Choose Your Own Adventure Boosters
The CDC is leaving it up to you!
In something of a counterpoint to my previous post arguing that amateurs shouldn’t try to second-guess experts on COVID treatments, the Atlantic’s Katherine J. Wu observes that “No One Will Stop You From Getting Whatever Booster You Want.”
Mixing and matching vaccine brands is officially on the table in the United States. But that option might soon be billed as the B-list choice.
[On October 21], CDC Director Rochelle Walensky gave the green light for Moderna and Johnson & Johnson booster shots, the long-awaited follow-up to a similar recommendation given to the Pfizer formulation last month. As the endorsement stands, all who are eligible for an additional jab—which now includes tens of millions more Americans—should be able to pick whatever booster brand they like. But discussions among a panel of experts who advised Walensky hinted at a catch: The agency has yet to issue its final clinical guidance on who, specifically, might want to boost with what—and an early draft of the recommendations suggests that Americans “should” stick with the same brand they got in their first go-round.
Switching to a different shot would be allowed, as was authorized by the FDA on Wednesday; per the draft CDC guidance, people may opt to mix and match based on availability or preference, after assessing their individual risks and benefits. (As a reminder, the FDA’s authorizations tell Americans what vaccines they’re allowed to get. The CDC follows that up with advice on what folks should do with those options.)
The CDC’s stance on mixing and matching, then, could end up being a relatively soft one, neither extolment nor excoriation. That might also be the most practical course of action for the agency, given the variables involved and the lack of clear-cut evidence that could untangle them. But the wishy-washiness of Pick whatever is confusing as hell.
Wu goes into the pros and cons of sticking versus switching and then concludes,
Even in the U.S., getting more first shots to people remains the bigger priority—that’s how we collectively contain the coronavirus. But the hyper-individualistic American approach to the pandemic is once again nudging each of us to chart our own course. The government has kind of shrugged about mix-and-match boosting, and punted the decision to us: Choose whichever path seems right to you; turn to page 7; hope for the best. Here’s the trick, though—no one’s sure where this chapter ends. Good luck, I guess.
This may simply be a case where all of the available options are really safe and effective and simply getting boosted is more important than which booster. But, aside from being confusing as hell, it also effectively encourages people to become faux experts.
My plan is to get boosted next week, when I can afford to miss a day of work if the side effects are worse than they were for my second dose. I’ll almost certainly stick with Moderna because, well, why not. But it’s weird that the experts are leaving it up to me to decide rather than giving their best recommendation.