I got J&J. Which booster should I get?


A: First of all, there is no question that you SHOULD get a booster. As for which one, either of the mRNA vaccines is recommended for nearly everyone who got J&J as their first vaccine.

And if you got J&J and you already got a booster, you may now be eligible for another one–read on for more about this.

As more and more evidence comes out, we learn more about how the different vaccines stack up against one another. Evidence has been slowly accumulating that while J&J’s 1-dose vaccine isn’t a complete failure, the 2-dose mRNA vaccines from Moderna and Pfizer offer better protection. And getting an mRNA booster after you got J&J can improve your immunity.

During Omicron, deaths were 10 times higher among unvaccinated people compared to people who got 2 doses of an mRNA vaccine. Deaths were 4 times higher among people who got the J&J vaccine compared to people who got mRNA. So J&J offered much better protection than nothing, but also not nearly as good as the mRNA vaccine.

Another very nice study just released in preprint (and featured on Nature’s news page, see link below) was the first to compare four brands of COVID vaccines in a head-to-head randomized lab test. Researchers found that the two mRNA vaccines outperformed both J&J and Novavax’s vaccines, even after 6 months.

And a real-world vaccine effectiveness study compared rates of emergency department visits and hospital admissions for four different groups of people: those who had 1-dose of J&J, 2-doses of J&J, three doses of mRNA, and finally people who got 1 J&J dose + 1 mRNA booster. Vaccine effectiveness was considerably better in the mix-and-match group compared to both of the J&J-only groups. In fact, it was comparable to the mRNA-only group. This study was during Omicron.

So here’s the scoop:

🍎 If you have had 1 dose of J&J: you should unquestionably get a booster. CDC now recommends taking Pfizer or Moderna vaccines over J&J for all boosters (unless you are allergic to one of the ingredients).

🍎🍎🍏 If you had J&J and then a J&J booster: you can now get an mRNA booster. 💪 The latest CDC guidance on booster eligibility allows people who have had two doses of J&J to get a third (mRNA) shot.

🍎🍏🍏 If you have had 1 dose of J&J and 1 dose of an mRNA vaccine AND you are either at least 50 years old or you have a high-risk health profile: you can get a second mRNA booster now under the latest CDC guidance for additional booster doses. Figuring out whether you qualify as high risk can be aggravating indeed, so ask your clinician or pharmacist for advice.

🍎🍏 If you have had 1 dose of J&J and 1 dose of an mRNA vaccine, you are not yet 50 years old, and you do not have a high-risk health profile: you’ll have to wait a bit longer for another booster. We’re guessing that this group is a likely to be recommended for another booster in the future, so just be patient.

Who *should* get a J&J shot at this point? It’s only recommended for people who had a severe allergic reaction to the Pfizer or Moderna vaccine or who have a known allergy to the ingredients in them. You can also insist on a J&J vaccine. If you really want to get a J&J booster, you can. It is still a lot better than nothing.

Stay safe and stay sane,
Those Nerdy Girls

KHN Morning Briefing -Omicron Deaths Higher For Those Who Got J&J Than Other Vaccines: CDC Data

Nature – COVID vaccines: head-to-head comparison reveals how they stack up

CDC -Effectiveness of Homologous and Heterologous COVID-19 Booster Doses Following 1 Ad.26.COV2.S (Janssen [Johnson & Johnson]) Vaccine Dose Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults — VISION Network, 10 States, December 2021–March 2022

CDC – COVID-19 Vaccine Boosters

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