Additional Covid vaccine recommended for more adults, mix & match allowed for boosters

American Heart Association

Late yesterday, the U.S. Centers for Disease Control and Prevention (CDC) extended recommendations for a booster dose of COVID-19 vaccines for adults who received the Moderna and Johnson & Johnson COVID-19 vaccines. The new recommendation also allows “mixing & matching” of the types of COVID-19 vaccines for the booster dose. They may select an additional COVID-19 vaccine dose from any of the three COVID-19 vaccines authorized or approved in the U.S. – either the Moderna, Pfizer-BioNTech or Johnson & Johnson COVID-19 vaccines. The mix & match regimen is available only for booster doses of the COVID-19 vaccines, not for the primary vaccination series, which still requires the same, initial two doses of either the Moderna or Pfizer BioNTech COVID-19 vaccine.[1]

A booster of either the Moderna or Pfizer-BioNTech COVID-19 vaccine (mRNA vaccines) is recommended, at least 6 months after the two-dose same-vaccine series, for adults ages 65 and older who are immunocompromised or who live in an assisted-living or long-term care facility. Adults 18 and older who are at increased risk of exposure to COVID-19 at work as a first-responder, health care professional, teacher or other frontline worker may receive a booster dose of either the Moderna or the Pfizer-BioNTech COVID-19 vaccine, at least 6 months after receiving two-doses of the same mRNA COVID-19 vaccine.[2]

Adults ages 18 and older who previously received one dose of the Johnson & Johnson COVID-19 vaccine (an adenovirus vector vaccine) are eligible for a booster dose two months after the initial dose. They may select a second dose of the Johnson & Johnson COVID-19 vaccine or a booster dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccines.[3]

These recommendations follow Wednesday’s announcement from the U.S. Food and Drug Administration (FDA) amending the emergency use authorization of the Moderna COVID-19 vaccine and the Johnson & Johnson COVID-19 vaccine, and to allow “mixing & matching” of COVID-19 vaccine booster shots.[4]

The American Heart Association/American Stroke Association, a global force for longer, healthier lives for all, supports the new recommendations from the CDC. The Association remains concerned about the continuing gaps in COVID-19 vaccination among people from all eligible age groups in the U.S., more than 65 million Americans[5], including people from diverse racial and ethnic groups and among pregnant women. Therefore, we continue to urge all adults and children ages 12 and older in the U.S. to receive a COVID-19 vaccine as soon as they can, as recommended by the CDC and fully approved or authorized for emergency use by the FDA.

The following statement reflects the views of the American Heart Association/American Stroke Association and its science leaders:

  • President Donald Lloyd-Jones, M.D., Sc.M., FAHA,
  • Immediate Past President Mitchell S.V. Elkind, M.D., M.S., FAHA, FAAN,
  • President-Elect Michelle A. Albert, M.D., M.P.H., FAHA,
  • Chief Science and Medical Officer Mariell Jessup, M.D., FAHA, and
  • Chief Medical Officer for Prevention Eduardo Sanchez, M.D, M.P.H., FAHA, FAAFP.

“As recommended and allowed by the CDC and authorized by the FDA, we urge all adults who are eligible to receive a COVID-19 vaccine booster dose if appropriate according to their individual health risks. The CDC’s new recommendations are for an additional COVID-19 vaccine dose for adults, specifically as follows:

  • For adults who initially received two doses of either the Pfizer-BioNTech or the Moderna COVID-19 vaccines at least 6 months ago, the following adults are eligible for a booster dose and based on individual risks:
    • Adults ages 65 and older
    • Adults ages 18 and older who reside in an assisted-living or long-term residence
    • Adults ages 18 and older who have underlying medical conditions that increase the risk of severe COVID-19 infection
    • Adults ages 18 and older who work or live in high-risk settings, such as health care professionals, first responders, teachers or frontline workers

They may select a booster dose of either the Pfizer-BioNTech, Moderna or Johnson & Johnson COVID-19 vaccine, in the mix & match approach for booster shots.

  • For all adults ages 18 and older who initially received one dose of the Johnson & Johnson COVID-19 vaccine and received it at least 2 months ago:
  • They may select either a second dose of the Johnson & Johnson COVID-19 vaccine,

or

  • They may select a booster dose of the Moderna COVID-19 vaccine or the Pfizer-BioNTech COVID-19 vaccine.

“Recently published research of the mix & match approach to the COVID-19 vaccines booster doses, reviewed by the FDA and CDC, revealed strong immune response after an additional COVID-19 vaccine booster dose regardless of which COVID-19 vaccine was originally received.[6] Please consult with a health care professional if you have any questions about whether a booster dose of a COVID-19 vaccine is appropriate for you or a loved one.

“We continue to recommend that all adults and children ages 12 and older in the U.S. receive the COVID-19 vaccine as soon as they can. The CDC’s nationwide tracking of COVID-19 hospitalizations and deaths in the U.S. found that in August 2021, people who were unvaccinated had a 6.1 times greater risk of COVID-19 infection and an 11.3 times higher risk of death from COVID-19.[7]

“The Association continues to support the CDC’s ongoing safety recommendations: mask wearing for all people regardless of vaccination status when indoors, frequent handwashing and social distancing. These protocols along with full COVID-19 vaccination are essential to minimizing the spread of the COVID-19 virus.

“The COVID-19 vaccines are highly effective and fundamental to saving lives, protecting our families and loved ones against COVID-19, and ending the COVID-19 pandemic.”

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