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Local expert explains CDC decision to approve booster shots, mix-and-match approach

Published: Oct. 22, 2021 at 6:53 AM EDT
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COLUMBIA, S.C. (WIS) - Centers for Disease Control and Prevention Director Rochelle Walensky recommended Moderna and Johnson & Johnson vaccine booster shots for millions of Americans on Thursday.

This comes after the CDC’s Advisory Committee for Immunization Practices (ACIP) voted unanimously just a few hours earlier to accept the US Food and Drug Administration’s emergency use authorizations for each vaccine.

The CDC Director also said Americans could mix-and-match shots for vaccine boosters, meaning that eligible people could choose whichever vaccine manufacturer they desired as a booster.

Dr. Jennifer Grier, Clinical Assistant Professor of Immunology at the University of South Carolina School of Medicine Greenville, said this move by the CDC comes at a critical time, especially with the holidays around the corner.

“As we move indoors, people are going to be seeing family for the holidays, spending time more time around other people, I think we want to give people that didn’t have the great or really robust immune response from the first vaccine, we want to give them a chance to step up their protection a little more,” she said.

The booster recommendation is not for everyone, though.

For the Moderna booster, it includes elderly people aged 65 and older, and at risk-adults, 18 years and older who live in long-term care settings, have underlying health conditions or face potential on-the-job exposure to COVID-19. This booster shot should be taken six months or more after the initial doses and is the same guidance that was previously approved for the Pfizer-BioNTech booster.

Notably, this booster will be half the dose that’s used for the first two shots.

The Johnson & Johnson booster has been approved for everyone 18 years and older who received the initial dose at least two months ago.

“It really means that we’re going to see stronger protection for the population that really needs it,” Grier said.

A study from the National Institutes of Health released last Wednesday found that there was a stronger immune response from a booster that didn’t correspond with the initial vaccine manufacturer than when vaccines and boosters matched.

While Dr. Grier emphasized that data is still in the early stages, she echoed the benefits of interchangeability with the shots.

“Some of the preliminary data suggests that mixing might be better,” she said. “Some of the stronger responses were seen from people that originally received the Johnson & Johnson vaccine, and then went on to be boosted with Moderna. So the really important sort of boosts were seen if you were going from the Johnson & Johnson, which is an adenovirus vaccine, to an mRNA vaccine in the form of the Moderna.”

Dr. Grier said the effect of mixing booster shots could be compared to passing a person on the street versus encountering them in your workplace.

“It’s going to show you a similar piece of the virus, but in an entirely different context,” she said. “And that’s going to be sort of unexpected and interesting, and it’s going to give you a stronger immune response. So this is sort of like passing someone in the street, you might recognize their face and remember it for a little bit, but if they were to walk into your workplace, that’s a surprising encounter and you’re going to have a stronger recognition to that and a better memory.”

Dr. Wilbur Chen, a CDC ACIP voting member, said he’s glad this approach has now been approved.

“I really appreciated that we were finally able to look at, consider and recommend a mix-and-match approach, as part of our way to boost people’s immunity.”

As many Americans consider getting their seasonal flu vaccine around this time as well, Dr. Grier said it’s completely safe to receive the flu shot at the same time as a COVID booster.

In a statement Thursday before the CDC gave the final approval, the South Carolina Department of Health and Environmental Control said they were awaiting this final go-ahead before changing their booster recommendations.

DHEC officials added that they have no current issues meeting the demand for vaccines, and are confident they’ll be able to meet the increased demand now that more vaccine boosters are authorized.

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