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FDA expected to greenlight mix-and-match COVID boosters

The Food and Drug Administration is planning to let Americans mix and match booster shots as all are relatively effective at boosting immunity regardless of patients’ original vaccination series, the New York Times reported Monday, saying that the agency may make it official later this week.

According to the Times’ sources, the government will not recommend one booster shot over another but may tell Americans that matching their initial vaccines to their booster when possible would be preferred.

The move stands to quench some worry about supply and demand around the three U.S.-approved vaccines. After President Joe Biden announced a national booster campaign in August, some localities became worried that about having adequate supplies to offer boosters of the Pfizer, Moderna and Johnson & Johnson jabs.

According to the Centers for Disease Controls, Pfizer remains the only approved booster shot as of Monday, and only for those who previously received the Pfizer series six months ago. The groups eligible for a third shot of the two-dose Pfizer regimen are adults age 65 and older, those at high risk of severe COVID-19 due to chronic health conditions like diabetes, and those whose jobs put them at higher risk of infection — like health care workers, teachers, first responders and grocery store clerks.

In September, the FDA authorized the company to provide the Pfizer boosters for these populations but said widespread booster shots for all of those who received Pfizer have yet to be found necessary based on the shot’s continued effectiveness.

The FDA’s advisory panel has since recommended both Moderna and Johnson & Johnson boosters this month. The former is expected to be approved for use later this week.

Unlike the Pfizer and Moderna vaccines, whose boosters are intended for older or at-risk individuals, the FDA panel has recommended a second dose for any J&J recipient over the age 18.

While trials in Europe have suggested mixing vaccines when getting boosters still results in good protection from the virus, results from the U.S.’s National Institute of Health trials studying this phenomenon were just presented Friday at an FDA meeting. 

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Using trial participants who had received either Pfizer, Moderna or J&J in the U.S., researchers tested the results of switching boosters by comparing nine groups of 50 people each.

According to the results, the level of coronavirus antibodies in participants jumped regardless of the combination of initial and booster shots. 

What’s more, for those who first received the J&J vaccine initially, their antibody levels increased significantly more with Pfizer or Moderna boosters. With a J&J booster, their antibodies multiplied four-fold, the study found, while with Pfizer they went up 35-fold and Moderna, 76-fold.

Switching shots between initial and booster also produced notable side effects, the study said. However, researchers are still collecting data on how well different boosters increase T cells, elements of the immune system that target specific antigens — such as the novel coronavirus.

The practice of administering booster shots within the U.S. has drawn controversy, with much of the world still unprotected in the least against the novel coronavirus. The World Health Organization has gone as far as to say that it is immoral for richer countries to offer their populations booster shots.

The condemnation from the United Nations’ health agency came on the same day in that the United States said it would recommend boosters because of the risk that immunity against the virus will decline in the coming months.

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Lance Cheung/USDA

According to the Centers for Disease Controls, Pfizer remains the only approved booster shot as of Monday, and only for those who previously received the Pfizer series six months ago.