San Francisco's Department of Public Health (SFDPH) and Zuckerberg San Francisco General Hospital (ZSFG) on Tuesday announced they will make special accommodations for patients who received a dose of Johnson & Johnson's (J&J) Covid-19 vaccine and wish to receive a "supplemental" shot of either the Pfizer-BioNTech or the Moderna vaccine.

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'We are accommodating requests,' SFDPH official says

SFDPH officials said individuals who have received the J&J vaccine can make a special request to receive a "supplemental dose" of an mRNA vaccine. However, officials stated that this constitutes a special accommodation—not a broad recommendation—and said they still align with CDC guidance, which does not recommend booster shots at this time.

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"We are not recommending," Naveena Bobba, deputy director of health at SFDPH, said. "We are accommodating requests." According to Bobba, officials opted to allow the accommodation after receiving several requests for an additional shot "based on patients talking their physicians."

However, SFDPH reiterated that the move "does not represent a change in policy for SFDPH. We continue to align with the [CDC] guidance and do not recommend a booster shot at this time. We will continue to review any new data and adjust our guidance, if necessary."

As Chris Colwell, chief of emergency medicine at ZSFG, put it, the extra shot should not be considered a booster shot, but a supplemental shot.

"It's not a booster because it's not specific for some of the variants, which the booster ultimately will be," he said. "Potential benefit, no downside. To me, as we look at the future of the virus and now we're facing a fourth surge, it does make sense."

According to the SFist, the decision also follows research assessing the efficacy of J&J's vaccine against the delta variant, with one small, non-peer reviewed study suggesting that it might be beneficial for J&J vaccine recipients to receive a supplemental mRNA dose to protect against the delta variant. However, small studies published by J&J earlier in July showed its vaccine was effective against the delta variant even eight months after immunization.

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J&J has not responded to SFDPH and ZSFG's announcement, CNBC reports.

Accommodation details

ZSFG said it is prioritizing San Francisco residents for the supplemental shot, but Lisa Winston, ZSFG's chief of staff and hospital epidemiologist, said the hospital will accommodate residents of other counties while supplies last. In total, 665,000 residents of San Francisco have been vaccinated, of which around 7-8% have received J&J's vaccine, ABC7 News reports.

According to Bobba, the supplemental vaccine doses will be recorded in a manner similar to how all other Covid-19 vaccinations are documented. "These get entered into the system, just like other doses have as well, and the patients [who] have gotten them will be followed, just as others [who] have gotten the vaccines throughout the country have continued to be followed," Bobba said.

Bobba added that while each vaccine site in the city will choose how to proceed with the accommodation, "the expectation is that they have had a discussion with a health care provider when they come in." (Barmann, SFist, 8/3; Larsen, ABC7 News, 8/3; Lovelace Jr., CNBC, 8/3; Mascarenhas/Waldrop, CNN, 8/3; Mandavilli, New York Times, 7/20)