All U.S. adults qualify for COVID-19 boosters; which is best?

A woman receives Pfizer-BioNTech COVID-19 vaccine as a booster dose at Skippack Pharmacy in Schwenksville, Pennsylvania, August 14 (Hannah Beier, Reuters)

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CHICAGO – On Friday, the Centers for Disease Control and Prevention expanded the availability of COVID-19 booster shots to all American adults, hoping to preserve vaccine protection against the rapidly spreading delta variant.

Earlier, the agency had recommended booster shots only for people aged 65 and older, or at high risk for covid-1[ads1]9, and said they could choose a different vaccine than the one they received for their first inoculation.

Millions of Americans are now faced with the choice of which booster to use. Here is what some experts recommend:

The latest guidelines

Previous CDC booster guidance was based on meeting specific age, health or other risk requirements that left some people confused as to whether they were eligible.

The new guide aims to clarify this. It states that all adults 18 years and older who received their second dose of a Pfizer / BioNTech or Moderna vaccine at least six months ago are eligible for a booster injection.

Advisers to the CDC also recommended boosters for adults aged 50 and older. Advance guidance recommended boosters for all 65 years and older.

Many people between the ages of 18 and 64 wondered if they were eligible for boosters under previous guidance, which allowed them for people aged with medical conditions that increase the risk of serious illness, such as obesity or diabetes. It also included people at greater risk due to their profession or life situation.

For adults who originally received a single dose of Johnson & Johnson vaccine, the instructions remain unchanged: they should receive one of the authorized COVID-19 boosters two months later.

Which booster is correct?

American Booster Guide allows individuals to mix and match, using the same vaccine as the original series or another they choose.

Although the choices may seem confusing, Dr. Monica Gandhi, an expert in infectious diseases at the University of California, San Francisco, tried to break it down easily.

“Basically, you can get whatever you want for your booster, except for something very special: Johnson & Johnson should be followed by an mRNA (from Pfizer or Moderna), period.”

The FDA approved a second J&J shot based on data showing increased efficacy against COVID-19 to 94%, up from 72% as a single-dose vaccine.

However, a US government study of mixed booster shots found that people who followed a J&J shot with an mRNA booster had significantly higher levels of protective antibodies.

The mix-and-match policy gives physicians more leeway to advise patients at risk of certain side effects to try another vaccine. It also opens up the possibility that not all pharmacies or doctors’ offices will carry all three types of boosters.

Pfizer or Modern?

For those who received mRNA vaccines, the evidence suggesting a need for a booster is strongest for older adults who received the Pfizer / BioNTech shots, said Dr. Paul Offit, an infectious disease expert at the University of Pennsylvania and a member of the FDA’s vaccine advisory board. panel.

For younger individuals who have first been vaccinated with an mRNA vaccine, the decision is more nuanced. According to data presented on Friday for an advisory panel for the CDC vaccine, protection against the Pfizer / BioNTech vaccine appears to be declining faster than Moderna shots, but both still do a good job of preventing hospitalization and death.

Pfizer’s syringe contains 30 micrograms of vaccine and so does the booster. Modern’s original shot was 100 microgram doses, but the booster is approved as a half dose. It is not yet known whether Moderna’s low-dose booster will have the same durability as the original shots.

Kathryn Edwards, a vaccine researcher at Vanderbilt University Medical Center, said Moderna’s lower dose may reduce the short-term side effects such as fever and body aches associated with the higher dose of Moderna syringe.

Vaccines from both Moderna and Pfizer have been linked to a side effect known as myocarditis in younger men, but data presented to CDC advisers on Friday suggest a booster dose does not increase the risk.

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