You can now mix and match COVID-19 booster shots

Those eligible for boosters no longer need to stick to one brand.

Americans eligible for COVID-19 booster shots no longer need to stick to one brand — a development that could not only increase the number of people who get boosters, but possibly offer them better protection, too. 

The challenge: The available COVID-19 vaccines are highly effective, but studies have shown that their efficacy wanes over time. They’ve also shown that administering a vaccine booster can ramp back up the protection.

However, the FDA and CDC have been slow to recommend COVID-19 booster shots, and when they have, the authorizations have been for narrow populations to receive specific shots. 

Research suggests that mixing shots can be more effective than sticking to one brand’s vaccine.

In August, for example, the officials gave immunocompromised people, such as those with organ transplants, the go-ahead to get COVID-19 booster shots.

However, the authorization was only for Pfizer or Moderna (not Johnson & Johnson), and recipients had to match their booster to whatever COVID-19 vaccine they received initially (they couldn’t get a Pfizer booster if they’d received Moderna’s vaccine, for example).

Why it matters: These limitations have prevented some qualified people from getting COVID-19 booster shots — when one type of vaccine was widely available six months ago but is now hard to find, for example.

They’ve also made distributing boosters in places like nursing homes — where residents might have gotten different initial shots — more difficult for health officials.

“Being able to carry one vaccine and give it to all who are eligible speeds up the process.”

Nirav Shah

“If the FDA were to authorize mixing and matching, the ability to provide boosters on the ground at the state and local level would be greatly enhanced,” Nirav Shah, president of the Association of State and Territorial Health Officials, told the Washington Post on October 20.

“[W]hen our teams are going into a community or a nursing facility to provide boosters, being able to carry one vaccine and give it to all who are eligible speeds up the process,” he added.

Research also suggests that mixing shots — getting vaccinated with Moderna and a booster from Pfizer, for example — can actually be more effective than sticking to one brand’s vaccine, so these restrictions may be working against efforts to protect people as much as possible.

The latest news: On October 21, the CDC loosened its criteria for Moderna’s and Johnson & Johnson’s COVID-19 booster shots, and it also gave eligible people the green light to choose any brand for their booster — not just the one that made their initial vaccine.

Now, anyone over the age of 65 who was vaccinated at least six months ago can get any brand’s COVID-19 booster shot. Johnson & Johnson vaccine recipients over the age of 18 can also get any booster, as long as they received their initial shot at least two months ago.

“I think the opportunity for these [mix and match] boosts [is] priceless.”

Helen Keipp Talbot

Pfizer and Moderna recipients over the age of 18 who have underlying health conditions, have jobs that put them at high-risk of COVID-19 (healthcare workers, teachers, etc.) or live in long-term care settings (homeless shelters, prisons, etc.) are also eligible for boosters.

“I think the opportunity for these [mix and match] boosts [is] priceless,” Helen Keipp Talbot, an infectious-disease doctor at Vanderbilt University and CDC panel member, told the Washington Post.

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