What do we know about taking more than one vaccine?

March 29, 2021 2:03 PM

A late middle-aged, fully vaccinated (Pfizer x2) relative has an opportunity through his workplace to get a J&J injection in about ten days. He insists this is a no-brainer, and because it's through his employer, he would not be taking a dose from someone else. I'm not sure this is a good idea, but I can't find much actual evidence for my concern. Where is the science on doubling/tripling up on vaccines?

(Asking this anonymously because the relative in question was pretty active on MeFi several years ago...)

In case it matters, he tells me he had no side effects from the first dose and almost none from the second.

posted by anonymous to Health & Fitness (26 answers total)

because it's through his employer, he would not be taking a dose from someone else.

Sure he would though. It's not like they get X number of vaccines for X employees. When my sister got vaccinated through her workplace and they had extra vaccines, they gave them to the janitorial staff. Your relative is already 95% protected from COVID and fully protected from serious hospitalization and death. I do not know the science on combining vaccines except that J&J is a slightly different mechanism than Pfizer, but I do know the science on herd immunity and more shots in more different arms is how you get there.
posted by jessamyn at 2:05 PM on March 29, 2021 [64 favorites]

It's unlikely to be dangerous, but I have not seen any studies on this. He'd be conducting a pharmacological experiment on himself. His previous side affects are not relevant. J&J is very different to Pfizer.

Your relative would absolutely be taking a dose from someone else. I don't know what "because it's through his employer" means, but unless his employer will throw his dose in the trash if he doesn't personally take it, how he has access to this vaccine is not relevant. Around 3% of the world's population has been vaccinated so far. 30-something countries have not vaccinated a single person.
posted by caek at 2:40 PM on March 29, 2021 [28 favorites]

There is no science because there have been no studies. There is no existing evidence that getting fully vaccinated more than once could be beneficial. (To be fair, there is no existing evidence that it could be harmful, either.) There is simply no existing evidence, period.

The no-brainer here is not what your relative thinks it is.
posted by jesourie at 2:41 PM on March 29, 2021 [19 favorites]

Seconding jesssamyn, the no-brainer is to let someone else get that shot so that herd immunity becomes a thing more quickly. There is no evidence that getting another vaccine dose would help or harm him, as that has not been the concern of scientific study, but it would definitely be wasteful overall.
posted by Aleyn at 2:52 PM on March 29, 2021 [6 favorites]

Has he lied to his employer and said he hasn't been vaccinated? Your relative might also have to lie on the consent form, if it says that he attests he hasn't been vaccinated for COVID-19 prior to this. Lying to an employer isn't usually a good idea. If he was vaccinated by the state in which the employer is, it's possible that someone will catch him at it, and the employer will find out.

The vaccines come from somewhere, like a state source, and organizations that give them out to employers for distribution are accountable. It's conceivable that the employer could get in trouble for "wasting" a vaccine and for not vaccinating according to protocol they agreed to in order to become a distribution site.

One could also argue that your relative is taking a J&J vaccine away from those who need the vaccine the most, before the vaccines will be widely available to anyone who wants one. The J&J vaccines are especially valuable to large organizations who must vaccinate populations that are difficult to reach out to twice, such as those who are so high risk that they cannot travel, those in rural areas and the homeless.
posted by answergrape at 2:55 PM on March 29, 2021 [10 favorites]

From a pure theory perspective, both vaccines work in a similar way. If I was doubling up, I would want to have one NRNA vaccine (moderna/pfizer) and a traditional (johnson & johnson) for the double coverage.
posted by bbqturtle at 3:08 PM on March 29, 2021

My thoughts are:
1. He should get an antibodies test if he thinks there's a problem with his immunity.
2. He seems to care disproportionately about COVID. There are other viruses/diseases that exist outside of COVID that he can get vaccinated/tested from if he wants to improve his health.

And yes, there is no data around this right now just as there is no data around taking the same flu shot five times in a week.
posted by kinoeye at 3:25 PM on March 29, 2021 [3 favorites]

"He insists this is a no-brainer, and because it's through his employer, he would not be taking a dose from someone else."

There is no science yet on whether you can double up. I've heard speculation from serious sources that they wouldn't expect a problem, but this is just educated guesses at this point.

As for having seconds before everyone has been served, personally, I wouldn't be able to sleep at night, but I'm not your friend. He'd be taking someone else's shot from the larger supply -- it's not like it either goes to him or into the garbage.
posted by Capt. Renault at 3:38 PM on March 29, 2021 [2 favorites]

The vaccine gives instructions to your cells. His cells already have the instructions. They're not going to get a second set of identical instructions and say ok wow guess we really should get to work on this, the boss is serious! They already took the instructions & used them. A second set isn't going to accomplish anything.
posted by bleep at 3:56 PM on March 29, 2021 [7 favorites]

Unless his employer is in the business of making bespoke vaccines, he is absolutely taking a J&J dose from another person.

Just because he doesn't see the person he harms, doesn't mean his action isn't harmful.

(There is no science on this and there likely will never be any science on this, because a trial that involves double/triple vaccinating a privileged few while literal billions wait in line violates every principle of medical ethics.)
posted by basalganglia at 3:56 PM on March 29, 2021 [12 favorites]

Another thing, just to pile on: There are five doses in a vial. If there are four doses left in a vial at the end of the day he gets his *third* vaccination, that's not one dose gone to waste but five. I hope he changes his mind.
posted by kate4914 at 4:09 PM on March 29, 2021 [1 favorite]

The vaccine gives instructions to your cells. His cells already have the instructions. They're not going to get a second set of identical instructions and say ok wow guess we really should get to work on this, the boss is serious! They already took the instructions & used them. A second set isn't going to accomplish anything.

I mean, this isn't really true so it would not be a good argument to make. Pfizer and AstraZeneca are two shots, not one, for a reason. They're testing whether a second shot of J&J is beneficial as we speak. There are existing booster shots for other vaccines. His logic isn't necessarily faulty in that regard.

It's just that getting another vaccine dose *so soon*, which is a completely untested dosing schedule, whilst other people are still in need, for what can only ever at best be a very marginal benefit seems... both selfish and unwise.
posted by stillnocturnal at 4:16 PM on March 29, 2021 [4 favorites]

he would not be taking a dose from someone else

Just to add another angle to the pile-on, one of the reasons the medical & political community is enthusiastic about the J&J vaccine is that not only is it a single shot but it doesn't require super-low temperatures for storage & transport - which means it's a great vaccine to use for variously disadvantaged people (the homeless, those with mobility & travel issues, the currently jobless, etc etc etc.) Ohio/Cuyahoga County/the city of Cleveland (I forget which off the top of my head) has been intentionally and specifically using their J&J doses to reach those people and not middle-aged folks with jobs and health insurance who can diddy-bop on over to any of a hundred pharmacies and urgent care centers and wherever any time they feel like.

So, there's a damn good chance that an unused J&J vaccine will not get thrown away but will get sent on to someone who needs it a lot more than your relative does.
posted by soundguy99 at 4:29 PM on March 29, 2021 [12 favorites]

I mean, this isn't really true so it would not be a good argument to make. Pfizer and AstraZeneca are two shots, not one, for a reason. They're testing whether a second shot of J&J is beneficial as we speak.

There is no reason why someone would need a booster for this just weeks after having gotten a complete round though. Point is his cells already got the instructions. Unless he's the one person who it didn't work on what would be the purpose of another vaccine?
posted by bleep at 4:48 PM on March 29, 2021 [1 favorite]

He is already well-protected, the dose is in fact needed elsewhere, and he will have to lie or assertively hide the truth to do this. tell him he's being a doofus (kindest term I can think of) and to cut it out.
posted by theora55 at 4:54 PM on March 29, 2021 [7 favorites]

There is no science; no relevant studies have been performed. It probably won’t hurt him, but who knows?
posted by mr_roboto at 6:33 PM on March 29, 2021 [1 favorite]

I suspect it won't be a problem, and I've wondered if we'll eventually transition to doing exactly that, but his idea of "not taking it from anyone" is off.

That said, if he's decided to accept the dose, you're very unlikely to change his mind. Decide, before pushing it to that point, whether or not you're willing to accept this as the hill for the relationship to die/change significantly on, just in case.

(In my personal perspective, if that person were a follower of a particular politician, and/or an avid anti-masker or unwilling to take precautions, it would definitely be my hill to finish the relationship off. If I hadn't already, given this last year. I've got zero patience left with certain nonsense.)
posted by stormyteal at 6:49 PM on March 29, 2021

I am not a scientist, medical professional or particularly smart, but it occurs to me that if this person has say both does of Pfizer, were he to get a J&J shot, assuming the Pfizer is working it will cause their body to start fighting the J&J vaccine as if it were the virus. Seems like it would be a stressor on their body if nothing else.

Having said that, let us know how it works out if they do take the J&J version. Although I do not know the person directly, I have heard of a person in my town that had the 1st does of Pfizer and then got a J&J shot and never got the 2nd Pifzer. No idea how that worked or why they did it that way. It might have been their medical provider who suggested it for all I know.
posted by AugustWest at 7:59 PM on March 29, 2021

It's hard enough getting people to get vaccinated with one version at all right now, without figuring out doubling up. That's why there are no studies on this. Your relative may be the first person ever with this option.

I will honestly be surprised if he's ALLOWED to get a third shot, there's databases being kept on this sort of thing.
posted by jenfullmoon at 9:29 PM on March 29, 2021 [1 favorite]

Tell him if he does it and gets away with it he'd better keep it a secret. If he goes around proudly telling everyone about how clever he's been, a lot of people might come to different conclusions than what he intended.
posted by trig at 1:57 AM on March 30, 2021 [3 favorites]

All vaccine manufacturers are interested in learning about instances in which people receive doses of multiple vaccines, because it does happen (accidentally and intentionally) and we're interested in the science of it. If he does get the J&J vaccine, he should alert both Pfizer and J&J vaccine clinical review teams (both have easily googleable points of contact for this sort of thing). If he's unwilling to do so, he should not volunteer for the J&J vaccine. I'm saying all of this wearing my epidemiologist hat, without wading into any discussion of the ethics or general wisdom of his outlook.
posted by late afternoon dreaming hotel at 2:56 AM on March 30, 2021 [8 favorites]

I frankly do not think your relative will be moved by scientific evidence or an ethical argument but maybe you could somehow convey that this is such a "sitcom dumb guy" thing to do. Michael Scott bragging about "completing the set" while Darryl looks at the camera. Homer getting "topped up" with the last shot Mr. Burns secured for the plant so Frank Grimes misses out. That kind of thing.
posted by katiec at 9:23 AM on March 30, 2021 [2 favorites]

Here is an article in the NYTimes that talks about it and suggests that the studies show that it is not only not a bad idea, but might be a good idea.
posted by AugustWest at 10:33 PM on March 30, 2021 [2 favorites]

Though note that according to that article the only studies with results so far are with mice, and they're only testing combinations of two shots from different vaccines designed to be delivered in two doses, not the effect of a third shot on someone who's already received the full two doses.

The concept of mixing vaccines — sometimes called a heterologous prime-boost — is not new to our pandemic era. For decades, researchers have investigated the approach, hoping to find potent combinations against a range of viruses, such as influenza, H.I.V. and Ebola.

But scientists had little to show for all that research. It was easy enough to demonstrate that two vaccines may work well together in a mouse. But running full-blown clinical trials on a combination of vaccines is a tall order.

posted by trig at 1:22 AM on March 31, 2021 [3 favorites]

This is a silly and unnecessary idea, and has never been researched so no one knows the effect (although there's no theoretical reason why it would be harmful) but what can you do? Relative is probably going to do what they want to do.
posted by latkes at 10:38 AM on March 31, 2021 [3 favorites]

Looks like AugustWest has the real answer. Still, I doubt your relative is open to feedback on their plan. Also, it's probably pretty inconsequential in the scheme of things whether they do this or not. I'm just happy to see people who want to get vaccinated. - A nurse
posted by latkes at 10:51 AM on March 31, 2021