The safety and efficacy of the Johnson & Johnson COVID-19 vaccine administered after one dose of an mRNA COVID-19 vaccine has not been established. However, in limited, exceptional situations where a patient received the first dose of an mRNA COVID-19 vaccine but is unable to complete the series with either the same or different mRNA COVID-19 vaccine (e.g., due to anaphylaxis), a single dose of the Johnson & Johnson COVID-19 or Novavax vaccine may be considered at a minimum interval of 28 days from the mRNA COVID-19 vaccine dose. Please consult with your provider about this decision.