If you want a different vaccine for your COVID booster than what you got for your initial vaccine series, experts say you should talk to your doctor first. "I think it's incredibly important that you have these conversations with your primary care physician so that they can give you the best advice out there based on your medical conditions," Mohammad Sobhanie, MD, an infectious disease expert at the Ohio State University Wexner Medical Center, told AARP.
This is especially important for people who may be at higher risk for certain adverse reactions in relation to a specific vaccine. Men younger than 30 are more at risk for a rare case of heart inflammation called myocarditis after getting an mRNA vaccine, while women younger than 50 are more at risk for a rare blood clotting event called thrombosis with thrombocytopenia syndrome (TTS) after getting the Johnson & Johnson vaccine, per AARP.
Both the CDC and the FDA have determined that mixing and matching your booster is safe, despite these very rare vaccination risks. Early data on mixing and matching vaccines from the National Institutes of Health (NIH) and the National Institute of Allergy and Infectious Diseases (NIAID) study released Oct. 13 indicated that mixing and matching is a safe approach that might also produce an even stronger boost to your immune response.
"There are no additional safety concerns with mixing and matching and they're not bad choices," Sandra Fryhofer, MD, the American Medical Association's (AMA) liaison to the CDC's Advisory Committee on Immunization Practices (ACIP), said. "Being able to mix and match greatly increases flexibility. You can choose the boost vaccine depending on the vaccine available and the potential vaccine reactions. It also gives patients and physicians more input in the process."
If you aren't at risk for any adverse reactions, you might be interested in choosing the booster that's most effective. But in terms of which booster is best, experts say all three elicit strong increases in protection. "I don't think there are any losers here," Kathryn Edwards, MD, a professor of pediatrics at Vanderbilt University Medical Center who studies vaccines, told The Wall Street Journal. "Whether you get the same vaccine or a different one, it's going to boost your immune response."
According to the NIH study, a Moderna booster produced the highest overall antibody levels for the recipients of all three vaccines. This may be particularly relevant for Johnson & Johnson recipients, as getting a Johnson & Johnson booster increased antibody levels much less than Moderna or Pfizer did for those who initially got that shot. The researchers found that while another Johnson & Johnson shot boosted antibodies four-fold for this group, a Moderna booster increased them 76-fold and a Pfizer booster raised them 35-fold.
"Having antibody levels that are higher are probably associated with longer duration of protection," Edwards explained. "So I think that a lot of people that got Johnson & Johnson initially may decide they're going to get an mRNA [booster]."
Other experts warn that the NIH study might not tell the whole story, however. "We don't have all the data yet, and this one small study only measured antibody levels which don't give us the complete picture regarding a person's immunity," Vivek Cherian, MD, an internal medicine physician at Amita Health in Illinois, previously told Best Life.
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