Study of COVID vaccine boosters suggests Moderna or Pfizer works best

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A study by the National Institutes of Health this week suggests people who got the J&J vaccine as their initial vaccination against the coronavirus may get their best protection from choosing an mRNA vaccine as the booster.

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Francine Orr/Los Angeles Times/Getty Images

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The most significant finding suggested that people who initially got the J&J vaccine got the best response if they got Pfizer or Moderna as their booster. In an email to NPR, Nathaniel Landau, a microbiologist at the New York University Grossman School of Medicine, said the findings show that getting a J&J boost after the initial one-shot immunization is «not as good» as receiving one of other vaccines as a booster. The antibody levels of people in those groups went up 10 to 20 times higher than in those people who got another J&J shot.

And that antibody increase is probably big enough to make a difference in how much better the protection will be, the scientists say. How much better isn’t known — this study wasn’t large enough to determine how much less likely people who subsequently got infected with the coronavirus were to get sick — or how sick they got. But, based on other research, that kind of difference in antibody response probably is enough to offer greater protection.

There are some caveats to this study that make it a little hard to know how to interpret the data. First, the researchers tested full doses of all the vaccines — not the half-dose that Moderna is seeking authorization for in its booster.

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Also, researchers measured antibody levels two and four weeks after the booster. So there’s a chance antibody levels from a J&J booster could continue to rise with more time. And the scientists are assuming that higher antibody levels translate into more protection. That’s probably true, but other factors may also play a role, such as responses by other parts of the immune system.

The researchers also say that their study wasn’t designed to compare varying responses among the different booster regimens and that the data set isn’t large enough to reach conclusions about one versus the other. Finally, the study findings were posted without peer review on the preprint server medRxiv.

The results don’t come as a complete surprise. Something similar was seen in the U.K., when people who got the AstraZeneca vaccine — which is similar to the J&J shot — got boosters.

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The data from the NIH study will be reviewed by advisers to the Food and Drug Administration later this week as part of meeting to consider requests from both Moderna and J&J to authorize booster doses of their vaccines.

The FDA has already authorized a booster dose of the Pfizer-BioNTech vaccine for anyone older than 65, or whose health, occupation or living situation puts them at risk for severe disease.

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