Another Booster Question

October 22, 2021 6:59 AM

I JUST qualify for the CDC's recommendation for a booster for 18-64. Being a Moderna haver, the news from yesterday prompted making an appointment at Walgreens for the half-dose booster. But they've been giving these low doses probably just since opening today. Would it be better to wait for my county health dept. to start offering boosters from real nurses, or letting a few days go by so that the pharmacy techs are more accustomed to giving the half-dose?

If I accidentally end up getting a third full dose of Moderna, is that the worst thing in the world?

posted by hwyengr to Health & Fitness (6 answers total)

Not the worst thing in the world - people who qualify for a third Moderna (immunocompromised folks) dose have been getting full 3rd doses all along.

But mix and match doses are now approved, and there is evidence that receiving a booster of another vaccine may offer broader protection. So maybe ask for a Pfizer booster? It's also a full dose, exactly the same as the 1st and 2nd doses.

The one thing vaccine experts agree on is not to get your booster before 6 months have elapsed from your 2nd dose to maximize efficacy.
posted by citygirl at 7:35 AM on October 22, 2021

Response by poster: Forgot to note in the question that the underlying condition granted earlier access to the vaccine in IL, so the 6 mos has gone by.
posted by hwyengr at 7:45 AM on October 22, 2021

Pharmacists in most states, including IL, administer vaccines all the time, not just for Covid. Every year they do flu shots, some pharmacies offer travel immunizations, etc. . The pharmacist will have given different kinds of vaccines that all have different dosages (including the different Covid-19 vaccines, which have different dosages). I wouldn't worry any more about getting an incorrect dose from them today versus in a few days. I wouldn't worry about a pharmacist vs a nurse, either, in fact I prefer a pharmacist because it saves me the rigamarole of making an appointment at my clinic.

Pharmacy techs in IL can only administer under the direct supervision of a pharmacist, even with the Covid expansions.
posted by assenav at 8:08 AM on October 22, 2021 [6 favorites]

I'm a doctor.

If I accidentally end up getting a third full dose of Moderna, is that the worst thing in the world?

I'm not aware of a dose-dependent relationship between Armageddon and the Moderna vaccine, so I'd say no.

All kidding aside, a full 3rd dose behooves you.

(I just answered another booster question someone had. It's tangentially relevant, so I've copied it below in case your interested)

1) Homologous vs heterogenous booster vaccination regimens

Not complicated

HOM = 3rd shot same as shots 1 and 2
HET = 3rd shot different than 1 and 2

NB: shots 1 and 2 = Primary vaccination regimen (PRI)

2) What do we know about whether one regime is better than the other?

Nothing definitive, though two studies out this week--a major one from Israel with 12000 participants, and a smaller one from Switzerland (I think)--found HET was about 30% more effective against the Delta and Beta (don't ask) variants of Covid.

In Israel's turgid words:

The fold increases from baseline in both binding and neutralizing antibody titers were similar or greater after heterologous boosts compared to homologous boosts

and

this preliminary report demonstrates that boosting with any of the three vaccines currently licensed or authorized for emergency use in the US will stimulate an anamnestic response* in persons who previously received of the primary series of any of these vaccines. Homologous boosts provided a wide range of immunogenicity responses, with heterologous boosts providing comparable or higher titers

That said:

In these two studies, as well as every other one I'm aware of, both HET and HOM regimens boosted immunity regardless of PRI regimen

*With infection and with vaccination, one has a peak immune response in the weeks after antigen exposure, then a natural decay over months to years. This is 100% normal and to be expected. Following this decline in immunity, the immune system responds more rapidly and strongly when exposed to the antigen again. That's what anamenestic means--hence the logic of booster vaccinations
posted by BadgerDoctor at 8:08 AM on October 22, 2021 [1 favorite]

There's no skill-level difference between the two options, if your concern is that they'll somehow do it poorly. I think anybody who's been doing vaccinations for the past 6-10 months is going to be as good as they're ever going to get at it.

The amount of vaccine to draw into the syringe is going to be top-of-mind. But should someone mess up, my understanding is that the half-dose recommendation is more of a "good enough" situation than "a whole dose is bad". The only harm will be to the pharmacy's inventory levels.
posted by Lyn Never at 8:34 AM on October 22, 2021 [4 favorites]

FWIW, my father-in-law is a retired pharmacist who reads FDA and NIH reports for fun. He's not sold on the mix and match vaccines - says they don't have enough data to proclaim them safe and effective. They probably are, but his advice to us was stick to what you got the first go-around if at all possible.
posted by COD at 2:45 PM on October 22, 2021