Utah doctor’s advice for COVID-19 booster shots: Get the brand you started with

CDC has now approved boosters for all three U.S.-approved brands, and OKs ‘mix-and-match’ shots.

(Francisco Kjolseth | The Salt Lake Tribune) Laura Kennedy administers a COVID-19 shot at a vaccination clinic at Salt Lake City's Rose Park Elementary on Sept. 22, 2021. The federal Centers for Disease Control and Prevention approved booster doses of the Moderna and Johnson & Johnson vaccines on Oct. 21, 2021 — after approving a booster for the Pfizer vaccine a month before.

Cutting through the confusion about COVID-19 booster shots, a leading Utah doctor is offering this advice: When possible, get the brand you got the first time.

“We’re still recommending people that can get their booster shot to match their original series, if that’s available to you,” Dr. Eddie Stenehjem, infectious diseases physician at Intermountain Healthcare, said Friday. “If you had a Pfizer vaccine series and you are able to get a Pfizer booster, go ahead and do that. Same thing with Moderna. Same thing with [Johnson & Johnson].”

The federal Centers for Disease Control and Prevention on Thursday recommended the use of booster shots of the Moderna and Johnson & Johnson COVID-19 vaccines — following a similar recommendation for the Pfizer version last month.

As of Wednesday, the Utah Department of Health reported, more than 112,000 third doses of the Pfizer vaccine have been given to people in Utah.

“The data are clear, providing booster doses can help prevent COVID-19 related hospitalizations and deaths,” Dr. Leisha Nolen, Utah’s state epidemiologist, said in a statement Friday.

“Almost universally,” Stenehjem said, his fellow health care workers — one of the groups for whom the booster has been recommended — received their doses as soon as they became available. “We’ve not had any concern in our health care providers that we’re worried about that third shot,” he said.

The CDC’s recommendation for the Moderna booster has the same qualifications as the Pfizer booster: to get a shot six months after receiving their second dose. The boosters for Moderna and Pfizer are recommended for people 65 and older, or people living in long-term care facilities, or people 18 and older with underlying medical conditions (such as obesity), or people — like health care workers and teachers — who live or work in places that put them at higher risk of exposure to COVID-19.

The CDC’s guideline for the J&J booster is simpler: Anyone 18 and over who got their shot at least two months ago can get the booster.

The CDC has said it may recommend additional populations receive booster shots as more data become available.

The distribution of boosters in Utah is on the honor system, UDOH spokesman Tom Hudachko said, adding that he’s not heard of any providers requiring proof that a recipient fits into the population for which the CDC is recommending these shots.

Unlike the eligibility requirements for vaccines last winter, the CDC’s booster recommendations are not based on how much supply of the vaccine is available, Hudachko said. “It’s who can benefit most from receiving a booster dose,” he said.

The CDC’s advisory also allows people to mix and match brands — the medical term is heterologous vaccination, Stenehjem said — if one’s original vaccine isn’t available.

“It’s a recommendation to allow convenience of boosting across the general public,” Stenehjem said at Intermountain’s weekly COVID-19 community briefing on Facebook Live. “It’s so people don’t have to go out and hunt down a Moderna shot or a Pfizer shot. If they’re in a setting where they don’t have a Pfizer shot, and they had Pfizer initially, they can go out and get a Moderna shot or a J&J shot. It really offers some flexibility.”

Nolen said flexibility, for both patients and providers, is one upside of the mix and match option. “Some people may have a preference for the vaccine type that they originally received and others may prefer to get a different booster,” Nolen said. “And providers should have an easier time managing inventory by being able to offer their patients different choices for boosters.”

Stenehjem said that while the early data about the effectiveness of boosters is encouraging, there is little data so far about the effectiveness of switching brands. “We’re going to be certainly following very closely the effectiveness of boosting strategy. And if we see that one strategy is more effective than another, then we’d make that recommendation,” Stenehjem said.

Nolen said there is some data to suggest people who got the Johnson & Johnson vaccine “are better protected if they receive a booster of either the Moderna or Pfizer.”

She added, that “with hospitals still operating at full capacity, and with the winter months just around the corner, the timing is right to seek out a booster dose if you qualify.” She also stressed that it’s “critically important that people who haven’t been vaccinated go get their vaccine now.”

To make an appointment to get a COVID-19 vaccination — whether it’s the first, second or now third shot — go to vaccinate.utah.gov. UDOH also has compiled a list of local health departments, with their contact information, at coronavirus.utah.gov/vaccine-distribution.