I missed the J&J update on the radio but I thought they said they were considering a cocktail of other vaccines instead of a repeat of J&J.
Not a “cocktail”. They are considering allowing anyone who gets a booster to get any of the vaccines as a booster. This gives people more flexibility, and also let’s little who got J&J opt for an mRNA booster, which is probably better, without the FDA explicitly recommending one vaccine over another.
It sounded specific to J&J but I could have misheard.
What’s specific to J&J is that a small, not-yet-peer-reviewed study found that it was significantly less good as a booster than the mRNA shots, so that’s a good reason to mix&match, even if you can get whatever you want.
Prior studies with AZ (which is similar to J&J, except that it was given in two shots) and Pfizer, for the first and second shots, showed the same results, and that’s a much larger study that has been peer-reviewed. That study found that the immune response appeared, from best to worst, to be
AZ → Pfizer
Pfizer → Pfizer
Pfizer → AZ
AZ → AZ
Where the first two were almost the same, and I don’t think they were significantly different. But there was a big drop in antibody production when the second dose was AZ, with AZ after Pfizer a little better than AZ after AZ.
So the small study that had 50 people each with all 9 options of J&J, Pfizer, and Moderna, has extremely plausible results.
So, is there evidence that a Moderna booster is better after an original Pfizer series? I got Pfizer, and I want to get whatever is most effective as a booster. My partner is pretty sick with a breakthrough infection, and I don’t want to take any chances.
Here’s the NYT article (paywalled, but you get a couple free each month). They are the newspaper that broke the news that the FDA is expected to approve mix& match, and it’s a good article. (Although i wouldn’t have wasted my free article had the place that linked it said what the link was to.)
https://www.nytimes.com/2021/10/18/us/politics/fda-mix-and-match-boosters.html?smid=url-share
Here’s a link to the small NIH study everyone is citing:
it’s a PDF download, and clicking the link doesn’t work on my phone, but does on my laptop.
The goal of the study was to quickly test the safety of mixing and matching, and to see whether it produced an increase in antibody titers in the one month the participants were monitored. The study wasn’t designed to be large enough to reliably compare the efficacy of the different regimens.
Statistical Analysis:
Safety analyses included all participants who received the booster vaccines. Immunogenicity analyses
included only those who had at least one post-boost serum sample available for testing. No statistical
comparisons between groups were planned and the analyses of safety and immunogenicity endpoints
are only descriptive. The selected sample sizes of 50 per group and 25 per age stratum, allow for 99.5%
and 92.8% probability of observing at least one an AE with a true event rate of 10%, respectively.
Confidence intervals were not adjusted for multiplicity. The statistical analysis plan for this study is
available at NEJM.org.
If you look at the tables at the end of the paper, though, you can see that J&J over J&J performed SO MUCH WORSE than all the other combinations, that the difference is almost certainly real despite the small sample-set. Also, they published data at 1, 15, and 29 days post vaccination. But this preprint was released prior to gathering complete data at 29 days, and so you really can’t compare Moderna over Pfizer to Pfizer over Pfizer.
Thanks.
Well I timed that vaccine poorly. Actually J&J was the first booking I could get.
Here’s some news:
So how big are the lines where you live to get vaccinated now considering the big expansion of booster shots for Moderna and Johnson and Johnson?
Since I was vaccinated with Moderna I checked with Walmart and got an appointment with them yesterday. There was only one other person there in the 20 minute slot.
I get my injections at a medical office since I use my thigh and that requires a different needle. I had an appointment at the vaccine clinic within a couple of days (they’re in operation twice a week at the moment). This was when Pfizer became available, and I assume they’ll add days as needed.
I drove to town, walked straight up to the pharmacy counter and asked for a Moderna Booster. Once I was checked in I waited about 2-3 minutes for the shot giver and was on my way. As I was walking out, I grabbed a bottle of Bailey’s Salted Caramel and took it to the self check out. It took longer for someone to come and age verify me to buy a bottle of booze than it did to get my booster.
So.no lines out here. Deucy has declared COVID to be a non-issue and so it is!
Here’s a non-paywalled link ( for two weeks), I get 10 unpaywalled links a month to share as part of my subscription. I try to take advantage of it as much as possible.
Long line at my grocery store pharmacy yesterday. I waited about 90 minutes. The pharmacy manager told me they were almost out of the Moderna serum. He anticipated an even bigger demand on Monday, as he said many people haven’t heard the booster was approved.
I posted earlier about how I planned to wait to get my booster, to get it closer to 7 or 8 months.
I just thought I’d mention here that my spouse and I were both vaccinated in April (Pfizer), and we both wound up getting breakthrough infections before we even got to the 6 month mark. Symptomatic infections – my spouse wound up with pneumonia.
So, think twice about delaying after you are eligible to get boosted.
I went to Rite Aide and they said they weren’t comfortable mixing vaccine/boosters, so I just got straight J&J booster yesterday. Today I feel terrible but oh well.
In Georgia, they finally let us get Moderna and J&J boosters starting Tuesday 10/26. I started hunting for local availability immediately and found an opening yesterday a few minutes drive from me (unlike how far I drove to get dose 1 and 2). I’m now boosted with Moderna, and other than and injection sore spot and being a bit over tired, I’m fine so far. Yay, science!
As for lines, I was able to make an appointment and there was zero wait at CVS.
Wow, practices vary so much from pharmacy to pharmacy. A friend got a booster under pretense of being immune compromised. “Might you be immune compromised?” the pharmacist asked him. “Well, i might need to get a shot of cortisone for my knee sometime”, he replied. That pharmacist was happy to give him the shot. In contrast, when my sister went to get a booster, the pharmacist asked her why. She said, “I’m over 50 and obese”. “You don’t look obese” (pharmacist went to computer and looked up list of eligibility), “well, i guess you qualify”. He gave her the shot. She thought he was just being careful, but who knows.
My local CVS offers to give you Pfizer if you had J&J and urges you to discuss it with your doctor if you prefer to get boosted with j&j.
I had been wondering how long to wait to get my booster. Now, I’ve had a breakthrough infection, which I have read, does indeed act as a booster. In addition, I wound up getting a monoclonal antibody treatment, which requires me to wait 90 days before getting any kind of vaccination for Covid, including a booster. So the earliest I can get boosted now is in late January. Maybe by then there will be clearer guidance about how long you should wait after a breakthrough infection.
Too early, and it may be less effective and less necessary. But I got my breakthrough infection when I was just short of 6 months post vaccination, so I don’t want to try to stretch it out, either.