Should You Mix and Match Your Booster Shot?

[Nevilledog]

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Adrienne LaFrance
@AdrienneLaF
A very brief guide to mixing boosters, in descending order of antibodies:

3 shots of Moderna = Best
Pfizer → Moderna = Next best
Moderna → Pfizer = Also very good!
J&J → Moderna = Do it
J&J → Pfizer = Yes
J&J → J&J = Get Moderna or Pfizer instead

Should You Mix and Match Your Booster Shot?
We know more than ever about how to use boosters, but still very little about when to use them.
theatlantic.com
5:54 AM · Oct 21, 2021

https://www.theatlantic.com/health/archive/2021/10/mix-match-booster-covid-vaccine/620395/

In this week’s installment of the booster chronicles, the plot is picking up. An advisory committee to the FDA began a two-day meeting today to formulate recommendations for whether the agency should authorize additional doses of the Johnson & Johnson and Moderna COVID-19 vaccines. (The FDA still has to authorize, and the CDC still has to recommend, any new use of boosters before they’ll be readily available.) Committee members have already voted yes on giving boosters to people over 65 and other high-risk adults who received the Moderna vaccine. Meanwhile, the NIH released the results of a long-awaited (and not yet peer-reviewed) clinical trial on the “mix and match” approach to booster shots, in which people receive a dose of a different vaccine from the one they started with. The FDA committee is scheduled to discuss that idea, too, before this meeting ends.

The 458-person NIH study showed that mix-and-match—also known as heterologous—boosting is safe and induces an increase in the relevant antibody counts, no matter the combination of vaccines. This isn’t particularly surprising, given the data that have already emerged from countries such as the U.K. and Spain, which have been studying the mix-and-match approach to initial shot regimens for months. In general, these have shown it’s about as good as, and in some cases better than, a homologous regimen. This week’s report expands that finding for the booster age, and adds one more: When boosters were compared head-to-head, the mRNA vaccines blew J&J’s out of the water.

When the vaccines first debuted last winter, Americans were told that each one was excellent, so we should all get whichever of the three was most accessible. If mix-and-match boosters are authorized, we might find ourselves with a more bewildering decision: Nine different paths will be available in total, depending on where you started. Assuming that every option will soon be on the table, which one should people take?

The NIH study tested and compared every possible combination, and here’s the gist: If you need a booster, don’t take J&J. Two weeks after boosting, people who had followed a J&J → Moderna regimen registered average antibody levels that were 9.8 times higher than those who had gotten two J&J shots; antibody levels among J&J → Pfizer recipients hovered just behind. Overall, the highest antibody levels were found among people for whom all three doses were Moderna; Pfizer → Moderna produced the second-highest levels, then Moderna → Pfizer.

*snip*

[MineralMan]

1. Since my primary vaccine was Moderna,

I'm going to opt for a third Moderna shot. My wife has already gotten her third Pfizer.

I was a little disappointed to get Moderna at first. Now, I'm glad.

[bif]

2. Same here. Got the two Modernas.

I was thinking of getting the Pfizer for the booster, but now I'm opting for the Moderna. My wife got the 2 Pfizers and will probably get the Moderna booster.