How To Know If You Need Another One
If you get a vaccine in the meantime, it wont be immediately evident if your immunity to COVID-19 is waning. People who are participating in vaccine clinical trials are having their antibody levels tracked over time. Otherwise, you can get a commercial antibody test to detect when such proteins are generated in response to a vaccine or infection.
The bigger challenge is that the presence of such antibodies doesnt necessarily mean youre protected against COVID-19, says Dan H. Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston. Other research suggests that the lingering presence of B cells, which make antibodies, and T cells also plays an essential role. The way antibodies are currently measured in standard clinical tests may not be a good indication of immunity, says Barouch, adding: We need to know which immune responses are responsible for protection.
Perhaps vaccine-mediated protection against COVID-19 will last a lifetime, as it does against measles. Or, taking a second version of a vaccine may serve as a booster shot a decade down the linesimilar to how the polio vaccine is sometimes given today.
I dont think we have nearly enough information that people should start mixing and matching COVID-19 vaccines. ByAngela RasmussenGeorgetown University
Why Mix And Match
Mixing COVID-19 vaccines when you choose a different booster may enhance the immune response, the National Institutes of Health says, and it also allows for more flexibility when people are making a vaccine appointment or looking for a shot. Other countries have been allowing people to mix shots for their primary COVID-19 vaccine series.
“The most important reason is that mixing offers advantages in enhanced immune response and, therefore, anticipated enhanced protection,” Dr. William Schaffner, a professor of preventative medicine at Vanderbilt University, told UK health site Patient. He added, though, that the advantage of mixing two mRNA vaccines is smaller than the benefit someone who originally received Johnson & Johnson gets from an mRNA booster.
The CDC report published this week found that people who received two doses of Johnson & Johnson’s vaccine were less protected from emergency room or urgent care visits due to COVID-19 disease compared to people who received one dose of Johnson & Johnson followed by an mRNA booster . People who received three doses of an mRNA vaccine were 83% protected against emergency visits.
Because of the new data, adults who received two doses of Johnson & Johnson’s vaccine are included in the group of people who may receive another booster of Pfizer or Moderna, the CDC says.
If you have specific questions about which shot is best for you, talk with your health care provider.
What If I Have An Underlying Health Condition
The states that people with an underlying health condition can get vaccinated as long as they havent had a serious allergic reaction to:
- a previous dose of the vaccine
- any vaccine ingredients
This includes people who have a weakened immune system. Specific safety data for people with compromised immune systems is limited. But since these authorized COVID-19 vaccines dont contain live virus, they can be safely given to immunocompromised people.
Vaccination is important for people with underlying health conditions. This is because many types of underlying health conditions can increase the risk of severe COVID-19.
Before getting vaccinated, talk with a healthcare professional and let them know about any underlying health conditions you have or medications youre taking.
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Q & A With A Vaccine Expert
We spoke with Saad Omer, MBBS, PhD, MPH, director of the Yale Institute for Global Health, to get answers to the hard questions on the safety and efficacy of the COVID-19 vaccines in development. The shortened timelines surrounding the development of these vaccines, coupled with concerns over what some feel is undue political influence over the release of them, is concerning to many Americans.
We sat down with Dr. Omer, who addresses these concerns.
Can I Mix And Match The First Two Shots
No, the health officials’ allowance for mixing COVID-19 vaccines applies only to boosters. As of now, the FDA has only authorized a mixed-series booster, meaning the first coronavirus vaccine series must be two doses of Moderna or Pfizer or one dose of Johnson & Johnson.
More data on mixing for boosters will inform decisions on primary coronavirus vaccine series being used together, which could make it easier to reach underserved communities and possibly reduce health care and vaccine inequity.
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The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
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What To Expect During And After Your Booster Shot Appointment
- Bring your CDC COVID-19 Vaccination Record card to your booster shot appointment so your provider can fill in the information about your booster dose. If you did not receive a card at your first appointment, contact the vaccination site where you got your first shot or your state health department to find out how you can get a card.
- You may experience side effects after getting a COVID-19 vaccine. These are normal signs that your body is building protection against COVID-19.
- Use v-safe to tell CDC about any side effects. If you enter your booster shot in your v-safe account, the system will send you daily health check-ins.
Its Difficult To Accurately Compare Vaccines
In clinical trials, the Johnson & Johnson vaccine was found to be 66.9% effective at preventing moderate to severe or critical COVID-19 illness after at least 14 days and 66.1% effective at preventing those levels of illness after at least 28 days.
It was also found to be about 77% effective in preventing severe or critical cases of COVID-19 at least 14 days after vaccination and 85% effective in preventing severe or critical cases at least 28 days after vaccination.
Those numbers are lower than seen in the two-dose Pfizer vaccine, which was 95% effective at preventing COVID-19 at least seven days after the second dose, and the two-dose Moderna vaccine, which was 94.1% effective at preventing COVID-19 at least 14 days after the second shot.
But comparing those numbers alone is like comparing apples to oranges, said Katelyn Jetelina, an epidemiologist and assistant professor at the UTHealth School of Public Health in Dallas.
Those studies were very different, she said. Its really not a fair comparison.
Health experts say the three vaccines measured efficacy differently during clinical trials, making those numbers alone hard to compare. Pfizer and Moderna focused primarily on finding out whether their vaccines prevented a symptomatic COVID-19 infection, while Johnson & Johnson primarily analyzed how well its vaccine prevented moderate to severe illness, which was defined differently.
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Pfizer And Moderna Have Both Been Associated With Rare Adverse Reactions
There have been a few reported cases of allergic reactions and anaphylaxis following injections with Pfizer and Moderna’s COVID vaccines. According to a January report from the CDC, there were 10 cases of anaphylaxis reported among more than 4 million administered shots of Moderna between December and January, which is a 0.00025 percent rate. The CDC also reported that of 1.9 million shots of Pfizer administered in December, there were 21 cases of anaphylaxis, according to another January study, which is a 0.0011 percent rate. To see what you can finally do again after your shot, check out Dr. Fauci Just Confirmed You Can Do This After Getting Vaccinated.
Will We Be Able To Get A More Effective Vaccine Later If We Do Get The Johnson & Johnson Vaccine
Sostman said yes, it will be possible to take a different type of vaccine later.
Getting one kind of COVID-19 vaccine does not make it unsafe or ineffective to get a different kind later, he explained.
However, if receiving the Pfizer or Moderna vaccine for the first two shots, people should stay with the same vaccine. It is unknown if the effectiveness is the same with a mixed series.
As far as future boosters, since the vaccine updates will be based on the current vaccines, it may make sense to stay with the same one you started with, but likely this will be less critical, he said.
Sostman said that what boosters will look like in the future is unknown, but they may need to be updated each year, similar to flu vaccines.
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Mixing And Matching Covid
Because public health officials arent recommending one booster shot over another, individuals are left to make a choice based on personal factors
Daily Correspondent
Those currently eligible for a booster shot include older and high-risk recipients of the Pfizer and Moderna jabs, and those who received the one-shot Johnson & Johnson vaccine.
The Food and Drug Administration recently authorized a mix-and-match booster shot strategy that allows fully-vaccinated Americans to choose a booster shot of one of three Covid-19 vaccines: Johnson & Johnson, Pfizer-BioNTech or Moderna, even if its different from the one they initially received. A mix-and-match option not only makes it more convenient for Americans to access boostersstudies show benefits from making the switch to another brand, especially for those who initially received the Johnson and Johnson Covid-19 vaccine.
Public health officials arent recommending one vaccine brand over the other, instead they are allowing individuals to weigh personal benefits and risks. Studies have shown that mixing vaccines prompts a strong antibody response regardless of the combination of brands and provides effective protection against the hyper-infectious Delta variant. Those currently eligible for a booster shot include roughly 70 million older and high-risk recipients who received Pfizer and Moderna jabs, and those who received the one-shot Johnson & Johnson vaccine.
The Link Between Myocarditis And Covid
Myocarditis, an inflammation of the heart muscle, became a trending topic this spring when the Centers for Disease Control and Prevention reported that it is monitoring a small number of cases of heart inflammation that have arisen in young adults not long after mRNA COVID-19 vaccination. The side effect is considered important but uncommonarising in about 12.6 cases per million second doses administered. And now the Food and Drug Administration has announced it will place a warning on the mRNA vaccines. Its important to note that the vaccination is still recommended for everyone who is eligible.
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Mix And Match Boosters
It appears getting a booster shot is going to be a choose your own adventure type of experience after the FDA stipulated that people eligible for boosters can choose any of the jabs, regardless of what brand they initially received.
There is a growing body of evidence that boosting with a different vaccine could induce a broader and longer-lasting immune response though some combinations may work better than others.
In announcing the emergency authorizations for the Moderna and J& J boosters, the FDA stated no preference for who gets what, or in what order. People who got J& J can get a second shot of Moderna or Pfizer. People who got one of the mRNA vaccines can get the J& J vaccine as their booster, the agency said.
Not stated in the FDAs announcement is the fact that this new policy will make life much easier for folks delivering booster shots, especially those trying to boost people living in long-term care, homeless shelters or prisons. They will need to bring only one vaccine when they go to administer booster shots, rather than trying to match people to their original vaccination brand.
Are Covid Boosters Different From Primary Doses
The J& J booster, which doesnt contain mRNA, is no different than the primary dose.
The Pfizer booster contains 30 micrograms of mRNA, as does each of the two primary doses.
The Moderna booster is a half-dose, but thats more than enough to boost immunity, Yagnik said. It contains 50 micrograms of mRNA, while each of the two primary doses contains 100.
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Does The Johnson & Johnson Covid
Most vaccines produced to prevent viral diseases also help in reducing the spread of the disease. Unfortunately, it is not currently known if the COVID-19 vaccine will reduce transmission. Therefore, even if you have received the vaccine, you should take precautions to avoid spreading the disease as much as possible, such as wearing a mask and maintaining social distance, at least until more is known about the impact of vaccination on transmission.
Why Get The Covid
Sandra Trevino, LCSW, is a founding member of Yales Cultural Ambassadors programa 10-year-old organization whose mission is to broaden community participation in clinical trials at the Yale Center for Clinical Investigationand is doubling her efforts to help educate people about COVID-19 vaccines.
In December, the Kaiser Family Foundation released results of a survey in which more than one-quarter of Americans said they would probably or definitely not get the vaccine. Republicans, and rural and Black Americans were most hesitant, according to the survey.
Its a great responsibility to make sure we continue to address the elephant in the room, which is mistrust with regard to the vaccines, says Trevino.
In a recent interview, she explained why shes encouraging everyone to get the COVID-19 vaccine and talked about her own familys experience with COVID-19.
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Should You Still Choose The J& j Vaccine
The CDC says the benefits of getting the vaccine still outweigh the threat of being infected with the coronavirus.
As more people are vaccinated, fewer will become infected, and that could slow the spread of the virus, resulting in better protection for everyone. While no vaccine guarantees 100% protectionand there is more to learn about vaccine effectiveness against Omicronso far, all three COVID-19 vaccines have been very effective at preventing serious illness and death.
If you got J& J as your initial vaccine and are 18 or older, you are eligible for a booster shot two months later, regardless of which one you choose . Those ages 16 and 17 are eligible to get the Pfizer-BioNTech booster.
Note: Information provided in Yale Medicine articles is for general informational purposes only. No content in the articles should ever be used as a substitute for medical advice from your doctor or other qualified clinician. Always seek the individual advice of your health care provider with any questions you have regarding a medical condition.
Why Do The Pfizer And Moderna Vaccines Have Different Waiting Periods Between The First And Second Shot
The time interval between the first and second shot is determined by the data collected from their clinical trials. The companies have published their safety and efficacy results based on these specified intervals. Pfizers is based on a 21-day interval between doses, while Modernas is based on a 28-day interval.
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Investigating Combos Safety And Effectiveness
Around the world, studies are underway in animalsand peopleto investigate the safety, types of immune response generated and how long immunity lasts when one person receives two different COVID-19 vaccines.
Results from a Spanish trial of more than 600 people indicated that vaccination with both the viral-vector AstraZeneca and mRNA-based Pfizer-BioNTech COVID-19 vaccines triggers a robust immune response against the SARS-CoV-2 virus.
Preliminary results from a German study that has not yet been peer-reviewed found that getting the AstraZeneca vaccine first followed by the Pfizer vaccine resulted in production of more protective antibodies and provided better protection against variants of concern compared to two AstraZeneca doses.
The Com-COV study in the U.K. is also investigating the safety and effectiveness of giving patients a combination of the AstraZeneca and Pfizer-BioNTech shots. Preliminary findings indicate that people who got one shot of each type were more likely to report mild to moderate side effects than those who received two doses of the same vaccine. Final results of this study, including the effectiveness of this approach, are expected in June 2021. The expanded Com-CoV2 study is testing other combinations of COVID-19 vaccines, namely from Modernas mRNA platform and Novavaxs protein platform.
Why Did The Cdc Recommend The Mrna Vaccines Over J& j
In December, the CDC recommended a preference for the two mRNA vaccines over J& J in response to concerns that had been building over a small, but growing number of cases of a rare, but serious clotting disorder in people whod gotten the shot. In April 2021, the agency put a two-week pause on the vaccine while the matter was investigated. The pause was then lifted, but concern grew as more cases were reported.
The clotting disorder is called thrombosis with thrombocytopenia syndrome , and it is rarein 17 million people who got J& J, 54 cases of TTS were reported, 36 of those people were cared for in an intensive care unit, and nine people died . The Food and Drug Administration updated its fact sheet on the shot.
The FDA also attached a warning to the J& J vaccine in July, after reports linked the vaccine to Guillain-Barré syndrome, a rare neurological disorder. For both warnings, the agency said the incidence was very rare, and the benefits of the vaccine still outweighed the risks.
All three vaccines available in the United States have had reports of rare adverse events. The FDA added warnings to the Pfizer and Moderna vaccines following reports of rare cases of myocarditis and pericarditis after mRNA vaccination, particularly in male adolescents and young adults.
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