Where Things Stand on Boosters for Three Vaccines in the U.S.
It can be hard to keep track of developments on coronavirus vaccine boosters without a scorecard.
The Food and Drug Administration’s panel of expert advisers voted on Thursday to recommend booster shots for many recipients of the Moderna coronavirus vaccine, and is meeting on Friday to consider boosters for recipients of Johnson & Johnson’s vaccine.
The agency has already authorized booster shots of the other vaccine in use in the United States, from Pfizer-BioNTech, for certain groups who got that vaccine initially. Third doses of the Pfizer-BioNTech and Moderna vaccines also have been authorized for some people with weaker immune systems, who may not have gotten full protection from the original two doses.
All three vaccines initially provide very strong protection against infection, serious illness and death from Covid-19. The impetus for boosters comes from studies suggesting that while that protection remains strong against serious illness and death, it may decline somewhat over time and could allow more breakthrough infections, especially of the highly contagious Delta variant. The decline tends to be most pronounced in older people and those with certain underlying medical conditions.
Here is a rundown of the booster-shot situation for the three vaccines available in the United States.
What you would get: A third full dose, at least six months after your second.
Where it stands in the U.S.: Available now for many people. The F.D.A. has authorized third shots for people over 65, people with certain medical conditions and some others who are at high risk because of where they work or live. (Some immunocompromised people can get a third shot a month after their second.) The agency has put off a decision on whether to authorize boosters for other people.
Where it stands elsewhere: Israel and some other countries are administering Pfizer-BioNTech booster shots widely.
What the science says: The Pfizer-BioNTech vaccine was the first to win full approval in the United States (for those 16 and older), the first to be authorized for some children (those 12 to 15) and the first to be authorized for boosters; the available data on its safety and effectiveness is especially robust. Some studies suggest that the vaccine may decline in effectiveness over time a bit more than the Moderna vaccine.
What you would get: A half-dose, at least six months after your second full dose.
Where it stands in the U.S.: An F.D.A. advisory panel voted on Thursday to recommend Moderna boosters for the same population groups who are now eligible for a Pfizer booster. The panel’s vote is nonbinding, but its recommendations are generally followed by the F.D.A. (Some immunocompromised people can receive a full third dose a month after their second.)
Where it stands elsewhere: Some countries are already offering Moderna booster shots or planning to do so soon.
What the science says: Some studies suggest that the Moderna vaccine’s effectiveness declines less than the other two vaccines available in the United States do. That may mean there is less need for Moderna recipients to get boosters. Taking that into account, an F.D.A. staff report took a neutral stance on Moderna’s booster-shot application.
The State of Vaccine Mandates in the U.S.
- Vaccine rules. On Aug. 23, the F.D.A. granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for mandates in both the public and private sectors. Such mandates are legally allowed and have been upheld in court challenges.
- College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
- Schools. California became the first state to issue a vaccine mandate for all educators and to announce plans to add the Covid-19 vaccine as a requirement to attend school, which could start as early as next fall. Los Angeles already has a vaccine mandate for public school students 12 and older that begins Nov. 21. New York City’s mandate for teachers and staff, which went into effect Oct. 4 after delays due to legal challenges, appears to have prompted thousands of last-minute shots.
- Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get vaccinated. Mandates for health care workers in California and New York State appear to have compelled thousands of holdouts to receive shots.
- Indoor activities. New York City requires workers and customers to show proof of at least one dose of the Covid-19 for indoor dining, gyms, entertainment and performances. Starting Nov. 4, Los Angeles will require most people to provide proof of full vaccination to enter a range of indoor businesses, including restaurants, gyms, museums, movie theaters and salons, in one of the nation’s strictest vaccine rules.
- At the federal level. On Sept. 9, President Biden announced a vaccine mandate for the vast majority of federal workers. This mandate will apply to employees of the executive branch, including the White House and all federal agencies and members of the armed services.
- In the private sector. Mr. Biden has mandated that all companies with more than 100 workers require vaccination or weekly testing, helping propel new corporate vaccination policies. Some companies, like United Airlines and Tyson Foods, had mandates in place before Mr. Biden’s announcement.
Johnson & Johnson
What you would get: A second dose, probably six months after the initial dose.
Where it stands in the U.S.: Awaiting authorization. The F.D.A. advisory panel is meeting on Friday to decide on a recommendation. An F.D.A. staff report found significant shortcomings in the data that the company submitted with its application, but it was not clear whether that would delay a decision.
Where it stands elsewhere: No country has yet recommended administering second doses of the Johnson & Johnson vaccine.
What the science says: The Johnson & Johnson vaccine gives strong initial protection after one dose, though not as strong as the Pfizer or Moderna two-dose vaccines, so there has long been interest in boosters for Johnson & Johnson recipients.