https://acpinternist.org/weekly/archives/2021/10/26/1.htm

More booster authorizations, research on vaccine safety and uptake

The FDA and CDC endorsed boosters of the Johnson & Johnson and Moderna vaccines. Recent research showed that COVID-19 vaccination was not associated with miscarriage, and a small financial incentive for receiving a COVID-19 vaccine or providing transportation to a vaccination site increased uptake.


Regulatory agencies endorsed booster doses for more COVID-19 vaccine recipients last week. The FDA gave an emergency use authorization and the CDC made a recommendation for all recipients of the Johnson & Johnson (Janssen) vaccine to get a second dose at least two months after their first dose. A third dose of the Moderna vaccine was authorized and recommended for the same population as the Pfizer vaccine: anyone ages 65 years and older, and those ages 18 to 64 years who have an underlying medical condition or work or live in a high-risk setting. In the same statements, the agencies also authorized mixing and matching of the COVID-19 vaccines—that is, patients can choose to get a booster of a different vaccine from the one they originally received.

A letter published in the New England Journal of Medicine on Oct. 20 supported the safety of vaccination during pregnancy. It compared Norwegian women in early pregnancy (13,956 women with ongoing pregnancies and 4,521 who had miscarriages). About 5% of the women had received a COVID-19 vaccine, and the study found no increased risk of miscarriage in the three or five weeks after COVID-19 vaccination.

Small financial incentives may be helpful to increase uptake of the COVID-19 vaccines, according to a research letter published by JAMA on Oct. 25. A North Carolina program provided a $25 cash card to adults who either received or drove someone to receive their first dose. Vaccination rates increased significantly at the intervention vaccination sites compared to others in the area, and significant proportions of patients reported the cash and the ride being important to their vaccination.

Finally, the NIH's treatment guidelines panel made a number of updates to its advice on COVID-19 care. The updates address postexposure prophylaxis, complications of COVID-19, and treatment with monoclonal antibodies, interleukin-1 and -6 inhibitors, and kinase inhibitors, among other topics.