Can I Mix And Match The First Two Shots
No, the health officials’ allowance for mixing COVID-19 vaccines applies only to boosters. As of now, the FDA has only authorized a mixed-series booster, meaning the first coronavirus vaccine series must be two doses of Moderna or Pfizer or one dose of Johnson & Johnson.
More data on mixing for boosters will inform decisions on primary coronavirus vaccine series being used together, which could make it easier to reach underserved communities and possibly reduce health care and vaccine inequity.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
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About The Clinical Considerations
- COVID-19 vaccines currently approved or authorized by FDA are effective in preventing serious outcomes of coronavirus disease 2019 , including severe disease, hospitalization, and death.
- COVID-19 primary series vaccination is recommended for everyone ages 5 years and older in the United States for the prevention of COVID-19.
- A 3-dose primary mRNA COVID-19 vaccine series is recommended for people ages 5 years and older who are moderately or severely immunocompromised, followed by a booster dose in those ages 12 years and older.
- In most situations, Pfizer-BioNTech or Moderna COVID-19 Vaccines are preferred over the Janssen COVID-19 Vaccine for primary and booster vaccination.
- At least 1 booster dose of COVID-19 vaccine is recommended for everyone ages 12 years and older. Recommendations for booster dose vary based on age, COVID-19 vaccine product, and immunocompetence.
- Efforts to increase the number of people in the United States who are up to date with their COVID-19 vaccines remain critical to preventing illness, hospitalizations and deaths from COVID-19.
- These clinical considerations provide additional information to healthcare professionals and public health officials on use of COVID-19 vaccines.
What About The Future
The COVID vaccine you get today is not likely to be your last. As immunity naturally wanes after immunisation, periodic boosters will become necessary to maintain effective protection.
There is now promising data from Spain that mix-and-matching vaccines is safe and can trigger very potent immune responses. So this may be a viable strategy to maintain high vaccine effectiveness over time.
In other words, the best vaccine might in fact be a number of different vaccines.
Talking with those who know: personal vaccination strategy for COVID is: 2 doses of AstraZeneca, then hoping for a booster shot of Pfizer later. Higher we get our antibody levels, the more protected we are against virus variants. Increasing data from Europe favors mixing vaccines
Prof. Peter Doherty May 24, 2021
Variant viruses have started to circulate, and while current vaccines show reduced protection against these variants, they still protect .
So, while one vaccine might have a greater efficacy in a phase 3 trial, that vaccine might not necessarily be best at protecting against future variants of concern circulating near you.
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Could An Mrna Vaccine Change My Dna
An mRNA vaccine cannot change your DNA.
mRNA, or messenger RNA, is genetic material that contains instructions for making proteins. mRNA vaccines for COVID-19 contain man-made mRNA. Inside the body, the mRNA enters human cells and instructs them to produce the “spike” protein found on the surface of the COVID-19 virus. Soon after a cell makes the spike protein, the cell breaks down the mRNA into harmless pieces. At no point does the mRNA enter the cell’s nucleus, which is where our genetic material lives.
The immune system recognizes the spike protein as an invader and produces antibodies against it. If the antibodies later encounter the actual virus, they are ready to recognize and destroy it before it causes illness.
The two mRNA vaccines available in the US are made by Pfizer/BioNTech and Moderna. Both have been granted full approval by the FDA.
Vaccination Of Children And Adolescents
This section summarizes special considerations for COVID-19 vaccination of children and adolescents.
Dosing and formulation
Children should receive the age-appropriate vaccine formulation and follow the schedule based on their age on the day of vaccination, regardless of their size or weight . Children ages 511 years should receive the 10 µg Pfizer-BioNTech COVID-19 Vaccine formulation and adolescents ages 12 years and older should receive the 30 µg Pfizer-BioNTech COVID-19 Vaccine formulation.
If a child turns 12 years old between their first and second dose, they should receive the age-appropriate 30 µg Pfizer-BioNTech COVID-19 Vaccine formulation for their second dose. However, the FDA authorizationexternal icon allows children who will turn from age 11 years to 12 years between their first and second dose in the primary series to receive, for either dose: the Pfizer-BioNTech COVID-19 Vaccine formulation for children ages 511 years or the Pfizer-BioNTech COVID-19 Vaccine formulation authorized for use in people ages 12 years and older . If such dosing occurred, the child has completed their primary series. This is not considered an error and Vaccine Adverse Event Reporting System reporting is not indicated.
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Do I Still Have To Wear A Mask If I Get A Vaccine
The CDC continues to monitor the spread of COVID-19 and makes recommendations for wearing face masks, both for those who are fully vaccinated as well as people who are not fully vaccinated.
The CDC also recommends that masks and physical distancing be required when going to a doctors office, hospital or long-term care facility, including all Johns Hopkins hospitals, care centers and offices.
Johns Hopkins Medicines mask safety guidelines have not changed, and we still require everyone to wear masks inside all of our facilities.
Do The Vaccines Protect Against The Variants
The optimism that came with the approval of COVID-19 vaccines in late 2020 was tempered by the emergence of several coronavirus variants that had mutated to be more contagious, deadlier, and potentially able to evade the vaccines.
But the data so far suggest that currently available vaccines work well against the variants.
Chen says that those who are vaccinated and later infected with one of the concerning variants are still unlikely to be hospitalized. Though there is little real-world data on how the vaccines work against the B.1.351 variant a particularly concerning one first detected in South Africa one small clinical trial for the AstraZeneca vaccine was halted after it showed only 22% efficacy against the variant. Notably, none of the vaccinated people, who were generally low-risk for severe COVID-19 to begin with, were hospitalized or died.
The World Health Organization says that the vaccines are likely to provide at least some protection against each of the variants because they prompt a broad immune response beyond just targeting the spike protein that is the focus of the vaccines.
Pfizer and Moderna have begun testing third booster shots of the vaccines to see if the extra dose could provide further protection against the variants. They are also developing variant-specific vaccines targeting the B.1.351 variant.
Edwards would not be surprised if it turns out that people need to continue to get COVID-19 booster shots as additional variants emerge.
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Which Covid Vaccine Is Best Heres Why Thats Really Hard To Answer
With the rollout of COVID-19 vaccines accelerating, people are increasingly asking which vaccine is best ?
Even if we tried to answer this question, defining which vaccine is best is not simple. Does that mean the vaccine better at protecting you from serious disease? The one that protects you from whichever variant is circulating near you? The one that needs fewer booster shots? The one for your age group? Or is it another measure entirely?
Even if we could define whats best, its not as if you get a choice of vaccine. Until a suite of vaccines become available, the vast majority of people around the world will be vaccinated with whichever vaccine is available. Thats based on available clinical data and health authorities recommendations, or by what your doctor advises if you have an underlying medical condition. So the candid answer to which COVID vaccine is best is simply the one available to you right now.
Still not convinced? Heres why its so difficult to compare COVID vaccines.
Where To Get The Covid Vaccine
Now, the big question is where to get the vaccine for COVID. The Centers for Disease Control and Prevention is in partnership with several pharmaceutical giants in the United States to provide the COVID vaccine free of cost to every eligible American.
You can use the official website of these pharmaceutical giants to create an appointment. Walgreens, Rite Aid, and CVS pharmacy Are offering all the vaccines at their respective pharmacies throughout the nation.
In total, there are more than 10,000 locations of just these three pharmaceutical giants. Apart from that, the Centers for Disease Control and prevention is also providing vaccines through several independent clinics and public health care centers.
You are completely free to use the services of any pharmacy you want. For example, you get your primary series of vaccines from Rite Aid, and now you want to get your booster shots at Walgreens. No one is stopping you from doing that. You are completely free to create an appointment and get vaccinated.
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Which Vaccines Has The Fda Approved And Authorized For Covid
The FDA has granted full approval to the mRNA COVID-19 vaccines developed by Pfizer/BioNTech and Moderna, and has granted emergency use authorization to Johnson & Johnson’s adenovirus vaccine. In December 2021, the CDC stated a preference for vaccination with either of the mRNA vaccines.
The Pfizer/BioNTech vaccine has also been authorized for children ages 5 to 17 years, though children ages 5 to 11 will receive a lower dose.
In addition, booster doses of all three vaccines have been authorized for eligible recipients.
Should I Get The Covid
Both COVID infection and full vaccination protect against subsequent COVID infection for several months. A report published in MMWR even suggested that prior infection may be more protective than vaccination. Still, the CDC recommends vaccination for everyone who is eligible, even those who were previously infected. If you are sick with COVID-19, you can get vaccinated as soon as you meet the criteria for discontinuing your isolation.
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The Fda Has Granted Full Approval To The Pfizer/biontech And Moderna Covid
The FDA has granted full approval to the Pfizer/BioNTech COVID-19 mRNA vaccine for use in people ages 16 years and older, and to the Moderna COVID-19 mRNA vaccine for use in people ages 18 years and older.
For both vaccines, the transition from EUA status to full licensure was based on additional data and longer follow-up showing that the vaccines met certain safety, effectiveness, and manufacturing quality standards. Safety data will continue to be collected and monitored.
Before granting full approval, the FDA also inspected vaccine manufacturing facilities to ensure vaccine quality. Full approval gives doctors some leeway to prescribe the vaccine for “off-label” use. The Pfizer/BioNTech vaccine can now be marketed under the brand name Comirnaty. The Moderna vaccine will be marketed under the name Spikevax.
EUA status may be granted by the FDA during public health emergencies when they determine that the known and potential benefits of a medical product â in this case, the COVID-19 vaccine â outweigh the known and potential risks.
I Have A Severe Allergy Can I Get The Mrna Covid
There have been rare cases of people having a severe allergic reaction after receiving the mRNA COVID-19 vaccine. As a result, everyone getting an mRNA vaccine in the US must be observed for at least 15 minutes after getting their shot, so they can receive immediate medical treatment if they experience a severe allergic reaction.
Despite the small risk, most people with a history of severe allergy can safely get the mRNA COVID-19 vaccine. This includes people who are allergic to food, pollen, bee stings, and medications taken by mouth. If you have a history of severe allergy, tell the person administering your vaccine. You will be observed for at least 30 minutes, instead of the usual 15 minutes.
If you have a history of allergic reactions to injectable medications or other vaccines, the CDC recommends asking your doctor if you should get one of the currently available mRNA vaccines.
There are some people who should not get an mRNA COVID vaccine. You should not get one if you are allergic to any components of the mRNA vaccine, which include polyethylene glycol and polysorbate. If you had an allergic reaction within the first 30 minutes after receiving the first vaccine dose, ask your doctor whether or not you should get a second dose. There are different types of allergic reactions and the specifics of your reaction can help inform the decision.
If you have questions regarding the safety of the COVID vaccine for you, your best option is to talk to your doctor.
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What’s The Difference Between Pfizer’s And Moderna’s Booster
Pfizer and BioNTech’s booster dose is the same size as its original vaccine, 30 micrograms. While Moderna’s booster dose is only half the size of the doses given as the first two shots, its booster is slightly larger than Pfizer’s, at 50 micrograms. Both are mRNA vaccines, which teach our cells to make a specific protein and build immunity against a virus.
Johnson & Johnson’s booster and vaccine are the same dose. It’s a viral vector vaccine that uses a harmless virus to activate an immune response that teaches our bodies what to fight in future infections. However, the FDA recently said Johnson & Johnson’s vaccine should only be given to people who either can’t take Pfizer’s or Moderna’s vaccine and those who choose Johnson & Johnson’s because they don’t want an mRNA vaccine.
Are The Vaccines Safe
Every vaccine that is approved in the United States, even if under emergency use authorization, undergoes stringent safety testing, and the CDC continues to collect data on any side effects or adverse outcomes that could be related to the vaccine over time.
People who receive vaccines may experience a number of side effects, such as a sore arm, fever, fatigue, chills, nausea, and body aches especially after the second dose of one of the two-dose regimens. This is a sign that the immune system is reacting and is not a cause for concern. The CDC recommends taking a painkiller after getting the shot and exercising the arm to avoid soreness.
The side effects are generally more intense after the second shot, as the immune system reacts to the known spike protein. The CDC also reports that 80% of those who reported experiencing side effects were women, which may be related to sex hormones role in the immune response, according to a New York Times article.
There are some rare serious side effects, such as anaphylaxis a life-threatening, but treatable, allergic reaction. In the United States, this reaction has occurred in about two to five people per million vaccinated and has not resulted in any deaths.
The CDC requires that vaccinated people stay at the vaccination site for observation for at least 15 minutes after getting the shot in case they do have a negative reaction.
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What Needed To Happen Before The Fda Authorized Or Approved A Vaccine For Covid
Approval of the Pfizer/BioNTech and Moderna vaccines and authorization of Johnson & Johnson’s vaccine required completion of the following steps:
- Pre-clinical testing: Animals are infected with the virus. Scientists study their immune response to see what aspects of the immune response might be critical for protection. Normally, a vaccine is first tested in animals. However, in the setting of a pandemic such as this one, the animal testing stage can be skipped.
- Phase 1 trials: A vaccine is tested in small groups of people to determine what dose safely and consistently stimulates the immune system. At this stage, scientists don’t yet know if the immune response triggered by the vaccine will protect against the virus.
- Phase 2 trials: The vaccine is given to hundreds or thousands of people. Scientists continue to focus on whether the vaccine is safe and produces a consistent immune response.
- Phase 3 trials: These trials typically enroll tens of thousands of people. This is the first phase that involves a placebo group. It compares the number of people who get sick in the vaccine group to the number of people who get sick in the placebo group. This is the only phase that can show whether or not the immune response triggered by the vaccine actually protects against infection in the real world.
Safety data continue to be collected and monitored even after the vaccines are approved or authorized.
Appendix B People Who Received Covid
Participants in clinical trials within or outside the United States who received all the recommended primary series doses of a vaccine listed for emergency useexternal icon by WHO that is not FDA-approved or FDA-authorized are considered fully vaccinated. In addition, U.S. trial participants, along with non-U.S.-based participants in the same trial, who received a vaccine that is not listed for emergency use by WHO but for which a U.S. data and safety monitoring board or equivalent has independently confirmed efficacy are considered fully vaccinated at this time, only the Moderna COVID-19 Vaccine in children ages 617 years and the Medicago COVID-19 Vaccine in people ages 18 years and older meet these criteria.
If clinical trial participants have questions about whether they should receive an additional and/or booster dose outside of the clinical trial, they should consult with their healthcare provider. Clinical trial participants who did not receive all the recommended doses, or who received other vaccines not listed above, should consult with their healthcare provider to determine if they should receive an FDA-approved or FDA-authorized COVID-19 vaccine series.
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