Missouri vaccine expert: What you should know about booster mixing and matching

Joplin Area Coronavirus

COLUMBIA, MO. — Missourians ages 18 and older can receive Moderna, Johnson & Johnson, and Pfizer booster shots, but one doctor is steering away from using one of those vaccines after the Food and Drug Administration approved mixing and matching. 

The Department of Health and Senior Services (DHSS) amended the state’s orders Friday to allow Johnson & Johnson and Moderna booster shots to be administered in the state. Pfizer was previously approved by the state health department. Last week, the Food and Drug Administration (FDA) announced patients are allowed to mix and max vaccines. 

MU Health Care Dr. Laura Morris, the co-chair of the health system’s COVID vaccine and influenza committees, said Tuesday she plans to use the Johnson & Johnson vaccine less since the FDA’s approval.

“In the world of vaccines, what we are looking for is the immune system’s reaction, and that’s usually something that is not as specific or as limited to one vaccine product,” Morris said. 

She said that mixing and matching COVID-19 vaccines was a long time coming. 

“The reason those limitations were in place before, and we only gave one vaccine product at a time, is really because of the timing and the way the data and the evidence, the research studies, were presented to the FDA,” Morris said. 

Of the three vaccines, Morris said one of them isn’t as effective: Johnson & Johnson. 

“The immune system reaction was not quite as strong, and patients had a higher risk of being infected or being hospitalized,” Morris said. “Folks that have received that, the numbers have never quite stacked up as well as the mRNA [Messenger RNA] vaccine.”

“We are tapering off of that because it doesn’t look like it’s an advantage of patients to receive a booster of Johnson and Johnson,” she continued. “We feel it’s the safest for us to have one vaccine here in clinic with one dosing scheduling.”

Morris suggests those who received the Johnson & Johnson vaccine the first time use Moderna or Pfizer for their booster. 

“When a Johnson & Johnson shot is followed up by one of the mRNA vaccines, the antibody levels are boosted a little bit higher,” Morris said. “So those patients benefit from mixing and matching.”

Morris said those who benefit the most from getting the booster are those at high risk like those 65 and older, those 18 and older who live in long-term care facilities, have underlying medical conditions, and who live or work in high-risk settings like a hospital. 

“People that didn’t like their reaction to their second shot might be people who would choose to mix and match,” Morris said. “Maybe they want to try the other vaccine product to see if their action is any better.”

The FDA recommended the agency give emergency use authorization for the Pfizer vaccine in children ages 5 to 11 years old. Morris said she knows parents who are lined up to get their children vaccinated. 

“The Delta variant changed a lot of what we saw in young people, healthy people and that includes kids,” Morris said. “Kids don’t typically get severe illness with Coronavirus infection but kids are part of families and families have older patients and can be a method of transmitting Coronavirus in your household even if the child doesn’t get very sick.”

Nearly 50% of Missouri’s population is fully vaccinated, with the lowest age group vaccinated being those 12 to 17 at 36%. 

DHSS recommends those who received the Johnson & Johnson vaccine get their booster shots two months after the initial dose. For Missourians who got the Moderna or Pfizer series, the booster is recommended six months after your second shot. 

Morris said it is okay to receive your flu shot and your COVID vaccine at the same time. 

“There’s no time interval so if you get a flu shot today, you can still get a COVID booster tomorrow,” Morris said. “It’s safe and effective to get both the flu shot and the COVID vaccine in the same day.”

She said for those who still haven’t received their first dose of the COVID vaccine, it’s not too late. 

“We can see clear as day how safe and effective this vaccine is, so for folks who are waiting for proof, you know the proof is there,” Morris said. 

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