FDA Gonna Boost Your Moderna, J&J Vaccines To The Mooooon

This is good news, in case this week had you wondering.

The US Food and Drug Administration yesterday approved booster shots for the coronavirus vaccines made by Moderna and by Johnson & Johnson, and also cleared the way for people to "mix and match" vaccine boosters if they want, meaning that booster shots don't have to be the same brand as the vaccines people initially received. Both moves are expected to make it a lot easier for more Americans to get a vaccine booster.

Last month, the FDA and the Centers for Disease Control and Prevention approved booster shots for the Pfizer-BioNTech vaccine, so once the CDC signs off on guidelines for the Moderna and J&J vaccines, all three of the vaccines being used in the US will have approved boosters. An independent panel that advises the CDC on vaccines is scheduled to meet today and vote on specific recommendations for the boosters, after which the CDC could give the go-ahead for booster shots to begin as early as this weekend, to be followed by Tucker Carlson spouting all sorts of outrageous lies about the vaccines on Fox News.

The AP sums up the details on the boosters and who ought to get 'em:

Specifically, the FDA authorized a third Moderna shot for seniors and others at high risk from COVID-19 because of their health problems, jobs or living conditions — six months after their last shot. One big change: Moderna's booster will be half the dose that's used for the first two shots, based on company data showing that was plenty to rev up immunity again.

For J&J's single-shot vaccine, the FDA said all U.S. recipients, no matter their age, could get a second dose at least two months following their initial vaccination.

The FDA rulings differ because the vaccines are made differently, with different dosing schedules — and the J&J vaccine has consistently shown a lower level of effectiveness than either of the two-shot Moderna and Pfizer vaccines.

The other decision, to allow people who qualify for booster shots to get them from any manufacturer they want, means that people won't have to stick to the same vaccine as they got the first time around, although they can if they want. The FDA says that strategy should make it easier for people at higher risk to get boosters, especially for residents and employees of nursing homes or other congregate settings. Again, here's the AP:

FDA officials said they wanted to make the booster guidance as flexible as possible, given that many people don't remember which brand of vaccine they received.

"Being able to interchange these vaccines is a good thing — it's like what we do with flu vaccines," FDA's Dr. Peter Marks told reporters Wednesday evening. "Most people don't know what brand of flu vaccine they received."

Good point; I can say for certain that I have no earthly idea what flu vaccine I received last week. I think the vial said "ACME Veterinary Supply," so probably I should be safe from bird or coyote flu, but possibly not from crashing into tunnels painted onto sheer cliff walls.

So let's review where the booster recommendations are, or are likely to be once the CDC makes its final recommendations:

If your first vaccination was the two-dose Pfizer vaccine, boosters are recommended six months after your second dose for:

• people over 65

• residents in long-term care

• people aged 50-64 with underlying medical conditions

In addition, the CDC said that people may want to get a booster if they're 18 to 49 and have underlying medical issues, or if they work or live in settings where they're likely to be exposed to the virus.

If your first round was the Moderna vaccine, the FDA approval is for the same groups, and it's likely but not yet definite that the CDC recommendations will be similar.

For folks whose first vaccine was the single-dose J&J vaccine, the FDA has approved boosters for people of any age who are at least two months out from their vaccination.

Again, the mix-and-match approval means that for all three vaccines, you can choose a booster that's from another manufacturer if you want.

The New York Times notes that the decision to approve mix-n-match boosters was based in part on

preliminary data from a federally funded study that measured antibody levels in people who received a different vaccine as a booster, comparing nine groups of 50 volunteers each. Those getting another dose of Johnson & Johnson saw antibodies go up just fourfold, the study found. Switching to a Pfizer-BioNTech booster raised antibody levels by a factor of 35. A full-dose Moderna booster raised them 76-fold.

All of those are good results! Also, keep in mind that word "preliminary" there, since one of the researchers on that study, U of Maryland medical school prof Dr. Kirsten E. Lyke, told the Times in an interview that the study is still ongoing:

By next month, the researchers hope to know how well the different boosters increase virus-attacking T cells. It is possible that Johnson & Johnson's vaccine could do well in those results, she said, adding, "We'll get a more rounded picture."

Hooray for cautious reporting, and now everyone who initially got the J&J or Pfizer vaccines will ignore that disclaimer and demand the Moderna booster anyway, because people seize on one data point that way. It's also worth noting that the study was conducted using a full dose of the Moderna vaccine, not the half-dose for which Moderna is actually seeking approval.

Again, the FDA says any of the vaccines are good as boosters, once the CDC recommendations are in place. All of them will improve immunity over the initial course of vaccines, so if you qualify for a booster now and are unsure which one to get, you should talk it over with a healthcare provider, not the fucking internet, people. And remember, I'm only a Doktor of Rhetoric, not an MD.

[ AP / NYT ]

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