UPMC doctors offer perspective as more covid booster shots near approval

As federal regulators move closer to approving booster shots of the Moderna and Johnson & Johnson covid-19 vaccines, UPMC doctors remain focused on the unvaccinated — those they called most vulnerable people.

“I want to make sure we do not put the cart in front of the horse,” said Dr. Donald Yealy, UPMC’s chief medical officer and chair of emergency medicine. “The most important job right now in immunization is to get those who haven’t yet decided to get fully vaccinated … to the point where they are choosing the vaccine and getting vaccinated.”

As UPMC was holding the virtual briefing by Yealy and Dr. Graham Snyder, medical director of infection prevention and hospital epidemiology, a panel of health advisers at the federal level were hearing evidence related to the Moderna and J&J booster shots and the concept of mixing and matching vaccines.

The FDA’s advisory panel voted unanimously that a booster should be offered, according to The Associated Press. The advisers cited growing worry that recipients of J&J’s vaccination seem to be less protected than people who got two-dose Pfizer or Moderna options — and that most got that single dose many months ago.

Booster doses of the Pfizer vaccine were approved and began last month for people at a particularly high risk of severe illness. An FDA advisory panel has also recommended the same approach for Moderna recipients.

“It’s not that you need a booster because all of a sudden you’re completely unprotected again,” Yealy said. “The people who are unprotected are those who have not chosen vaccination yet and a very small portion of the population who just never responded to the first doses.”

Across the country, about 66% of the population has received at least one dose of a covid-19 vaccine, and around 57% of people are fully vaccinated, according to the latest New York Times data.

In Pennsylvania, about 60% of the entire population is fully vaccinated, including about 70% of adults in the state.

The federal advisory panel on Friday also discussed early data from a government “mix-and-match” study that indicated those who received the J&J vaccine have a stronger immune response if they get a booster shot of either Moderna or Pfizer, the AP reported.

Snyder said it’s too soon to tell whether the mix-and-match strategy is more or less effective, and he cautioned against the “what’s the best?” mindset.

“It’s too early to start to compare vaccine strategies,” he said. “The conversations we’re having now … are about trying to refine the best strategy.”

Snyder said despite the differences in development of the vaccines, he sees little substantial difference in the vaccines. One does not appear better or worse than the others, he said.

“We’re starting to talk about … whether or not getting a second or third dose with the same vaccine is quote unquote ‘better or worse’ than getting a different vaccine for a subsequent dose, but the strategies we have available to us right now are excellent.”

Data suggests the vaccines are effective in keeping people from severe illness and death.

“I would focus less on, ‘Am I missing a better strategy?’” Snyder said, “and go with what we know right now, because it’s incredibly effective.”