Update to Recommendations Regarding COVID-19 Booster Vaccination

Background

Vaccination with COVID-19 vaccines is one of the most important ways patients can prevent infection, hospitalization, and death from COVID-19. The Pfizer BioNTech COVID-19 vaccine received full FDA approval on August 23, 2021, the Moderna COVID-19 vaccine received full FDA approval on January 31, 2022 and the Janssen COVID-19 vaccine received an Emergency Use Authorization from the FDA on February 27, 2021. As more information is gathered over time about the effectiveness of these vaccines against COVID-19, guidance is updated to provide the maximum protection for patients. Data continue to support the importance of the booster doses of the COVID-19 vaccine in preventing hospitalization and death from COVID-19. According to the CDC, during the omicron surge individuals who had received a booster dose of an mRNA vaccine were 21 times less likely to die from COVID-19 than the unvaccinated and were 7 times less likely to be hospitalized. On March 30, 2022, the CDC updated its COVID-19 vaccine guidance to improve protection for certain patient populations by making available a second booster dose at least four months after the first booster dose.

• Guidance for all Booster Dosing of the mRNA Vaccines
  • Currently the CDC recommends that booster doses be with either of the mRNA vaccines. The Janssen vaccine may be used for the first booster dose in certain situations. The Janssen vaccine is not recommended for the second booster dose.
  • Pfizer BioNTech vaccine (5 years and older):
    • Booster doses have only been approved for ages 12 and older.
    • The Pfizer BioNTech vaccine (ages 12 and older) booster dose is 30mcg which is the same dose as the primary series.
  • Moderna vaccine (18 years and older):
    • The Moderna vaccine (ages 18 and older) booster dose is 50mcg which is half the dose of the primary series.
• Guidance for Moderately to Severely Immunocompromised PatientsPatients with moderately to severely immunocompromising conditions are at higher risk for morbidity and mortality due to COVID-19 and may not mount an adequate immune response to the traditional COVID-19 vaccine series. The following recommendations for this patient population should improve the protection and immune response for immunocompromised patients.
  • The mRNA vaccines (Pfizer BioNTech and Moderna):
  • Moderately to severely immunocompromised patients ages 12 and older who received one of the mRNA vaccines as their primary series and their booster dose may receive a second booster dose of an mRNA vaccine at least 4 months after the first booster dose.
  • Booster doses have only been approved for ages 12 and older.
  • The Pfizer BioNTech vaccine (ages 12 and older) booster dose is 30mcg which is the same dose as the primary series.
  • The Moderna vaccine (ages 18 and older) booster dose is 50mcg which is half the dose of the primary series.
  • The Johnson and Johnson (Janssen) vaccine:
    • Moderately to severely immunocompromised patients ages 18 and older who received the Janssen vaccine as part of their primary series and who received a primary booster dose of either the Jansen vaccine or an mRNA vaccine may receive a second booster dose of an mRNA vaccine at least 4 months after the first booster dose.
  • The Pfizer BioNTech vaccine booster dose is 30mcg which is the same dose as the primary series.
  • The Moderna vaccine booster dose is 50mcg which is half the dose of the primary series.
  • Current CDC recommendations do not support the use of the Janssen vaccine for the second booster dose
• Guidance for a second booster dose for immunocompetent patients who are 50 years of age and older who received an mRNA vaccine as their first booster dose.
  • Patients who are 50 years of age or older may choose to have a second booster dose of an mRNA vaccine at least 4 months after their first booster dose.
    • The Pfizer BioNTech vaccine booster dose is 30mcg which is the same dose as the primary series.
    • The Moderna vaccine booster dose is 50mcg which is half the dose of the primary series.
• Guidance for a second booster dose for immunocompetent patients aged 18-49 years who received Janssen as both their primary series and booster dose.
  • All patients who received the Janssen vaccine for both the primary series and booster dose may receive a second booster dose with an mRNA vaccine at least 4 months after the first Janssen vaccine booster dose.
    • The Pfizer BioNTech vaccine booster dose is 30mcg which is the same dose as the primary series.
    • The Moderna vaccine booster dose is 50mcg which is half the dose of the primary series.

If you have any questions, please call PA DOH at 1-877-PA-HEALTH (1-877-724-3258) or your local health department.