Booster shots simplified: Just like a stoplight, it is either red, yellow, or green.

I have been inundated with questions on the booster vaccines that were approved during the FDA advisory committee this past week. My opinion on COVID-19 vaccine boosters depends on which vaccine you initially got. To simplify the message, I use a traffic light analogy to evaluate the boosters from the three approved vaccines.

Johnson and Johnson:  RED stop and immediately get a booster!

If you got one dose of Johnson and Johnson, then you HAVE to get a booster no matter your age, occupation, or health. As I have said before, this vaccine should never have been approved as a single shot and basically loses most of its inferior protection in six months. The good news is that you can get any vaccine as a booster for the Johnson and Johnson vaccine, and it will work. I personally prefer people get a Pfizer or Moderna booster, and a recent preliminary study suggest that it works better than a second dose of J and J vaccine.

Pfizer:  YELLOW proceed with caution.

According to the FDA advisory committee, the protection from the Pfizer vaccine decreases minimally over six months, but still protects against severe infection or hospitalization. If you got both doses of the Pfizer vaccine and are young and healthy, you don’t need a booster. But if you are over 65, immune compromised, or at occupationally high risk, you probably should get a booster. You do not need to check antibody levels, which do not give an accurate idea of remaining immunity anyway. Just wait six months after your second dose and then get a third. And the side effects appear no different from the first two shots.


Moderna:  GREEN, good to go and no rush for an additional shot. 

The immunity from the Moderna vaccine seems longer lasting than Pfizer, probably because it was given at three times the dose.  The FDA advisory panel supported a booster of this vaccine for the same at risk groups as Pfizer, but the data was less compelling and the dose was only half of the prior shots. So while there will be the offer of a booster, unless you have significant immune problems (cancer of the blood system or organ transplant), you are good to go and do not have to worry about protection. You are the most fortunate of the vaccinated!

Hope this helps. Really feel the MRNA vaccines look most effective and safe right now, either as primary vaccines or boosters.

Published by jbakerjrblog

Immunologist, former Army MD, former head of allergy and clinical immunology at University of Michigan, vaccine developer and opinionated guy.

7 thoughts on “Booster shots simplified: Just like a stoplight, it is either red, yellow, or green.

  1. Do you know where a J&J person can get the Moderna or Pfizer shot? I live in Northern MI and they said that until the CDC approves it, they won’t give the mRNA to a J&J person!

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  2. Just for the record – I have RA and the third Pfizer shot kicked it into high gear. I’m now on massive steroids.

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  3. Thank you for this information! Is there any research or data on the effects of repeated MRNA vaccine doses over time?

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  4. Earlier this year, it was stated that mRNA vaccines could be updated to be more effective against variants and rolled out in ~6weeks if needed. It’s still not clear to me why this didn’t appear to happen to address Delta variant. Any info on this?

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