Health Bulletin: Mix it up with COVID-19 vaccines


Chair, Westfield Board of Health

By Juanita Carnes FNP, Board of Health chair

About a month ago, one of my sons asked me what I thought about mixing COVID vaccines. I was thinking along the lines of accessibility and necessity. He was wondering if it would provide stronger immunity. I readily admit, I had not even thought about it. Nor had I come across it in my readings and research.

This week the FDA authorized mixing vaccines when getting a booster shot. Limited research has shown that mix-and-match vaccine schedules elicit a stronger immune response. They also authorized booster shots for Moderna and Johnson & Johnson. New research shows the mixing and matching different types of COVID-19 vaccines is highly effective.

Recent research done in Sweden found that protection against infection was stronger in those who received a first dose of the AstraZeneca (vector-based vaccine, as is J&J) and a second dose of a mRNA vaccine than those that received two doses of AstraZeneca vaccine. Research at the NIH here in the U.S. showed those who received the J&J and then received a Moderna saw antibody levels rise 76-fold, compared to four-fold after an extra J&J vaccines. Canada and several European countries recommending a different vaccine booster out of necessity, after the AstraZeneca had some clotting side effects, have found it to be beneficial.

We are seeing breakthrough infections. The approval of any available single booster, following completion of primary vaccination, has been looked at for many reasons. Giving second doses and booster of the same vaccine has proved challenging under guidelines of same type of vaccine. Allowing any available vaccine will improve access, provides flexibility, helps with supply issues, reduces wait times, gives patients choices and offers options to those who have had adverse reactions. Most important is the research showing two different vaccines may be more potent than either alone. Mixing the two types may give the immune system multiple ways to recognize a pathogen.

Along the same thought process is the immunity gained from having had the COVID infection and the vaccine. Preliminary research shows that people who have been infected and were fully vaccinated have strong protection, including against variants. COVID-19 infection effectively serves as a dose of the vaccine. One will eventually need a booster, but not as quickly. This combination of real-world infection and the protection generated by vaccination is called “hybrid immunity” and gives more immunity that either the vaccine or infection alone.

My thoughts and my son’s thoughts were both on track. Mixing up vaccines offers increased access and stronger immunity. Research is continuing to add to this evidence. With this present focus on boosters, it is important to stress that the priority is getting the unvaccinated vaccinated. Get vaccinated if you are not, encourage those that are not vaccinated, get a booster shot no matter what kind, socially distance, use hand sanitizer, spread the truth, dispel misinformation and wear your mask.

Take care of yourself and someone else.

Dedicated health department members have been working tirelessly throughout the pandemic, as well as Board of Health members Juanita Carnes, FNP, Margaret Doody, and Stan Strzempko, M.D.

We keep working to keep you safe.

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