Fauci says ‘mix and match’ strategy for COVID-19 vaccine boosters still on the table

A healthcare professional holds a vial of the Moderna COVID-19 vaccine on April 7, 2021. (Jacob King/POOL/AFP via Getty Images)
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Michael Wilner McClatchy Washington Bureau (TNS)

WASHINGTON — The federal government may determine in the coming weeks that Americans can “mix and match” their initial COVID-19 vaccine with booster shots from a different manufacturer, Dr. Anthony Fauci said on Monday.

Ongoing studies suggest it may be safe and even preferable to boost one manufacturer’s product with a jab from another vaccine maker, said Fauci, head of the National Institute of Allergy and Infectious Diseases and chief medical adviser to President Joe Biden.

“We are in the process of doing those studies right now,” Fauci said in an interview with McClatchy. “We already have the data that was recently published actually of using Moderna as the boost for any of the other three vaccines – Moderna against Moderna, Moderna against Pfizer, and Moderna against J&J.”

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“Within the next few weeks, we’ll get data on the J&J boosting and on the Pfizer boosting,” Fauci said. “We have not abandoned that concept, because we realize there will be situations for one reason or another where a person may not have the availability to be boosted with the same product that they were originally vaccinated with.”

The Centers for Disease Control currently recommends that people eligible for boosters use the same vaccine they received for their initial doses.

“For people who received either Pfizer-BioNTech or Moderna’s COVID-19 vaccine series, a third dose of the same mRNA vaccine should be used,” the CDC says on its website, referring to the design of the vaccine. “A person should not receive more than three mRNA vaccine doses.”

But Fauci said there is a possibility that studies will show that one of the three available vaccines works best as a booster for all of them.

The Biden administration is prepared for such a scenario and has enough supply in case one vaccine booster is in particular demand, he said. “We definitely have enough supply, without a doubt.”

DELTA VARIANT STILL HAS ‘VULNERABLE TARGETS’

For vaccinated people, Fauci anticipates that more will become eligible for booster shots as data becomes available. Moderna and Johnson & Johnson boosters will likely become available “in the fall and winter,” he said.

Fauci said that in the coming weeks, Americans can expect to see an “expanding” of eligibility as new data comes in. “The recommendation for boosting will likely go to a younger and younger group, and not just 65 and older,” he said.

So far, a Food and Drug Administration panel has limited its recommendation for booster shot eligibility to individuals 65 and older and those who are at particularly high risk because of other health issues.

But those who are currently eligible, along with health workers required to get boosters, would make up the “majority” of the U.S. population, Fauci said.

Once children between 5 and 11 years old become eligible for vaccination — likely in the next few weeks, pending FDA approval — and another 70 million people get their first vaccinations, the country will be well-equipped to enter the fall and winter months to fight additional surges of COVID-19, Fauci said.

“We are in a good potential place. I want to make sure you understand that if we don’t get those people vaccinated, we are not going to be in a good place,” he said.

“We have 70 million people in the country who are eligible to be vaccinated who are not vaccinated,” he said. “As long as they remain unvaccinated, the delta variant is going to have a lot of vulnerable targets. 70 million people is a lot of vulnerable people.”

While other coronavirus variants have emerged — the beta and mu variants may evade the vaccines better than delta — Fauci said his primary concern is still the delta variant because of its high transmissibility. “That’s the reason why, right now, we need to focus on delta, because it’s the big tough guy on the block,” he said.

This fall and winter is unlikely to be as troubling as last year during the deadliest phase of the pandemic.

“If we implement a vaccine program for the people who are thus far unvaccinated, we could have a very different — in a positive sense — fall and winter,” he said. “If we don’t succeed in getting the overwhelming majority of people in that group vaccinated, we could have a tough time this winter.”

As the days get shorter, the nights get colder and more events are forced inside, vaccinated people can expect federal mask recommendations for indoor gatherings to continue for some time, he said.

“It’s going to be a numbers game,” Fauci said.

“You’re going to have the mask recommendation for vaccinated people indoors so long as you’re averaging 150,000 new cases a day,” he said. “When the dynamics of the outbreak change, and you get very, very much fewer infections per day, then I think you’ll see a relaxation of the mask recommendation.”

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