FDA approves ‘mix and match’ COVID-19 vaccine booster

key takeaways

  • The FDA has authorized Moderna, Pfizer, and Johnson & Johnson COVID-19 booster doses.
  • People don’t have to get a booster dose of the same brand of vaccine they originally got, the FDA said.


Booster doses were approved by the U.S. Food and Drug Administration (FDA) in October 2021 for eligible individuals who received Moderna or Johnson & Johnson’s COVID-19 vaccine. (The booster for Pfizer vaccine recipients was previously authorized.)

Importantly, however, the booster dose does not have to be the same brand of the original vaccine a person received.In a statement released late Wednesday, the agency said, “Today, the FDA also authorized the use of a heterologous (or ‘mix and match’) booster dose.[s] For currently available (i.e. FDA-authorized or approved) COVID-19 vaccines. ”

The authorization to mix and match boosters is based on clinical trial data from the FDA, Peter Marks, MD, director of the FDA’s Center for Biologics Evaluation and Research, said on a Wednesday night call with reporters after the booster was authorized. The National Institute of Allergy and Infectious Diseases, last week’s discussion of the data by the FDA’s Advisory Committee on Vaccines and Related Biologics, and the agency’s own assessment of the available data.

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Mix and match case

Research on mixing and matching boosters, which has not yet been peer-reviewed, found that any booster dose produced a strong immune response. The booster doses of Pfizer or Moderna produced stronger antibody responses than the booster doses of J&J in people who were originally vaccinated by J&J. For this reason, the Centers for Disease Control and Prevention (CDC) prefers Pfizer’s or Moderna’s vaccine boosters over Johnson & Johnson’s.

Based on these studies and committee and agency discussions, the FDA said in its statement, “A single booster dose of any available COVID-19 vaccine can be administered as a heterologous vaccine. [mix and match] Booster doses after primary vaccination with different available COVID-19 vaccines. ”

For those who initially received Johnson & Johnson

According to the FDA, Johnson & Johnson COVID-19 vaccine recipients 18 years of age and older (the starting age for the current booster dose) can receive a booster dose of the Johnson & Johnson Moderna vaccine (half the dose has been administered at least two days after receiving the primary vaccine from Johnson & Johnson). months, authorized as a booster dose) or the Pfizer vaccine (full dose).

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For those who initially received Pfizer or Moderna

Moderna and Pfizer vaccine recipients who qualify for a booster can receive a booster dose of Moderna, Pfizer or J&J vaccine at least five months after completing their initial vaccination, the agency said.

Acknowledging that both patients and physicians will have questions about authorized boosters, the FDA updated each vaccine’s fact sheet to include booster dosage information.

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CDC signed as follows

The FDA’s decision on booster doses, while important, is actually a temporary step. The next day, an advisory committee from the Centers for Disease Control and Prevention (CDC) also met to discuss the booster dose, eventually agreeing with the FDA’s recommendation.

The CDC Director reviews the ACIP committee’s recommendations, but can revise them. For example, the ACIP committee does not recommend giving Pfizer boosters to people whose jobs put them at higher risk of contracting COVID. But CDC Director Rochelle Walensky, MD, MPH, allows it.


In a call with reporters after the FDA authorized the booster Wednesday, Acting FDA Commissioner Janet Woodcock MD said the agency “expects many people to get the same series they received, but recommends speaking with the provider if an individual has concerns.”

It’s important to check with providers, Woodcock said, “because some people don’t know what vaccines they’ve had or have had a reaction to. [to the vaccine they got], so they want another brand. ”

The FDA’s Peter Marks said on a conference call with reporters that he ultimately believes that if the COVID vaccine continues to be needed, people may get a booster without knowing what brand it is, “like they often do with the flu shot.” like that.”

Aaron Glatt, chief of infectious diseases at Mount Sinai South Nassau, New York, and spokesman for the Infectious Diseases Society of America, told VigorTip that he believes that “once all the [the COVID vaccines] Works just as well, it might get to that point. But Glatter said, “It’s hard to make any predictions about that right now. Much will depend on whether more resistant COVID-19 strains develop, or whether side effects are more likely to be noticed in one vaccine than the other. ”

The information in this article is current as of the date listed, which means that you may have updated information as you read this article. For the latest updates on COVID-19, visit our Coronavirus news page.