect that we would have guidance."
The boosters will likely be eligible for select groups six months after their initial shots.
Of course, many questions remain—like how long will you have to wait between your first shots and your booster, and who will be eligible to receive them? To answer the latter question, in the case of Pfizer, is U.S. adults 65 and older, residents in long-term care settings, people under 65 with underlying medical conditions, and people in high-risk occupational and institutional settings (like healthcare workers or people in prisons). But it remains to be seen who will be eligible for the Moderna and Johnson&Johnson boosters.
As for the timeline, however, it seems likely the Moderna booster and Johnson&Johnson booster will follow the recommendations for the Pfizer vaccine, which is that recipients must wait at least six months after their last initial dose in order to get a booster. Like Pfizer, Moderna also tested its boosters on recipients after six months. "Neutralizing antibody titers had waned significantly prior to boosting at approximately 6 months," the company said in a statement announcing the booster data had been submitted for FDA EUA approval. "A booster dose of [Moderna] at the 50 µg dose level boosted neutralizing titers significantly."
Johnson&Johnson announced the results of its Phase 3 trial data in September, including information on boosters, and then filed for EUA with the FDA on Oct. 5. The company found that when given at six months, its booster yielded a 12-fold increase in antibodies. "Our clinical program has found that a booster of our COVID-19 vaccine increases levels of protection for those who have received our single-shot vaccine to 94 percent. We look forward to our discussions with the FDA and other health authorities to support their decisions regarding boosters," Mathai Mammen, MD, PhD, global head of research and development for Johnson&Johnson, said in a statement.
The dose of the Moderna booster may be half of the original.
As research has shown recently, even the two mRNA vaccines, Pfizer and Moderna, do not function exactly the same. Studies have found that protection from COVID-19 with the Moderna vaccine doesn't wane as quickly as it seems to with Pfizer. A Sept. 24 study from the CDC found that the Moderna vaccine was still 93 percent effective at preventing hospitalization among adults who weren't immunocompromised in the U.S. amid the Delta surge from March to August; meanwhile, Pfizer and Johnson&Johnson's vaccines had dropped to 88 and 71 percent, respectively.
All of this is to say, the dosage of the Moderna vaccine may be a bit lower since it's still quite protective. While the Pfizer booster is a true third shot with the same amount of vaccine as the first two, when Moderna submitted data to the FDA seeking evaluation for its booster shot on Sept. 1, it recommended a half-dose booster of 50 µg. "The Moderna initial series was a little bit higher actually than Pfizer and the booster may be a little bit lower, but for adults, for the Pfizer booster, it is the exact same … for the first, the second, and the booster," Arwady told NBC 5 Chicago. (The initial Moderna series was 0.5 mL per shot while Pfizer's was 0.3 mL per dose.)
"We are pleased to initiate the submission process for our booster candidate at the 50 µg dose with the FDA. Our submission is supported by data generated with the 50 µg dose of our COVID-19 vaccine, which shows robust antibody responses against the Delta variant," Moderna CEO Stéphane Bancel said in a statement when the paperwork was submitted.
Side effects for COVID boosters are similar to those from the second shots (or first, in the case of Johnson&Johnson).
For those concerned about side effects—which are expected as your immune system responds to a vaccine—evidence shows that they are similar to those reported after the second dose of Moderna or initial dose of Johnson&Johnson.
In late September, the CDC published a report on boosters that analyzed 22,191 volunteers who completed a survey from the agency on their smartphones after they received three COVID vaccine doses. Among the respondents, 10,453 had gotten three doses of Moderna; 11,209 had gotten three shots from Pfizer; and about 50 had been given two shots of Johnson&Johnson. What they found was that booster side effects were very similar to those after the second dose of the mRNA vaccines: 79.4 percent reported local reactions—meaning isolated to the injection site—after the third dose compared with 77.6 percent who said the same after the second. Meanwhile, 74.1 percent reported systemic reactions to the booster—meaning side effects elsewhere in the body, like fatigue or fever—compared with 76.5 percent after their second dose.
The Johnson&Johnson study subject group was smaller, leading the CDC to write in its report: "The number of registrants who indicated that they received 2 doses of Janssen vaccine … was small, limiting any conclusions." However, in Johnson&Johnson's report on its trial, the company said: "The vaccine, when given as a second dose or booster, remained generally well-tolerated."