The single best tool in our COVID-19 public health toolbox is vaccination.
Currently, more than 190 million Americans are fully vaccinated, representing 57.5% of the U.S. population. Meanwhile, the range of COVID-19 options is increasing.
Late last week, after authorization by the Food and Drug Administration and comprehensive scientific review by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, the CDC approved use of booster doses for many primary vaccine recipients of Moderna’s COVID-19 vaccine and all those who have received a Janssen (Johnson and Johnson) COVID-19 vaccine. This comes after action last month to approve booster doses for many primary vaccine recipients of the Pfizer/BioNTech vaccine.
In addition, regulators approved the so-called mix-and-match strategy for booster doses. Mix-and-match, also known as heterologous vaccination, means that anyone eligible to receive a COVID-19 booster may receive any of the three available vaccines (Pfizer/BioNTech, Moderna or Janssen) for their booster dose. This was based on data from a National Institutes of Health clinical trial that demonstrated a strong antibody response following this mix-and-match vaccine approach.
Booster eligibility is based on the primary vaccine series as well as age and risk-based factors. For eligible at-risk people who received a two-dose series of an mRNA vaccine (Pfizer/BioNTech or Moderna), a booster dose of any available COVID-19 vaccine may be administered six months later to boost immunity.
Risk groups include people 65 and older or those living in a long-term care setting, people 18 to 64 with an underlying medical condition, and people at increased risk of transmission because of an occupational or institutional setting.
All adults who received a Janssen vaccine are eligible to receive a booster dose of any available COVID-19 vaccine beginning at least two months later.
People with moderate to severe immune compromise who received either a Pfizer/BioNTech or Moderna vaccine have been eligible for a third dose of that vaccine since the summer. Those people are also now eligible for a booster of any available COVID-19 vaccine beginning six months after that third dose.
Vaccines help to build immunity to infection from the SARS CoV-2 virus (which causes COVID-19), even among those who have been previously infected. Booster doses of vaccines are not unusual. Think of the yearly flu vaccine as one example. A booster dose can help to boost immunity.
Earlier this week, an FDA advisory board recommended Pfizer/BioNTech’s vaccine for use in children ages 5 to 11 years old. If approved, more than 28 million children in this age range would become eligible for vaccination, possibly as early as next week.
Despite the availability of boosters, primary vaccination of people who remain unvaccinated is the most important strategy to reaching community immunity and curbing the pandemic.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.
