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Which Booster Should You Get If You Received a Johnson & Johnson Vaccine?

Johnson & Johnson booster vial with cape

Jessica Olah / Verywell

Key Takeaways

  • According to the CDC, mRNA boosters are recommended for those who received the single-dose Johnson & Johnson shot as their initial COVID-19 vaccine.
  • A new study found that an mRNA booster provided more protection against emergency department visits compared to a second Johnson & Johnson vaccine shot.
  • Anyone who received the Johnson & Johnson vaccine for their primary and booster dose can get an mRNA vaccine as a second booster shot.

COVID-19 vaccines are highly effective at preventing infection or severe illness, however, this protection wanes over time. To improve vaccine-induced immunity, the Centers for Disease Control and Prevention (CDC) recommends that every vaccinated individual at least 12 years and older get a COVID-19 booster after completing their primary vaccination series.

Here’s what booster you should get if you initially got vaccinated with Johnson & Johnson.

Which COVID-19 Booster Is Recommended? 

According to the CDC, Pfizer-BioNTech or Moderna COVID-19 vaccine boosters are preferred for individuals who received the single-dose Johnson & Johnson shot.

“Individuals 18 years and older who received one dose of the Johnson & Johnson COVID-19 vaccine should get a booster dose,” William Moss, MD, executive director of the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health, told Verywell. “The CDC states that an mRNA vaccine booster is preferable because evidence suggests this provides better protection.” 

The Johnson & Johnson vaccine can also raise the risk of serious health effects, such as thrombosis with thrombocytopenia syndrome (TTS). Experts stress that the mRNA vaccines are safer and provide better protection. 

“While all vaccines help to decrease the risk of possible hospitalization, the mRNA vaccines can provide broader protection against different variants when compared to the Johnson & Johnson vaccine alone,” Carl Lambert, Jr., MD, family physician and assistant professor of family medicine at the Rush University Medical Center, told Verywell.

A recent study published by the CDC found that Johnson & Johnson vaccine recipients who received an mRNA booster had higher protection against emergency department or urgent care visits (79%) compared to those who had two doses of the Johnson & Johnson vaccine (54%). The protection conferred by receiving different types of vaccines was nearly the same as that of three mRNA doses (83%).

Three mRNA doses had the highest effectiveness against hospitalizations (90%) compared to one Johnson & Johnson shot and an mRNA booster (78%) or two doses of the Johnson & Johnson vaccine (67%).

“From a health equity perspective, we absolutely want patients to get vaccinated against COVID-19 regardless of which vaccine people might choose to receive,” Lambert said. “However, if we are talking about patients that are higher risk, like those of older age or those that are immunocompromised, then the mRNA booster is highly suggested.”

What This Means For You

If you received the Johnson & Johnson vaccine for your primary vaccine dose experts recommend you get an mRNA booster shot. If you received the Johnson & Johnson vaccine for your primary and booster dose you can get an mRNA vaccine as a second booster shot.

Is a Second mRNA Booster Necessary?

Not everyone is currently eligible for a second booster shot.

"A second mRNA [booster] vaccine is not necessary for everyone, and one has to weigh one’s risk of exposure, risk of getting severe COVID-19 if infected, and likelihood of responding to a second booster dose,” Moss said. “Only some people are currently eligible to receive a second booster dose.”

According to the CDC, anyone who received the Johnson & Johnson vaccine for their primary and booster dose can get a second booster shot.

In addition, adults aged 50 years and older who got the Johnson & Johnson vaccine for their primary dose can get a second booster, no matter which brand they got as their first booster. Their second booster dose must always be an mRNA vaccine. 

“There are certain populations where [a second booster] is highly recommended, and that currently includes patients over the age of 50 or those who have underlying medical conditions that could predispose them to severe COVID-19 infections or hospitalizations,” Lambert said.

Recipients of the Johnson & Johnson vaccine who are moderately or severely immunocompromised can get their second booster shot with an mRNA vaccine about four months after this first booster, making it their fourth vaccine dose overall.

“My personal view is that all recipients of the Johnson & Johnson COVID-19 vaccine should receive a second mRNA booster regardless of the type of first booster, based on the estimates of vaccine effectiveness in the CDC study cited above,” Moss said.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. COVID-19 vaccine boosters.

  2. Centers for Disease Control and Prevention. Johnson & Johnson’s Janssen COVID-19 vaccine: overview and safety.

  3. Natarajan K, Prasad N, Dascomb K, et al. Effectiveness of homologous and heterologous COVID-19 booster doses following 1 Ad.26.COV2.S (Janssen [Johnson & Johnson]) vaccine dose against COVID-19–associated emergency department and urgent care encounters and hospitalizations among adults — VISION network, 10 states, December 2021–March 2022. MMWR Morb Mortal Wkly Rep. 2022;71(13):495–502. doi:10.15585/mmwr.mm7113e2

  4. Centers for Disease Control and Prevention. COVID-19 vaccines for moderately or severely immunocompromised people.