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COVID Booster: Mix and Match Side Effects?

MRBXXXFVVS1

Brilliant_Rock
Joined
Dec 5, 2019
Messages
1,450
Has anyone here gotten a mix and match of the COVID vaccines for their booster? If so, which ones did you get, what side effects did you have, and how did they compare to your previous doses? I'm particularly interested in those who had Pfizer for their first 2 doses. Thanks!
 
I had Moderna for my first two doses and recently got a Pfizer booster, so the opposite from what you're asking about. Fwiw, the only thing I noticed from the Pfizer booster was a sore arm at the injection area for a couple of days. (With the Moderna, I felt mildly flu-ish for a couple of days after the second dose only).
 
My DH got the Pfizer the first time and I want him to get the Moderna if possible for a booster.
 
I'm hoping to mix, if I can. I had an allergic reaction to both Pfizer. Maybe Moderna will be better for me.
 
I'm hoping to mix, if I can. I had an allergic reaction to both Pfizer. Maybe Moderna will be better for me.

Eliza, maybe, but I am doubtful. Of course until you take the Moderna you won't know for sure. But this is my reasoning. Moderna is very similar to Pfizer but it has even more active ingredient in the vaccine. So if anything your reaction might be exacerbated over the Pfizer. See my post in the booster thread. Tread carefully. If this were me I would get another Pfizer. More people have a (more severe) reaction to Moderna than Pfizer. And the reasoning is because Moderna has more in their vaccine (100mcg for the first two and 50 for the booster) than Pfizer (30 mcg)
 
@elizat from my post yesterday in the booster thread.

"The Moderna booster contains 50 mcg of the active ingredient.
Moderna vaccines one and two contain 100 mcg of the active ingredient.
The Pfizer vaccines (booster or injections one or two) contain 30 mcg of the active ingredient.

More is not necessarily better though, to date, evidence does suggest that Moderna protects a bit better than Pfizer against the Delta variant.




"

Moderna vs. Pfizer: Both Knockouts, but One Seems to Have the Edge​

A series of studies found that the Moderna vaccine seemed to be more protective as the months passed than the Pfizer-BioNTech vaccine. Here’s why.

It was a constant refrain from federal health officials after the coronavirus vaccines were authorized: These shots are all equally effective.
That has turned out not to be true.
Roughly 221 million doses of the Pfizer-BioNTech vaccine have been dispensed thus far in the United States, compared with about 150 million doses of Moderna’s vaccine. In a half-dozen studies published over the past few weeks, Moderna’s vaccine appeared to be more protective than the Pfizer-BioNTech vaccine in the months after immunization.
The latest such study, published on Wednesday in The New England Journal of Medicine, evaluated the real-world effectiveness of the vaccines at preventing symptomatic illness in about 5,000 health care workers in 25 states. The study found that the Pfizer-BioNTech vaccine had an effectiveness of 88.8 percent, compared with Moderna’s 96.3 percent.
Research published on Friday by the Centers for Disease Control and Prevention found that the efficacy of the Pfizer-BioNTech vaccine against hospitalization fell from 91 percent to 77 percentafter a four-month period following the second shot. The Moderna vaccine showed no decline over the same period.

If the efficacy gap continues to widen, it may have implications for the debate on booster shots. Federal agencies this week are evaluating the need for a third shot of the Pfizer-BioNTech vaccine for some high-risk groups, including older adults.
Scientists who were initially skeptical of the reported differences between the Moderna and Pfizer-BioNTech vaccines have slowly become convinced that the disparity is small but real.
“Our baseline assumption is that the mRNA vaccines are functioning similarly, but then you start to see a separation,” said Natalie Dean, a biostatistician at Emory University in Atlanta. “It’s not a huge difference, but at least it’s consistent.”
But the discrepancy is small and the real-world consequences uncertain, because both vaccines are still highly effective at preventing severe illness and hospitalization, she and others cautioned.
“Yes, likely a real difference, probably reflecting what’s in the two vials,” said John Moore, a virologist at Weill Cornell Medicine in New York. “But truly, how much does this difference matter in the real world?”

“It’s not appropriate for people who took Pfizer to be freaking out that they got an inferior vaccine.”
Even in the original clinical trials of the three vaccines eventually authorized in the United States — made by Pfizer-BioNTech, Moderna and Johnson & Johnson — it was clear that the J.&J. vaccine had a lower efficacy than the other two. Research since then has borne out that trend, although J.&J. announced this week that a second dose of its vaccine boosts its efficacy to levels comparable to the others.
The Pfizer-BioNTech and Moderna vaccines rely on the same mRNA platform, and in the initial clinical trials, they had remarkably similar efficacy against symptomatic infection: 95 percent for Pfizer-BioNTech and 94 percent for Moderna. This was in part why they were described as more or less equivalent.
The subtleties emerged over time. The vaccines have never been directly compared in a carefully designed study, so the data indicating that effects vary are based mostly on observations.
Results from those studies can be skewed by any number of factors, including the location, the age of the population vaccinated, when they were immunized and the timing between the doses, Dr. Dean said.

The Coronavirus Pandemic: Latest Updates

Updated
Nov. 2, 2021, 7:33 p.m. ET

For example, the Pfizer-BioNTech vaccine was rolled out weeks before Moderna’s to priority groups — older adults and health care workers. Immunity wanes more quickly in older adults, so a decline observed in a group consisting mostly of older adults may give the false impression that the protection from the Pfizer-BioNTech vaccine falls off quickly.
Given those caveats, “I’m not convinced that there truly is a difference,” said Dr. Bill Gruber, a senior vice president at Pfizer. “I don’t think there’s sufficient data out there to make that claim.”

But by now, the observational studies have delivered results from a number of locations — Qatar, the Mayo Clinic in Minnesota, several other states in the United States — and in health care workers, hospitalized veterans or the general population.
Moderna’s efficacy against severe illness in those studies ranged from 92 to 100 percent. Pfizer-BioNTech’s numbers trailed by 10 to 15 percentage points.
The two vaccines have diverged more sharply in their efficacy against infection. Protection from both waned over time, particularly after the arrival of the Delta variant, but the Pfizer-BioNTech vaccine’s values fell lower. In two of the recent studies, the Moderna vaccine did better at preventing illness by more than 30 percentage points.
A few studies found that the levels of antibodies produced by the Pfizer-BioNTech vaccine were one-third to one-half those produced by the Moderna vaccine. Yet that decrease is trivial, Dr. Moore said: For comparison, there is a more than 100-fold difference in the antibody levels among healthy individuals.
Still, other experts said that the corpus of evidence pointed to a disparity that would be worth exploring, at least in people who respond weakly to vaccines, including older adults and immunocompromised people.

“At the end of the day, I do think there are subtle but real differences between Moderna and Pfizer,” Dr. Jeffrey Wilson, an immunologist and physician at the University of Virginia in Charlottesville who was a co-author of one such study, published in JAMA Network Open this month. “In high-risk populations, it might be relevant. It’d be good if people took a close look.”
“Pfizer is a big hammer,” Dr. Wilson added, but “Moderna is a sledgehammer.”
Several factors might underlie the divergence. The vaccines differ in their dosing and in the time between the first and second doses.

Vaccine manufacturers would typically have enough time to test a range of doses before choosing one — and they have done such testing for their trials of the coronavirus vaccine in children.
But in the midst of a pandemic last year, the companies had to guess at the optimal dose. Pfizer went with 30 micrograms, Moderna with 100.
Moderna’s vaccine relies on a lipid nanoparticle that can deliver the larger dose. And the first and second shots of that vaccine are staggered by four weeks, compared with three for the Pfizer-BioNTech vaccine.
The extra week may give immune cells more time to proliferate before the second dose, said Dr. Paul Burton, Moderna’s chief medical officer. “We need to keep studying this and to do more research, but I think it’s plausible.”
Moderna’s team recently showed that a half dose of the vaccine still sent antibody levels soaring. Based on those data, the company asked the F.D.A. this month to authorize 50 micrograms, the half dose, as a booster shot.
There is limited evidence showing the effect of that dose, and none on how long the higher antibody levels might last. Federal regulators are reviewing Moderna’s data to determine whether the available data are sufficient to authorize a booster shot of the half dose.
Ultimately, both vaccines are still holding steady against severe illness and hospitalization, especially in people under 65, Dr. Moore said.

Scientists had initially hoped that the vaccines would have an efficacy of 50 or 60 percent. “We would have all seen that as great result and been happy with it,” he said. “Fast forward to now, and we’re debating whether 96.3 percent vaccine efficacy for Moderna versus 88.8 percent for Pfizer is a big deal.”

"
 
I got Pfizer for all three, but my husband just got his booster last night around 7pm, and he opted for Moderna after receiving two Pfizers. So far (it's 4am) he's a little achy and sore with medium headache, which seems to be much less of a reaction than his Pfizer #2 (chills and massive headache). He normally has stronger reactions to vaccines compared to me. I had zero reaction except a lot of energy and increased senses for shots 1 and 2, but nothing at all for the booster. I wish I had the option to choose Moderna when I scheduled, but it wasn't approved for the booster at the time, and I was travelling 2 weeks later so I took what was available.

ETA: They say to drink a lot of water before/after the shots, which I did, but he didn't for #2. He drank a ton today before the booster appointment and seems to be taking it much better compared to #2. I wonder if that made a difference?
 
I too am hoping to mix, to get Pfizer as I had AZ for the first 2 doses.

No side effect with AZ except for a bit of soreness in the injection site which is normal - I had the same with my flu jab recently.

DK :))
 
I had Covid 1 year ago with J&J six months later for my first dose. I just received the Moderna booster. I did not have side affects with the J&J but had fever, headache and was very tired after the booster (like a mini Covid). Very glad I had the option to get the cocktail!
 
Eliza, maybe, but I am doubtful. Of course until you take the Moderna you won't know for sure. But this is my reasoning. Moderna is very similar to Pfizer but it has even more active ingredient in the vaccine. So if anything your reaction might be exacerbated over the Pfizer. See my post in the booster thread. Tread carefully. If this were me I would get another Pfizer. More people have a (more severe) reaction to Moderna than Pfizer. And the reasoning is because Moderna has more in their vaccine (100mcg for the first two and 50 for the booster) than Pfizer (30 mcg)

Thanks, I did look at that too. My other half is uncomfortable with me mixing because of that reason as well- he looked it up too. I should have gone to urgent care the first time but I was very dumb and didn't. At that time, there was not much on people getting allergic reactions so I thought I would be laughed at if I went. I will load up on the Benadryl again as I did with shot two. Second time it helped to have it onboard. Still had breakthrough numbness and tingling in face, eye twitches, and throat still felt like it was closing up, but it was much much better than the first shot. I am thinking after looking at what you posted and more reading, I probably should stick with the Pfizer.
 
Following up on my husband's booster. It's now 15 hours after his moderna booster (after pfizer #1 and 2), and he feels fine. Headache mostly gone, and he's not achy anymore. He's been cleaning the house the past 2 hours, not feeling exhausted like before. This is way better than #2, when he was achy for almost a full day and really tired.
 
I asked my doctor. I had Pfizer initially. She said that per her impression, Moderna would be stronger. This being said, she is very healthy and had very strong effects from Moderna. I fainted 5 min after 2nd dose of Pfizer. The first one I didn't notice.

Don't know...

My husband got Moderna and was sick for 4 hours after the 2nd dose, but then, he is healthy, too.

Will flip a coin.
 
Thanks, I did look at that too. My other half is uncomfortable with me mixing because of that reason as well- he looked it up too. I should have gone to urgent care the first time but I was very dumb and didn't. At that time, there was not much on people getting allergic reactions so I thought I would be laughed at if I went. I will load up on the Benadryl again as I did with shot two. Second time it helped to have it onboard. Still had breakthrough numbness and tingling in face, eye twitches, and throat still felt like it was closing up, but it was much much better than the first shot. I am thinking after looking at what you posted and more reading, I probably should stick with the Pfizer.

h, this makes me nervous. If you are going to get another shot, you might consider adding a 2nd generation antihistamine (like Zyrtec, Allegra, Claritin) and Pepcid (which is an antihistamine targeted towards H2 receptors). I know some allergists have the ability to check for allergu to the most common allergenic ingredients in the vaccines (typically PEG/polysorbate)
 
FYI. I found this very interesting.

"The mix-and-match study also suggested some modest benefits with mixed boosters among those who had received mRNA vaccines. For instance, for people fully vaccinated with Moderna, a Pfizer booster increased antibody titers about 10-fold compared to 8-fold with Moderna (the increase was only 5-fold with J&J). Similarly, for people fully vaccinated with Pfizer, a Moderna booster increased antibody titers about 17-fold compared to 15-fold with Pfizer (the increase was only 6-fold with J&J). Keep in mind that the Moderna booster dose used in this study was the regular Moderna vaccine (100 mcg), which is twice the dose of the booster (50 mcg) authorized for use by the FDA, while the Pfizer dose remains the same (30 mcg) for its booster. There is ongoing research on the effectiveness of 50-mcg Moderna booster (ClinicalTrials.gov, NCT04889209). Side effects of the boosters were similar to those reported with the primary series of the respective vaccine, although the study was too small and short-term to evaluate rare side effects (Latmar, medRxiv 2021 — preprint)."


Who is eligible for the booster dose?

"
For people who received Pfizer or Moderna vaccines, the following groups of people are eligible to be administered a booster shot at least six months after the two-dose series (CDC Expands Eligibility for COVID-19 Booster Shots, 10-21-21):

  • People 65 and older
  • People 18 or older with medical conditions that make them more likely to get severely ill from COVID-19, such as obesity, smoking (current or former use), heart conditions, diabetes, chronic liver diseases, and others (full list here). Schizophrenia and mood disorders have been added to this list by the CDC based studies that showing that among people with COVID-19, those with schizophrenia had 2.7 times the chance of dying as those without schizophrenia (Nemani, JAMA Psychiatry 2021), and those with mood disorders (e.g. depression or bipolar disorder) had a 31% higher chance of being hospitalized and a 51% higher chance of dying compared to those without (Ceban, JAMA Psychiatry 2021).
  • People 18 and older living in long-term care settings (e.g., skilled nursing facilities, inpatient psychiatric or substance abuse settings, assisted living facilities, etc.)
  • People 18 and older who work in high-risk settings. Occupations at increased risk for COVID-19 exposure include:

    • First responders (healthcare workers, firefighters, police, congregate care staff)
    • Education staff (teachers, support staff, daycare workers)
    • Food and agriculture workers
    • Manufacturing workers
    • Corrections workers
    • U.S. Postal Service workers
    • Public transit workers
    • Grocery store workers"
 
h, this makes me nervous. If you are going to get another shot, you might consider adding a 2nd generation antihistamine (like Zyrtec, Allegra, Claritin) and Pepcid (which is an antihistamine targeted towards H2 receptors). I know some allergists have the ability to check for allergu to the most common allergenic ingredients in the vaccines (typically PEG/polysorbate)

Thank you! This is super helpful. I think that makes sense, especally because the Benadryl didn't stop the reaction on shot two and I still had breakthrough throat pain/tightness/feeling as though I couldn't swallow, plus the other things. Was better, but still there. The nurse at the health department told me to take Benadryl for the second, after I reported my issue with the first by phone. I appreciate the advice a lot- I just wish I knew what I was reacting to in the shot!

I have a a lot of sensitivities to topical products- lotion, creams, skin care, facial masks, even some soaps, etc., they cause rashes, red marks that act/heal like burns, swelling. I'm now wondering if maybe the polysorbate/PEG is part of the answer.
 
Thank you! This is super helpful. I think that makes sense, especally because the Benadryl didn't stop the reaction on shot two and I still had breakthrough throat pain/tightness/feeling as though I couldn't swallow, plus the other things. Was better, but still there. The nurse at the health department told me to take Benadryl for the second, after I reported my issue with the first by phone. I appreciate the advice a lot- I just wish I knew what I was reacting to in the shot!

I have a a lot of sensitivities to topical products- lotion, creams, skin care, facial masks, even some soaps, etc., they cause rashes, red marks that act/heal like burns, swelling. I'm now wondering if maybe the polysorbate/PEG is part of the answer.

Yeah, your mention of throat tightness makes me nervous (I work in the emergency department, so I treat anaphylaxis regularly, and technically throat swelling + exposure to a possible allergen = anaphylaxis so that's why I say it makes me nervous). I know that a lot of allergy offices have the ability to test for PEG/polysorbate allergy so if you wanted a definitive answer (and your health insurance deductible isn't prohibitively high) you probably could get one.
 
I'll report back after having my booster on 17 November which will be a different brand to the AZ I had for my first 2 doses.

DK :))
 
Interesting dress
Good luck and good health to you all
i will get what ever the NZ govt buys for us to have
We got pfizer here so I'm thinking they'll order something else for the booster
But we are still a wee way off our 90% vacination target and pretty soon some peoole will be overdue for boosters as kiwis finally returning home are now discovering
 
Personally had Pfizer for first two and Moderna for the booster. Had the shot at 3:30pm and was fine for the evening and the morning after... Right before the 24 hour mark experienced elevated heart rate and fatigue that persisted 18 hours after onset. Felt completely fine less than 48 hours after getting the booster.

I noted the soreness in my arm was less in the Moderna booster compared to dose #2 of Pfizer. No fever/chills, either, which I had experienced with Pfizer dose #2.

Edit: full disclosure, I DID get the flu shot at the same time as getting my COVID booster shot. So perhaps the elevated heart rate and fatigue etc was worse for me than someone who's not getting two simultaneous whammies on their immune system.
 
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I had Pfizer for first two and Moderna for the booster yesterday (it’s been 15 hours since my booster).

I feel dreadful…. and it’s Christmas Day.

I have a really sore throat, my skin hurts & my joints ache. My arm is sore & my period came back HEAVY when it was just finishing. Very tired but can’t sleep because I can’t get comfortable.

I don’t regret getting it though.

Merry Christmas everyone

We always have a huge Christmas Day but I my find myself going for a snooze somewhere today.
 
I had Pfizer for all 3.

1st dose, nothing other than a sore arm.

2nd dose of Pfizer, I got a migraine. I had never had one before. It was awful. I couldn’t even open my eyes, I felt dizzy, nauseous, and went in and out of sleep in my dark bedroom for 24hrs. My head felt “tender” and sore for about 24hrs more. Maybe TMI but it messed with my “cycle” as well and I had horrible cramps. The pain I was in clouded out any awareness of other symptoms.

I just got my Pfizer booster 36hrs ago, sore arm (who cares though), crushing headache the next day and nausea, but not a migraine, some lower back cramps. Fatigue. Thank god no migraine! It was bad and I had to take off work, but I am feeling better the following day and have a very mild headache.
 
I got Moderna for the first two and Pfizer for my booster after doing research. For various reasons I felt it was the best way for me to go. My endocrinologist tested my antibodies last week and I was greater than 2500 which was the most they can test for...this doesn't mean I am protected or not but it just means I have lots of antibodies which is good.

I got a fever of 4 degrees over my norm with Moderna dose 2 and Pfizer as the booster. Plus sore arm and Covid arm with both Moderna vaccines. I was ill for approximately 36 hours with each shot IIRC. The Covid arm lasted for weeks however.

From here on in if getting three shots is the yearly norm I will continue to get Moderna for the first two and Pfizer for the booster. That is more than enough for my body I think. I might be fine with Pfizer for all 3 but I will stick with what I know produces antibodies for me.
 
I got Moderna for the first two and Pfizer for my booster after doing research. For various reasons I felt it was the best way for me to go. My endocrinologist tested my antibodies last week and I was greater than 2500 which was the most they can test for...this doesn't mean I am protected or not but it just means I have lots of antibodies which is good.

I got a fever of 4 degrees over my norm with Moderna dose 2 and Pfizer as the booster. Plus sore arm and Covid arm with both Moderna vaccines. I was ill for approximately 36 hours with each shot IIRC. The Covid arm lasted for weeks however.

From here on in if getting three shots is the yearly norm I will continue to get Moderna for the first two and Pfizer for the booster. That is more than enough for my body I think. I might be fine with Pfizer for all 3 but I will stick with what I know produces antibodies for me.

Hopefully the booster can be re-designed so that it carries effectiveness over a year. 3 shots a year is a lot! I usually feel like crap the next day and don't feel like doing much, but would prefer to not use up 3 PTO days or 3 weekend days feeling like crap. I am sure as research progresses the vaccines will become more refined and have more lasting effects.
 
Hopefully the booster can be re-designed so that it carries effectiveness over a year. 3 shots a year is a lot! I usually feel like crap the next day and don't feel like doing much, but would prefer to not use up 3 PTO days or 3 weekend days feeling like crap. I am sure as research progresses the vaccines will become more refined and have more lasting effects.

I agree. I feel really dreadful. I couldn’t tell if my arm is sore from the needle because I am aching everywhere. My feet are very tender.
I have also developed an ear ache in both ears.
 
I had Pfizer for all three and had virtually no side effects at all, injection site was sore, but that was all.
 
I agree. I feel really dreadful. I couldn’t tell if my arm is sore from the needle because I am aching everywhere. My feet are very tender.
I have also developed an ear ache in both ears.

Feel better @GoldenTouch! Hopefully by tomorrow you will be much better.
 
Hopefully the booster can be re-designed so that it carries effectiveness over a year. 3 shots a year is a lot! I usually feel like crap the next day and don't feel like doing much, but would prefer to not use up 3 PTO days or 3 weekend days feeling like crap. I am sure as research progresses the vaccines will become more refined and have more lasting effects.

That would be nice. My mom already informed me she isnt getting three Covid vaccines yearly. LOL. But let me tell you if that is the drill she will be getting them. :)
 
Since this popped up I wanted to update on DH, he had Pfizer for the first two with no real reaction, just some fatigue after #2. He got the Moderna booster and had fatigue, headache, low grade fever, body ache, and the armpit swelling (that lasted a few days). Since then he's been fine with no long lasting effects.
 
I had Covid in March 2020 (sick for 6 weeks). First Pfizer in January 2021, follow-up Pfizer and then had a Moderna booster in November. After Pfizer #2 and the Moderna, I had 24 hours of fever, body aches and fatigue. My husband had the same course (infection, Pfizer x 2, Moderna booster) and had no symptoms at all after the booster.
 
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