A Moderna or Pfizer booster seems to be better for the J&J COVID vaccine: gunshots

Updated October 14, 12:45 p.m. ET

Apparently, if you received the Johnson & Johnson vaccine as your first COVID-19 vaccination, a booster dose of either the Moderna or Pfizer BioNTech vaccine could produce a stronger immune response than a second dose of the J&J vaccine. That is the realization of a highly anticipated study released on Wednesday.

And if you started with either Pfizer or Moderna, it probably doesn’t matter that much, so research says, as long as you get either of the two mRNA vaccines as a booster.

The study carried out by the National Health Institute, involved 458 volunteers. They were divided into nine groups with about 50 volunteers in each group. Those who initially received the two-dose Moderna or Pfizer vaccines were given either a Moderna syringe, a Pfizer syringe, or a Johnson & Johnson syringe as a booster four to six months after their primary series.

And people who got the one-time J&J vaccine either got another J&J shot or a Moderna or Pfizer booster.

The researchers then measured the antibody levels in all of these people two weeks and four weeks after the boost. The results were very interesting.

People who received the Moderna vaccine for their original vaccinations and Moderna again for their booster vaccine seem to have received the best immune response, followed by those who received Pfizer with Moderna and then Moderna with Pfizer – although the immune response increased with the mRNA Vaccines were probably too small to really make a difference in protection in most groups.

The main finding suggested that people who originally received the J&J vaccine apparently got the best response when given Pfizer or Moderna as a booster.

In an email to NPR, Nathaniel Landau, a microbiologist at New York University’s Grossman School of Medicine, said the results showed that a J&J boost after the first single immunization is “not as good” as either of the mRNA vaccines Booster. The antibody levels of the people in these groups rose 10 to 20 times higher than those who received another J&J injection.

And that antibody surge is likely big enough to make a difference in how much better the protection will be, say scientists. How much better is not known – this study wasn’t big enough to determine how much less likely people who subsequently contracted the coronavirus were to get sick – or how sick they got. But based on other research, that kind of difference in antibody response is likely enough to offer greater protection.

“If you get a Moderna or Pfizer vaccine first, it really doesn’t matter which mRNA vaccine you get next,” Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco, told NPR. “But if you’ve had a Johnson & Johnson vaccine, it really shows us that the best vaccine for the next one is an mRNA vaccine – either a Moderna or a Pfizer.”

For its part, J&J said the study showed that a boost to the Johnson & Johnson COVID-19 vaccine boosted immune response regardless of a person’s primary vaccination, and confirmed previously published data on the sharp increase in immune response when the Johnson & Johnson COVID-19 occurs – Vaccination 19 vaccine is given as a booster. ”

There are a few caveats with this study that make the data a little difficult to interpret. First of all, the study wasn’t designed to compare one booster with another, but to see what kind of immune response each one creates. In addition, the researchers tested full doses of all vaccines – not half the dose that Moderna is seeking approval for in its booster.

The researchers also measured antibody levels two and four weeks after the booster. So there is a possibility that the antibody levels from a J&J booster will continue to rise over time. And the scientists assume that higher antibody levels mean more protection. This is likely true, but other factors can also play a role, such as reactions from other parts of the immune system.

The researchers also say their study was not designed to compare different responses between the different booster regimens, and that the data set is not large enough to draw conclusions about one or the other.

“I’m concerned about the interpretation of our data,” says Dr. John Beigel of the National Institute of Allergy and Infectious Diseases. Beigel helped run the study, which was published without peer review Preprint server medRxiv.

The bottom line is that the results show that all three vaccines could be useful as boosters, Beigel emphasizes.

“Any of the three or three vaccines would be a good boost, including Johnson & Johnson,” Beigel says.

In fact, says Saad Omer, a vaccine researcher at Yale University, the Johnson & Johnson vaccine could be very useful as a booster, especially in parts of the world where the other vaccines are not available.

“The end result will be in countries where the mRNA vaccine is not available, a second dose of the J&J vaccine is very reasonable as it gives a pretty decent response,” he says. “But where there are other options, I think an extra dose of an mRNA vaccine is a bit superior.”

The results are not entirely surprising. Something similar was seen in the UK when people who received the AstraZeneca vaccine – which is similar to the J&J shot – received booster shots.

The NIH study data will be reviewed later this week by advisors to the Food and Drug Administration during a meeting to consider requests from Moderna and J&J to approve booster doses of their vaccines.

The FDA has already approved a booster dose of the Pfizer BioNTech vaccine for people over the age of 65 whose health, job, or life situation is at risk for serious illness.