What's the deal with people seeking out Novavax as a booster?

March 17, 2023 10:59 AM

I've noticed that a fair number of people on my social medias are clamoring for--or reporting that they have already received--Novavax as a booster. Novavax is not approved for use as a booster in the US, so some sort of deception was involved. Is this A Thing, and are there any compelling arguments in favor of doing it?

To be completely clear, this is NOT a question about enthusiasm about Novavax from previously non-vaccinated folks. I'm aware this is a thing, possibly driven by (anti-vax-driven) misinformation about mRNA vaccines. (Unlike Pfizer or Moderna, Novavax is a tradvax protein-plus-adjuvant vaccine.)

These folks seem to be a part of "covid realist" or "zero covid" communities, which are not a thing I try to participate in intentionally but overlap with a lot of long covid folks who I do follow. The fact that Novavax boosting is now coming to my attention may be partially due to Twitter dysfunction subsequent to the acquisition--it seems like there's also suddenly a lot of fringey doomer stuff showing up unsolicited. Things like "once 40% of the population has long covid, which will happen in 202X, society will collapse, it's basic and inescapable arithmetic" or ghoulish speculation about which individuals or groups are behaving strangely or aggressively because of "covid dementia."

But these also seem like the same people are advocating for things like CPC mouthwash, which seems to be at least provisionally supported by real scientific evidence, and quasi-legal Enovid importers, which was recently covered by Ask with a general vibe of "can't hurt, might even be actually effective."

And, honestly, while I'm a more than a little itchy about seeking out any sort of medical device or treatment that requires skirting the law or my doctor's approval, I also understand that a lot of folks with long covid do so out of necessity due to poor awareness. It really does seem like there are still a lot of physicians treating ME/CFS as an essentially psychological complaint or a combination of deconditioning, anxiety and malingering. While I'm pretty sympathetic to anyone in that position looking outside of medical orthodoxy, I'm also acutely aware of the way it opens up a gap through which all sorts of scammers and hucksters (and simply misinformed folks) can rush through.

So, what's the deal with Novavax boosters?

posted by pullayup to Health & Fitness (18 answers total)

You may be right that it's affected by anti-mRNA propaganda. But there's another possible reason: there's some evidence from experts (and some strong belief by non-experts, which is related but not the same thing) that mixing vaccine types may provide some additional protection. I remember when the first wave of boosters became available, many of my friends intentionally sought out pharmacies with Moderna boosters because most of them had gotten Pfizer. If you believe this, then Novovax is a third option, and it's not mRNA, which "can't hurt" and also "might add another layer of protection if there's something about a strain that gets past mRNA." I know that might not line up with any given bit of research or facts, but it's a pretty strongly held and consistent line of thinking, and it (probably) isn't actively harmful so even if misguided, I wouldn't expect to see strong pushback from the medical community.
posted by Tomorrowful at 11:09 AM on March 17, 2023 [2 favorites]

Things like "once 40% of the population has long covid, which will happen in 202X, society will collapse, it's basic and inescapable arithmetic" or ghoulish speculation about which individuals or groups are behaving strangely or aggressively because of "covid dementia."


I would encourage you not to seek out information for these spaces. IMHO this is just the flip side of the crazy coin as the people who talk about the Great Reset and speculate whether every death is due to the vaccine.

That said, I think the logic behind Novavax as a booster is just the hope that getting different kinds of shots will offer you broader protection, but I have no idea if this is actually true.
posted by vanitas at 11:13 AM on March 17, 2023 [3 favorites]

Response by poster: I would encourage you not to seek out information for these spaces

Yeah, things like this merit a block when they come up, but even if I stay on top of blocking there's definitely a slow, steady leak of "suggested content" and (on Twitter, e.g.) retweets by people I do follow. I'm still struggling a bit with how intolerant I want to be, because I *don't* want to just systematically block folks who have long covid or entertain more extreme opinions about shielding than I do (and my opinions are not even slightly extreme, by any measure--I do a lot of stuff in my day to day life that would get me DRAGGED if I admitted them on covid Twitter).
posted by pullayup at 11:22 AM on March 17, 2023

Best answer: This CDC guideline says Novavax is approved for use as a booster. It’s unclear if the people you are seeing meet the guidelines, but it’s approved for certain use.

That said, we - especially those of us that are high risk, but every single human - has been left to manage this all mostly on our own. The US has the resources to slow this down and won’t. So many are rightfully terrified and trying to do their best to protect themselves and others.

It’s valid that in any arena there will be views that you disagree with or aren’t backed by science. And I feel that the doom circle is problematic and best to avoid. But I think the risk of mixing vax’s or getting one you don’t fully qualify for is probably less than risking Covid from peoples risk assessment. (I am not a doctor, I have not had this Vax, and I will likely follow my doctors advice but we are all left wondering what the hell to do right now.)
posted by Crystalinne at 11:25 AM on March 17, 2023 [9 favorites]

Response by poster: This CDC guideline says Novavax is approved for use as a booster.

I should have Googled this--I recently asked my PCP and was told it hadn't been approved, and took their word for it. I guess I should ask them about this. And with this I'll butt out.
posted by pullayup at 11:27 AM on March 17, 2023

Most of my socializing online happens in communities invested in avoiding acquiring or transmitting covid, or getting long covid, so I suspect it's probably at least partly overlapped with what you're referring to as "covid realist" community. I'm not seeing any particular interest in Novavax, so I'm not sure what subset of people you're running into.

But yes, I do see a general sense in my communities that there's some potential value in mixing brands of vaccine - especially as many of us have not to the best of our knowledge ever had covid so we're quite possibly not working with a level of acquired immunity there. I wouldn't be at all surprised to see someone in my circles saying "all things being equal maybe for this round of boosters I'll get the one I haven't had yet." Whether all else IS equal I don't know, I'll probably do a round of research in the fall and see what the data on the available boosters is looking like then.
posted by Stacey at 11:28 AM on March 17, 2023

I can’t speak to the Novavax as a booster idea specifically but within my science-friendly family, there is support for the idea that it may be wise to get vaccinated with vaccines manufactured by different companies. One family member has received all of the recommended shots including at least one from Pfizer, Johnson & Johnson and Moderna respectively so I would not be surprised if this person sought out the Novavax shot. Re: the need for a little bit of deception, that’s not ideal but I think it’s not crazy given that those who received the Johnson & Johnson vaccine found later that it may provide less immunity than Pfizer or Moderna.
posted by kat518 at 11:29 AM on March 17, 2023

A friend of mine is a General Practitioner and very much a believer in mainstream science.

She got Novavax for her booster because she'd already had 2 Pfizer and 2 Moderna and wanted to maximise her protection.
posted by chariot pulled by cassowaries at 11:29 AM on March 17, 2023 [2 favorites]

Response by poster: I know I promised to butt out, but after investigating Crystalline's link, it seems to indicate Novavax has been approved as a "first booster dose at least 6 months after completion of primary vaccination with an authorized or approved COVID-19 vaccine to individuals 18 years of age and older for whom an FDA-authorized mRNA bivalent COVID-19 booster vaccine is not accessible or clinically appropriate." Like a lot of people I've now had two Pfizer boosters, the most recent being the bivalent, so my next would be the third. So I might not be eligible. I'm still going to ask my physician.
posted by pullayup at 11:36 AM on March 17, 2023

Best answer: I was interested in Novavax as a booster because I read that the side effect profile wasn’t as significant as the Pfizer and Moderna shots. As no one in this area was offering Novavax, all four of my shots were Moderna and Pfizer and I spent 36-48 hours hating my life and sweating through sheets and having a sore arm and the stroke headache and vertigo. Basically feeling worse after the shots than the two times I actually had Covid (just for a much shorter amount of time). So, anecdotal, but you might be seeing people seeking a booster that won’t make them feel like death eating a cracker.
posted by sara is disenchanted at 11:52 AM on March 17, 2023 [2 favorites]

Here's something from this guy who saves links to everything. Wired magazine article "No One Knows if You Need Another COVID Booster".

I am a computer programmer, not an epidemiologist. I'm not even your computer programmer. FWIW.
posted by forthright at 12:15 PM on March 17, 2023 [1 favorite]

in Toronto ;
​Who can get immunized with Novavax Nuvaxovid?
Adults 18 years of age and older can be vaccinated with Novavax

You just have make an appointment to get it.

They still say mrna is preffered
posted by yyz at 12:25 PM on March 17, 2023

I was interested in Novavax as a booster because I acquired raging tinnitus as a side effect of my Pfizer booster. I ended up going with Moderna in the end, but for sure there were a lot of tinnitus sufferers debating whether to risk another booster and if so, which one would be least likely to aggravate their tinnitus.
posted by HotToddy at 2:09 PM on March 17, 2023

I got Novavax as a 4th shot, before the updated Omicron mRNA shots were available (which I later got as well). I had side effects that were significant and lasted for quite a few days with the earlier Moderna shots and had read anecdotally that Novavax tended to cause fewer side effects. I also spent a long time scrutinizing the available data and expert opinions on how mix-n-match fared in terms of protection from infection and severe disease. At the time (last summer), I think that evidence pointed to mix-n-match being possibly slightly better than all mRNA, though I think the evidence has now swung back in the other direction.

This is comparing a three original mRNA plus Novavax to four original mRNA — it's always been clear than an Omicron booster is better than Novavax. As it happened, I was able to get both, so I did. To be clear, I'm very strongly pro-vaccination.

I did have near-zero side effects from Novavax, while previous mRNA shots had put me out of commission for days (I have a chronic illness that was significantly worsened). That said, these side effects seems to be reducing as I get more shots, so my 5th shot (Omicron Moderna booster) wasn't too bad. I can certainly understand that there are a small number of people who have been even more significantly impacted by mRNA vaccine side effects than I have been, especially people with potential immune dysfunction. I don't blame them for looking for a vaccine with potentially fewer side effects. It's really unfortunate that the discussion about vaccine side effects has become totally mixed up with anti-vax sentiment.
posted by ssg at 4:59 PM on March 17, 2023

Potentially, you are seeing a lot of Novavax-related content on social media right now, because the company is reportedly in very dire straights financially, and people want them to not go out of business.

Pre-2021, everyone in my covid discussion group was very gung-ho about Novavax; their vaccine was believed to be not as expensive to produce and store as the mRNA vaccines but without the long-term concerns of all the adenovirus vaccines. They just could not get their authorizations and manufacturing up fast enough to matter, and there's no room for another type of vaccine shot.
posted by meowzilla at 7:44 PM on March 17, 2023

I sought out a novavax booster last year based on this Twitter thread from a biomedical researcher. It's approved in Ontario so it wasn't like a super crazy thing to do. That was my fifth shot. I will say when I finally did get covid for the first time this past January it still pretty much walloped me. I can only assume it would've been much worse without the vaccines.
posted by stray at 9:10 PM on March 17, 2023 [1 favorite]

Here in New Zealand Novovax is now available as an alternative booster to the Pfizer bivalent vaccine. It isn't available across the country though.
posted by i_am_joe's_spleen at 12:50 AM on March 18, 2023

Here are my thoughts as someone who got the J&J primary vaccine just before the serious adverse events became public. I got J&J to accompany a family member who was anti-mRNA.

So, the interest in Novovax is at least as much about cognitive bias as it is about any actual comparative merit. It’s part of developing an identity as knowing more than the mainstream, having access to “better” information than most, being smarter or more saavy. Getting the vaccine nobody else is getting makes you special.

With J&J the discourse was pretty irrational, since J&J uses a novel method of vaccine which, as it turned out, was likely more risky than mRNA (for certain groups). So my conclusion was that J&J seekers were more influenced by their need to have special knowledge than a dispassionate choice of vaccine.

Anyway, I have a 10 year old boy who had an adverse reaction to Pfizer and will not be getting another mRNA covid vaccine to avoid that and also due to myocarditis concerns. I sure wish there were better official guidance on the different boosters available and the costs-benefits for different categories of people.
posted by haptic_avenger at 6:24 AM on March 18, 2023