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March 30, 2022

National study finds that any booster strategy is more effective than single J&J vaccine to prevent moderate to severe COVID-19

National study finds that any booster strategy is more effective than single J&J vaccine to prevent moderate to severe COVID-19

A new nationwide study from the U.S. Centers for Disease Control and Prevention comparing booster strategies for the millions of people who have received Johnson and Johnson (J&J) vaccines, provides strong evidence that boosters following vaccination with the J&J vaccine are effective in protecting against hospitalizations from COVID-19.

“We found that any booster strategy is better than a single J&J dose, which should encourage anyone who has only had a J&J vaccine to get a second COVID-19 vaccine as soon as possible, especially before the expected next surge in COVID,” said Brian Dixon, PhD, MPA, of the Regenstrief Institute and Indiana University Richard M. Fairbanks School of Public Health, who is the senior author on the CDC study. “Individuals with three doses of mRNA had the strongest level of protection against severe consequences from the disease, but being boosted made a significant difference in protection for those who had J&J vaccines.”

Vaccine effectiveness against COVID-19-associated emergency department and urgent care visits was only 24 percent after one J&J vaccine. It increased to 54 percent after two J&J doses, and 79 percent after one J&J dose plus an mRNA booster. That’s compared to 83 percent after three mRNA doses.

Vaccine effectiveness for the same strategies against COVID-19 associated hospitalizations was 31 percent for the single J&J shot, 67 percent for two J&J shots, 78 percent for one J&J shot and an mRNA booster, and 90 percent for three mRNA doses.

“Even though our study focused on booster effectiveness during the period of Omicron prevalence, data continue to show that we should expect that boosters will be effective against new variants as they emerge,” said Dr. Dixon. “This paper reinforces the importance of getting boosted. It’s important to do it now when rates of disease are low, so you are protected against the resurgence that we expect to see later this year, especially among individuals in high-risk groups.”

The study was conducted by the CDC’s VISION Network which includes, in addition to the Regenstrief Institute (Indiana), Baylor Scott & White Health (Texas), Columbia University Irving Medical Center (New York), HealthPartners (Minnesota and Wisconsin), Intermountain Healthcare (Utah), Kaiser Permanente Northern California (California), Kaiser Permanente Northwest (Oregon and Washington) and University of Colorado (Colorado).

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” is published in the CDC’s Morbidity and Mortality Weekly Report.

Regenstrief Institute authors of the study, in addition to Dr. Dixon, are Regenstrief Institute Vice President for Data and Analytics and IU School of Medicine Professor of Family Medicine Shaun Grannis, M.D., M.S.; William F. Fadel, PhD; Nimish Ramesh Valvi; and Peter J. Embi, M.D., M.S., former Regenstrief president, and a current affiliate scientist.

All authors on this paper are Karthik Natarajan, PhD, Department of Biomedical Informatics, Columbia University Irving Medical Center, New York-Presbyterian Hospital; Namrata Prasad, PhD, CDC COVID-19 Emergency Response Team, Epidemic Intelligence Service, CDC; Kristin Dascomb, M.D., Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare; Stephanie A. Irving, MHS, Center for Health Research, Kaiser Permanente Northwest; Duck-Hye Yang, PhD, Westat; Manjusha Gaglani, MBBS, Baylor Scott & White Health, Texas A&M University College of Medicine; Nicola P. Klein, M.D., Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research; Malini B. DeSilva, M.D., HealthPartners Institute; Toan C. Ong, PhD, School of Medicine, University of Colorado Anschutz Medical Campus; Shaun J. Grannis, M.D., Center for Biomedical Informatics, Regenstrief Institute, Indiana University School of Medicine; Edward Stenehjem, M.D., Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare; Ruth Link-Gelles, PhD, CDC COVID-19 Emergency Response Team; Elizabeth A. Rowley, DrPH, Westat; Allison L. Naleway, PhD, Center for Health Research, Kaiser Permanente Northwest; Jungmi Han, Department of Biomedical Informatics, Columbia University Irving Medical Center; Chandni Raiyani, MPH, Baylor Scott & White Health; Gabriela Vazquez Benitez, PhD, HealthPartners Institute; Suchitra Rao, MBBS, School of Medicine, University of Colorado Anschutz Medical Campus; Ned Lewis, MPH, Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research; William F. Fadel, PhD, Center for Biomedical Informatics, Regenstrief Institute, Fairbanks School of Public Health, Indiana University; Nancy Grisel, MPP, Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare; Eric P. Griggs, MPH, CDC COVID-19 Emergency Response Team; Margaret M. Dunne, M.S.c, Westat; Melissa S. Stockwell, M.D., New York-Presbyterian Hospital, Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, Department of Population and Family Health, Columbia University Mailman School of Public Health; Mufaddal Mamawala, MBBS, Baylor Scott & White Health; Charlene McEvoy, M.D., HealthPartners Institute; Michelle A. Barron, M.D., School of Medicine, University of Colorado Anschutz Medical Campus; Kristin Goddard, MPH, Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research; Nimish R. Valvi, DrPH, Center for Biomedical Informatics, Regenstrief Institute; Julie Arndorfer, MPH, Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare; Palak Patel, MBBS, CDC COVID-19 Emergency Response Team; Patrick K. Mitchell, ScD, Westat; Michael Smith, Baylor Scott & White Health; Anupam B. Kharbanda, M.D., Children’s Minnesota; Bruce Fireman, Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research; Peter J. Embí, M.D., formerly of Center for Biomedical Informatics, Regenstrief Institute, Vanderbilt University Medical Center; Monica Dickerson, CDC COVID-19 Emergency Response Team; Jonathan M. Davis, PhD, Westat; Ousseny Zerbo, PhD, Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research;  Alexandra F. Dalton, PhD, CDC COVID-19 Emergency Response Team; Mehiret H. Wondimu, MPH, CDC COVID-19 Emergency Response Team; Eduardo Azziz-Baumgartner, M.D., CDC COVID-19 Emergency Response Team; Catherine H. Bozio, PhD, CDC COVID-19 Emergency Response Team; Sue Reynolds, PhD, CDC COVID-19 Emergency Response Team; Jill Ferdinands, PhD, CDC COVID-19 Emergency Response Team, Jeremiah Williams, MPH, CDC COVID-19 Emergency Response Team; Stephanie J. Schrag, DPhil, CDC COVID-19 Emergency Response Team; Jennifer R. Verani, M.D., CDC COVID-19 Emergency Response Team; Sarah Ball, ScD, Westat; Mark G. Thompson, PhD, CDC COVID-19 Emergency Response Team; Brian E. Dixon, PhD, Center for Biomedical Informatics, Regenstrief Institute, Fairbanks School of Public Health, Indiana University.

About Brian E. Dixon, PhD, MPA

In addition to his role as Regenstrief Institute and Indiana University Richard M. Fairbanks School of Public Health director of public health informatics, Brian E. Dixon, MPA, PhD, is a research scientist at Regenstrief and an associate professor of epidemiology at the Fairbanks School of Public Health, located on the IU campuses at Indianapolis and Fort Wayne. He is also an affiliate scientist at the U.S. Department of Veterans Affairs Health Services Research and Development Center for Health Information and Communication, Richard L. Roudebush VA Medical Center.

About Regenstrief Institute

Founded in 1969 in Indianapolis, the Regenstrief Institute is a local, national and global leader dedicated to a world where better information empowers people to end disease and realize true health. A key research partner to Indiana University, Regenstrief and its research scientists are responsible for a growing number of major healthcare innovations and studies. Examples range from the development of global health information technology standards that enable the use and interoperability of electronic health records to improving patient-physician communications, to creating models of care that inform practice and improve the lives of patients around the globe.

Sam Regenstrief, a nationally successful entrepreneur from Connersville, Indiana, founded the institute with the goal of making healthcare more efficient and accessible for everyone. His vision continues to guide the institute’s research mission.

About the Richard M. Fairbanks School of Public Health

Located on the IU campuses at Indianapolis and Fort Wayne, the Richard M. Fairbanks School of Public Health is committed to advancing the public’s health and well-being through education, innovation and leadership. The Fairbanks School of Public Health is known for its expertise in biostatistics, epidemiology, cancer research, community health, environmental public health, global health, health policy and health services administration.

  • Dr. Brian Dixon

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