The CDC recently announced that a fourth COVID vaccine, a second booster, is available for people over 50, for those with weakened immune systems ages 12 and older, generally referred to as immunocompromised, and for those who had two shots of the Johnson and Johnson vaccine. When a first booster was authorized for just about anyone, the question arose whether it should be the same brand as the original vaccine. It turns out from experience that switching from one type of mRNA, Pfizer or Moderna, to the other worked very well and possibly improved the immune response.
Working with no experience in this new area of vaccine technology, the same question arose with a second reminder. The Johnson and Johnson Janssen (J&J) viral vector vaccine came third in the vaccine race. It protects against key criteria for preventing serious illnesses, hospitalizations and deaths, but not as well. The subject of mixing really hit the news from October to November last year after the CDC approved the second recall.
A very astute person sent me an informative study of research done to test antibody responses in two small groups of people who received the first round of two primary vaccinations, 28 receiving Moderna and 45 receiving Pfizer/BioNTech. They were all young medical workers. Analysis was only done about 1 month after the second dose, not over several months to check for antibody loss.
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Both vaccines generated high levels of neutralizing antibodies, the kind that bind to the virus and prevent it from infecting cells. The Pfizer vaccine produced more antibodies of the Ig (immunoglobulin) G and IgM classes, which in most microbial infections are found in the blood. The Moderna vaccine stimulated relatively high levels of IgA antibodies, which are typically found on mucosal surfaces, such as the throat and pulmonary airways, the initial portal of entry for SARS-Cov2 viruses. Moderna also stimulated higher levels of antibodies that activate natural killer lymphocyte white blood cells to directly attack the virus, and other antibodies that stimulate neutrophil white blood cells, which ingest and kill (chew?) invaders.
These differences could complement each other enough to extend the spectrum of immunity beyond obtaining a single mark. Investigating this will likely be the goal of further research. An April 2 article in C/NET, an online media website under the Wellness label, reviewed the topic.
The actual CDC recommendation was made last October for mixing vaccine brands. The Pfizer booster is the same amount of material injected, 30 micrograms, as the original injections. Moderna is now 50 micrograms, half of the 100 micrograms that were in the first shots.
A professor of preventive medicine from Vanderbilt University said: “The most important reason is that the mixture provides benefits in terms of enhanced immune response and, therefore, anticipated enhanced protection.” A CDC report released last week found that people who received two doses of the J&J vaccine were less protected from emergency or urgent care visits (54%) due to COVID than those who received one. dose of J&J plus an mRNA boost (73% effective). ). People who received 3 doses of an mRNA vaccine were 83% protected against emergency room visits.
This makes it easier to get a second booster if your location only has one mark. It doesn’t matter which one you get shot with. For those who had a reaction from the original Moderna series, there should be less of a concern with the half dose.
Vaccination is not a perfect shield, but it is the best defense we have against this viral vermin and prevention against the emergence of new variants. Hopefully, this information could shed some light and allay any worries potential patients might have about getting shot with more “tricks.” And allay any worries about getting the right “stuff” because either vaccine available is excellent.
As for “mixing and matching”, I have never detected any difficulty in variation trials of dark chocolate brands that I mix and match in personal “therapeutic” post-prandial studies (after dinner ). I did not experience any ill effects of any specific type. They all produce the same undesirable reaction of making my clothes shrink.
Dr. Bures, a semi-retired dermatologist, has worked since 1978 in Winona, La Crosse, Viroqua and Red Wing. He also plays clarinet in the Winona Municipal Band and some Dixieland bands. And he appreciates a good pun.