The FDA Is Expected to Approve the 'Mix and Match' Approach for COVID Boosters

An announcement from the agency is expected this week that could greenlight "mixing and matching" boosters, aka receiving another dose that differs from one's original vaccine series.

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Over the course of the last few days, there has been a lot of new information about COVID-19 booster shots. Not only did an advisory panel for the U.S. Food and Drug Administration recommend additional doses of the Moderna and Johnson & Johnson vaccines, but now, it appears the agency will allow the "mix and match" approach for booster doses.

The FDA is expected to announce in the coming days that folks can receive a COVID-19 booster shot that differs from their initial dosage, reportsThe Washington Post, citing two federal officials. The publication also notes, though, that the agency may suggest that folks should try to get the same vaccine as their original inoculation, if possible.(

The idea of mixing COVID-19 boosters has been a topic of discussion for some time. And while matching a booster to an original series has been advised by experts (William Schaffner, M.D., an infectious disease specialist, and professor at the Vanderbilt University School of Medicine, previously told Shape that it's "the straightforward recommendation"), recent data from a study sponsored by the National Institute of Health found that the folks who received the one-shot Johnson & Johnson vaccine experienced an increase in antibody protection from an mRNA booster (aka Pfizer or Moderna). But as The Washington Post reports, there are a few question marks in regards to the booster dosage with the Moderna vaccine. For instance, some health officials have suggested half a dose of the original Moderna vaccine for a booster — which is what is expected to be authorized — or a full dose, which was used in the study, according to The Washington Post.

The three COVID-19 vaccines that are currently available in the U.S. are all safe but vary in terms of how they're made as well as their efficacy. For starters, the Johnson & Johnson vaccine uses an inactivated virus (an adenovirus, which causes the common cold) to deliver instructions to the body to trigger an immune response against COVID-19. The Pfizer and Moderna vaccines, on the other hand, rely on messenger RNA (mRNA) to carry out similar orders to the body in order to combat the virus. Further, Moderna and Pfizer have reported a 94.5 percent and 90 percent efficacy rate against COVID-19, respectively, and J&J's vaccine is 85 percent effective in preventing severe illness (which can potentially include hospitalizations and intensive care), according to a February 2021 press release.

When it comes to the COVID-19 boosters, however, only Pfizer has been granted emergency use authorization of its boosters for select recipients (e.g. those who are immunocompromised) six months after the second dose of their initial vaccination. The FDA is also suggesting a single-dose booster for folks whose jobs "puts them at high risk of serious complications of COVID-19," including severe illness, according to a September 2021 press release from the agency. (See more: This Is Who's Eligible to Receive a Pfizer COVID-19 Booster Shot)

With the FDA expected to make an announcement Wednesday in regards to the Moderna and Johnson & Johnson COVID boosters, according to The Washington Post, it remains as imperative as ever to take precautions. While masking up and social distancing are among effective ways to keep the virus at bay, but getting a vaccine, whether Moderna, Pfizer, or Johnson & Johnson, when eligible, can help you protect yourself and your loved ones as well.

The information in this story is accurate as of press time. As updates about coronavirus COVID-19 continue to evolve, it's possible that some information and recommendations in this story have changed since initial publication. We encourage you to check in regularly with resources such as the CDC, the WHO, and your local public health department for the most up-to-date data and recommendations.

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