Regulators Sign Off on COVID-19 Vaccine ‘Mix and Match’

By Jonathan Springston, Editor, Relias Media

Two key agencies have issued additional information on COVID-19 booster shots, including who should seek those doses and when.

First, the FDA amended the emergency use authorizations for the Moderna, Johnson & Johnson, and Pfizer-BioNTech solutions. For Moderna, people age 65 years and older, those age 18 through 64 years at high risk of contracting severe COVID-19, and those age 18 through 64 years with frequent institutional or occupational exposure to the virus may seek a single booster shot at least six months after completing the primary course.

For Johnson & Johnson, the one vaccine that requires only a single dose, the FDA says people age 18 years and older may take a second dose of this solution at least two months after receiving the first. For Pfizer-BioNTech, people age 18 through 64 years with frequent institutional or occupational exposure to COVID-19 may take another dose of this vaccine at least six months after completing the primary course.

Interestingly, the FDA supports a “mix and match” approach for these boosters in the eligible populations. For example, if an eligible patient received two doses of the Pfizer-BioNTech vaccine during their primary course, the booster does not necessarily have to be the Pfizer-BioNTech shot.

One day later, the CDC issued its own statement of support for this booster strategy, including the mix and match approach.

“We believe the FDA’s authorization and the CDC's recommendations in support of booster doses, including the flexibility to mix and match products, will help provide continued protection against COVID-19 for those who need it most. The balance of benefits and risks for booster doses varies, and we encourage those who have questions to reach out to their physician or vaccine provider,” Susan Bailey, immediate past president of the American Medical Association, said in a statement.

In September, there was some behind-the-scenes confusion at the CDC as agency panelists debated and discussed booster shots, as reported in the November issue of Hospital Infection Control & Prevention. For much more Relias Media coverage of the COVID-19 pandemic, please click here.