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2nd COVID-19 vaccine booster for older adults: What doctors must know

What’s the news: The Food and Drug Administration (FDA) authorized a second booster dose of either the Pfizer-BioNTech or Moderna COVID-19 mRNA vaccines for people over 50 and for certain people with compromised immune systems, which may be administered four months after receiving an initial booster dose. The Centers for Disease Control and Prevention (CDC) followed suit with a recommendation that these people may receive a second booster dose.

The CDC is recommending that adults who got the J&J vaccine for their primary series and booster dose at least four months ago may now receive a second booster dose of an mRNA COVID-19 vaccine.

The move is based on newly published data from its tracking network of COVID-19 related emergency department visits and hospitalizations in 10 states. For COVID-19 patients in the network hospitals, vaccine effectiveness against COVID-19 related hospitalization was 54% after two Janssen doses. That compares with 79% for one Janssen and one mRNA dose, and 83% for three mRNA doses.

The CDC’s action is commonly known as a “permissive recommendation,” meaning that certain people may get the second booster if they wish to get it, though the agency itself is not yet officially urging them to do so.

The news comes as the CDC reported that the highly transmissible SARS-CoV-2 BA.2 Omicron subvariant now accounts for more than half of cases in the U.S. The FDA said it had determined that the known and potential benefits of a second COVID-19 vaccine booster dose with either of these vaccines outweigh their known and potential risks in these populations.

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