Moderna vs Pfizer: is it OK to mix and match the updated COVID-19 booster shots?

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As residents prepare to roll up their sleeves for a third, fourth, or even fifth dose of COVID-19 vaccine, some may be wondering: Should I stick with the same brand, or is it safe to mix it up?

When it comes to the new COVID-19 Omicron bivalent booster, the answer is yes, you can mix and match.

You can get the Pfizer-BioNTech or Moderna version regardless of which offer you received before.

“The best booster for you is the one you can get — whether the Pfizer or the Moderna can be used, and they can be mixed or matched,” says Dr. Robert Kim-Farley, epidemiologist and infectious disease expert at the UCLA Fielding School of Public Health. “If there’s a shortage of one, don’t hesitate to take the other.”

Mix and match

Suppose a person has received three doses of the Moderna injection. Should they stick with Moderna or mix it up with a Pfizer booster?

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The effect on the body’s immune system should be similar anyway, wrote UC San Francisco infectious disease expert Dr. Peter Chin-Hong in a tweet.

“It’s okay to mix and match Moderna and Pfizer,” said Dr. Ralph Gonzales, associate dean for clinical innovation and chief innovation officer for UC San Francisco, at a city hall on campus last week. “I just got my Moderna two days ago and it was an interesting experience. I definitely felt a stronger response with the Moderna – because I had Pfizer before – but both combinations are fine.”

The US Food and Drug Administration allowed mixing and matching of COVID-19 booster doses last year after it allowed people to get their first booster dose. Despite having the choice, many people remained brand loyal.

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But others switched it over, either as a matter of preference, availability, or recommendation. For example, many of those who initially received the Johnson & Johnson single-dose vaccine opted for Pfizer or Moderna come booster time.

What comes next

When some people — 50 and older and immunocompromised — were eligible for a second conventional booster shot earlier this year, some decided to go for the other brand. dr. Robert Wachter, chairman of the UC San Francisco Department of Medicine, decided to go with Moderna in April for his fourth injection after three consecutive Pfizers.

“I saw it as a toss-up”, he said tweeted at the time.

Omicron’s updated bivalent booster injection is available for children 12 years and older. Adults can choose from Pfizer or Moderna; adolescents ages 12 to 17 are eligible for Pfizer only.

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LA County Public Health Director Barbara Ferrer said there is some expectation that the updated booster will be available for children ages 5 to 11, perhaps as early as October.

Officials are urging people to get the updated booster, which they expect will reduce the risk of infection. It is called a bivalent injection because it is designed to protect not only against the original coronavirus strain, but also against the latest Omicron subvariants that have dominated the nation this summer, including BA.5.

“The bivalent boosters provide protection against the sub-variants currently circulating at the highest levels, and they will be one of our best tools in planning a safe, healthier and happier fall and winter holiday season,” Ferrer said Thursday.

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