J&J vaccine boosters: Who needs one, and when can you get it?

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Johnson & Johnson’s coronavirus vaccine has been fraught with controversy over links to rare but serious side effects (administration of the vaccine was paused briefly in April, but was quickly resumed), and issues with production that led to millions of wasted doses

Partly because of this, and the fact that it came out after the two other coronavirus vaccines available in the US, Moderna and Pfizer, fewer people have received the one-dose Johnson & Johnson coronavirus vaccine — about 14.5 million people are fully vaccinated with Johnson & Johnson, according to the Centers for Disease Control and Prevention, compared to the over 165 million people who are fully vaccinated with either Moderna or Pfizer. 

But 14.5 million people is a lot of people, and officials have left them largely empty-handed when it comes to a timeline on when they’ll need a booster. When the Food and Drug Administration authorized an additional dose of COVID-19 vaccine for certain people with immunocompromising conditions, it did so only for Pfizer and Moderna, and only for those who were initially vaccinated with either shot. And while it’s likely more people currently eligible for a booster or extra shot received Pfizer or Moderna, because those vaccines were available earlier in the pandemic, it still leaves some questions unanswered.

Whether you got Johnson & Johnson because you took health officials’ advice and got the first coronavirus vaccine available to you, because a fear of needles made the one-dose regimen a better option for you, or another reason, here’s what we know about when you could get a booster.

Read more: Pfizer COVID booster shot still up in the air: The latest on eligibility after an FDA vote

I’m immunocompromised and got the Johnson & Johnson shot. Can I get an mRNA booster? 

An extra dose of an mRNA vaccine (Moderna or Pfizer) is only recommended by the CDC, and authorized by the FDA, for people who got fully vaccinated with either vaccine — it is not recommended for immunocompromised people who received a Johnson & Johnson shot. This is because, according to the CDC, “There is not enough data at this time to determine whether immunocompromised people who received the Johnson & Johnson’s Janssen COVID-19 vaccine also have an improved antibody response following an additional dose of the same vaccine.” That is, fewer people got Johnson & Johnson, so the available data on a third dose’s benefits for immunocompromised folks centers on those who got shots of Pfizer or Moderna.

However, there are many experts who disagree with the CDC and FDA’s stall on waiting for more data when it comes to those more vulnerable to severe COVID-19 who received Johnson & Johnson. Research shows that, while still protective against hospitalization and death caused by COVID-19, viral vector vaccines like Johnson & Johnson and AstraZeneca are likely less effective than mRNA vaccines, which affects certain folks in the US more than others. 

In an editorial for The Washington Post on why public health agencies should allow Johnson & Johnson recipients to receive a dose of mRNA vaccine, physician and CNN medical analyst Dr. Leana Wen wrote: “This isn’t a one-size-fits-all recommendation, but rather an individualized decision based on people’s medical circumstances and exposures.”

While a healthy younger person is probably adequately protected with Johnson & Johnson, someone who is severely immunocompromised is “likely not optimally protected by the J&J,” Wen said, and the unknown risks of mixing vaccine types is “almost certainly” outweighed by the risks of severe COVID-19. 

There may be some local exceptions: If you live in San Francisco and received Johnson & Johnson, you can get a dose of Pfizer or Moderna. However, the city’s health department stresses this is not a recommendation or change in policy, but an “accomodation” for Johnson & Johnson recipients who’ve asked their physicians about receiving a dose of mRNA vaccine.


If or when boosters become a reality in the US, it’s unclear how that will change the CDC’s definition of “fully vaccinated,” or how that will vary based on the type of vaccine you received. 

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Will everyone who got J&J eventually get a booster? When? 

For the vast majority of people, the jury is out. Biden administration health officials say that they do expect Johnson & Johnson recipients will need a booster, but they’re waiting on more information. (It’s worth noting that the booster timeline for the general adult population who received mRNA vaccines is also up in the air right now.) 

At the end of last month, Johnson & Johnson said a second dose of its vaccine elicited an antibody response that’s nine times higher than 28 days following a single dose (which isn’t shocking news to many public health experts, given that many vaccines are most effective when given in multiple doses). But at the moment, there’s no timeline as to when the FDA will authorize an extra dose or booster of Johnson & Johnson.

So instead of asking their physician to go against public health guidance, or lying about vaccination status, people who received Johnson & Johnson should be able to get another dose, especially if they’re at risk of severe disease from COVID-19, some argue.

Read more: Moderna’s COVID-19 booster vaccine: Approval status, who would get it and more

When boosters for J&J become available, will it be another dose of J&J or a dose of mRNA vaccine?

It is likely that the FDA might authorize a second dose of Johnson & Johnson, making it a two-dose vaccine, before it authorizes Johnson & Johnson recipients to get a shot of Pfizer or Moderna. This is because it appears studies being done on an additional dose of J&J are further along than studies being done to test mRNA vaccines in people who initially received Johnson & Johnson. And while many public health experts believe this “mix and match” approach will be safe, researchers and scientists need to conclude that the benefits of receiving two types of coronavirus vaccine outweigh any potential risks before they authorize or recommend people do it. 

But in this pandemic, new information emerges daily and scientific opinion changes accordingly. When there’s news about the fate of Johnson & Johnson, we will update this story.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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