Life with Chronic Disease: Mix and Match Covid Vaccines/Masking/Flu shot

A number of people have asked about the upcoming booster shots and whether “mixing and matching” (M&M) will be approved along with the possibility of  a J & J booster.

 

The one thing we can count on, be it Covid or anything else, is that things change as we learn more. Therefore, this post is accurate as of 8/28/21.

 

In response to supply challenges, a number of countries including England, Germany, Thailand and Canada are mixing and matching, with one of the more common strategies being AstraZeneca (AZ) followed by one of the mRNAs (Pfizer or Moderna). While AZ is not approved in the USA, J & J is a similar vaccine, though designed as a “one and done shot” vs the two shot AZ protocol. 

 

AZ and J&J  use “viral vector technology,” which has been around since the 1970s. Viral vector vaccines use a modified, harmless version of a different virus as a vector, or carrier, to deliver immunity instructions to cells in the body. The body then follows those instructions to build an immune response to the intended virus (in this case, SARS-CoV-2, which causes COVID-19.) The virus vector being used in J&J and AZ vaccines is an adenovirus, a common type of virus that typically causes mild cold symptoms when it infects someone.

 

As we’ve seen with the mRNAs, research findings on effectiveness are pretty similar, so it would seem the AZ research is relevant to the potential for a J&J mix and match.

 

mRNAS can Mix & Match:  With the approval of a third dose of an mRNA, regulators have stated that if a recipient’s original shot is not available, they can be vaccinated with the other one. E.g. If your first two shots were Moderna, your third can be Pfizer and vice versa

 

M&M Research to date looks good: A good review of the current situation appears in Nature,  which summed up findings as follows: Mixing COVID-19 vaccines is emerging as a good way to get people the protection they need when faced with safety concerns and unpredictable supplies…The lingering possibility of rare side effects is one reason some researchers recommend that people stick to the standard two shots of a single vaccine for now…But as new variants of SARS-CoV-2 emerge, the results of mix-and-match trials could provide policymakers with the data they need to switch to more protective combinations.

 

Countries already M&Ming it: While the World Health Organization said on July 12 that the M&M approach was a dangerous trend since there was little data about the health impact, as of Aug. 16, Reuters named a list of the countries that have decided and/or are considering M&M-Cambodia; Denmark; Germany; Indonesia; Russia; Turkey; UK and the US.

 

So where does that leave J&J folks? Some providers are referring to this as a “supplemental dose,” and San Francisco General Hospital made the decision, in conjunction with the San Francisco’s Dept. of Public Health, to offer an mRNA to those J&J recipients that want it. Note that the most recent research on J&J The New England of Medicine, shows that it’s offering lasting protection and works against Delta. It appears that people had stable and broader antibodies at 8 months after immunization than they essentially did at 8 weeks.

 

Johnson & Johnson Booster Shot: A booster dose of Johnson & Johnson's COVID-19 vaccine prompted a big spike in antibodies among clinical trial participants, when taken six to eight months after the first dose, the company announced on Wednesday (Aug.25). 

 

Breakthrough Data: The breakthrough data is interesting. Healthline recently published data on how well the vaccines have worked against the Delta variant, suggesting efficacy rates of more than 67 percent for the J&J vaccine, 72 to 95 percent for the Moderna vaccine, and 42 to 96 percent for the Pfizer-BioNTech vaccine.

 

COVID-19 Vaccines 66% Effective Against Delta Variant: Vaccine effectiveness against COVID-19 infection dropped from about 91% to 66% once the Delta variant became the dominant strain in the U.S., according to a new study published Tuesday by the CDC. The decline points to the highly contagious nature of the Delta variant and underscores the importance of vaccination to prevent severe disease, hospitalization and death, the study authors wrote. The latest update is part of an ongoing study that follows health care workers, first responders and essential workers who undergo weekly testing in eight locations across six states. The weekly testing helps researchers to better track the rates of people who develop mild or no symptoms and may be less likely to get tested overall.

 

US Plans COVID-19 Booster Shots at 6 Months Instead of 8: U.S. health regulators could approve a third COVID-19 shot for adults beginning at least six months after full vaccination, instead of the previously announced eight-month gap, the Wall Street Journal reported on Wednesday. Approval of boosters for three COVID-19 shots being administered in the United States, including J&J is expected in mid-September, the report said.

 

 So why a booster If Delta would be the parting shot of Covid that would be lovely, but it isn’t and we will be dealing with Covid for many years to come. Note, the 1918 flu virus H1N1 is still with us. Ultimately, the boosters are being put in play to better protect against the variants stacking up to take their turn at whacking the humans.

 

Can I get my flu shot and booster at the same time? The Morbidity & Mortality Weekly Report has just released updated flu vaccine recommendations for 2021–2022. COVID-19 vaccines may be given with flu vaccines. Everyone 6 months and older should get a flu vaccine this fall. That noted, if you had a reaction to the Covid vaccine and/or flu vaccines, discuss with your provider as it may be best for you to get them at different times.

 

Masking does work: Because of the highly transmission and the volume of virus in the nose and throat, masks make a lot of sense. In spite of raging Governors and parents shouting down pediatricians about how masks don’t work (they learned that from Dr. Facebook), the research is showing that they do save lives. Check out Masks Save Lives:Here’s What You Need to Know. 

 

The University of Texas Covid-19 Modeling Consortium is projecting nearly 100,000 more Covid 19 deaths between now and Dec. 1. However, this number could be cut in half if nearly everyone wore a mask in public spaces.