After 5 doses of Pfizer Covid-19 vaccine, Novavax?

October 29, 2023 1:03 AM

I’m wondering if switching to Novavax instead of the latest, updated Pfizer dose would be better for overall protection. And would getting both be even better or overload?
posted by jras to Health & Fitness (8 answers total)

It appears that heterologous vaccinations may provide better immunity, so switching sounds like a good idea.
posted by waving at 3:18 AM on October 29, 2023

Is Novavax now formulated for the new widely-circulating Covid variants? The Pfizer and Moderna are.
posted by citygirl at 5:33 AM on October 29, 2023

Yes, there's a new 2023-2024 Novavax, using the XBB.1.5 spike protein, the same one used in Pfizer and Moderna, per the FDA's selection in June. It was approved on October 3 and started to hit pharmacies about ten days later. The authorization also de-authorized the previous Novavax vaccine so in theory you shouldn't be able to mess up and get the old one.

I think the evidence is still thin and preliminary, but it's looking like the protection Novaxax offers is on par with the mRNA vaccines, and that there may be a slight advantage to mixing and matching, regardless of the vaccines you choose. However, I don't think there's any indication that getting multiple vaccines close together in time offers enhanced protection--your immune response needs to mature, ideally for 6 months or more, afterwards. That's why there are recommended intervals/wait times.

I picked Novavax this year because my previous Pfizer shots gave me a low-grade fever, chills and malaise for a few days, and I didn't want to take time off work (or scrap a weekend's plans) to get vaccinated. The only side effect from Novavax was a sore arm, similar to my flu shot.

I got mine at Costco, but I've heard CVS has it too.
posted by pullayup at 6:28 AM on October 29, 2023 [2 favorites]

As far as I can tell, research on the potential benefits of ‘mix and match’ was only for boosters. The current dose is not a booster — it’s a fully updated vaccine.
posted by theory at 6:47 AM on October 29, 2023 [1 favorite]

The evidence on this is very thin (there may be small benefit to mixing the two and the protection offered by Novavax is probably not significantly different from the mRNA vaccines). Personally, I'd get the new Novavax, if it was available to me, because I had significant reactions to the first three mRNA doses and very little reaction to Novavax. Lower reactogenicity seems to be pretty commonly observed for Novavax versus mRNA vaccines.
posted by ssg at 8:16 AM on October 29, 2023 [1 favorite]

Dr. Michael Osterholm talked about Novavax in a recent podcast. Here's a link to the episode. There is a full transcript of the episode available at the link, and I just did Ctrl+f and searched on Novavax and found the section pretty easily.

I'm the opposite of you, having done Moderna for all previous vaccinations; this time I changed it up to Pfizer - it was mainly due to timing/what was available, since my husband was about to travel and we wanted to have the new shot on board ahead of time, but also I just thought maybe it was good to cover the waterfront at this stage of the game. I'm kind of thinking that next time I might do Novavax, but plan to wait at least 6 months.
posted by gudrun at 9:23 AM on October 29, 2023

Your Local Epidemiologist (Dr.Katelyn Jetelina) wrote about it and said she's choosing Novavax this time, and I am, too. I had some serious exacerbations of my old health problem after previous covid vaccines, which may or may not have been triggered by them, so a potentially lower risk of side effects sounds good to me.
posted by metonym at 4:42 PM on October 29, 2023

Your other local epidemiologist (me) says that a lot of people in my field are still taking whatever vaccines are available. If you have a wealth of choice, I'd go with switching modalities between doses. This probably only makes a difference that's relevant at the population scale rather than the individual scale, but hey! A rising tide raises all ships.

And no, no need to overdose. You're not going to glean remarkable increases in immune response by almost any measure by spacing doses more closely together unless you have an established immunodeficiency.
posted by late afternoon dreaming hotel at 6:21 PM on October 29, 2023 [6 favorites]