Surgeon general says even J&J vaccine will likely need booster shot as studies underway on ‘mixing’ jabs

‘We are waiting on some data from the company about a second dose of J&J so the FDA can fully evaluate the safety and efficacy of that dose’

The US Surgeon General said on Sunday that almost all vaccinated people – including those who received the one-shot Johnson & Johnson jab – will likely need boosters, while researchers study the effectiveness or side effects of mixing vaccine types.

Dr Vivek Murthy, appearing on CNN’s State of the Union, said: “We believe that J&J recipients will likely need a booster, but we are waiting on some data from the company about a second dose of J&J so the FDA can fully evaluate the safety and efficacy of that dose.”

His comments followed a statement Wednesday from the Department of Health and Human Services, which announced third vaccine doses would start being offered in the US next month.

“Based on our latest assessment, the current protection against severe disease, hospitalisation, and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout,” the statement read.

“For that reason, we conclude that a booster shot will be needed to maximize vaccine-induced protection and prolong its durability.

“We have developed a plan to begin offering these booster shots this fall subject to FDA conducting an independent evaluation and determination of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines and CDC’s Advisory Committee on Immunization Practices (ACIP) issuing booster dose recommendations based on a thorough review of the evidence.

“We are prepared to offer booster shots for all Americans beginning the week of 20 September and starting eight months after an individual’s second dose. At that time, the individuals who were fully vaccinated earliest in the vaccination rollout, including many health care providers, nursing home residents, and other seniors, will likely be eligible for a booster.

It added: “We also anticipate booster shots will likely be needed for people who received the Johnson & Johnson (J&J) vaccine. Administration of the J&J vaccine did not begin in the US until March 2021, and we expect more data on J&J in the next few weeks. With those data in hand, we will keep the public informed with a timely plan for J&J booster shots as well.”

Pfizer and Moderna vaccines combat the virus in a different way from the one-shot Johnson & Johnson jab. The former two are mRNA vaccines, injecting genetic material that encode the Covid protein, prompting the body to produce antibodies to fight the virus.

The J&J vaccine – and others such as AstraZeneca – are known as viral vector vaccines, injecting a genetically engineered different virus to engender the same antibody response.

Dr Murthy told CNN on Sunday that “mixing studies” were being conducted to see how taking one type of shot and then another would affect people.

“As soon as that data is available, we can present that to the FDA, and they can also review it for safety,” Murthy said.

“And so as soon as those studies are done, we’ll have more to recommend to J&J recipients about the timing of a booster and which shot they should get,” he said.

The entire concept of mixing doses – or people trying to double up on vaccinations in an attempt to build more resistance to Covid – has been cropping up more frequently in conversations and debates.

According to an article published Friday in Popular Science, the one-shot vector virus systems “seem to be particularly good at at rousing T cells, which are white blood cells that play various roles, including destroying infected cells and coordinating the immune response. Meanwhile, the mRNA vaccines are especially adept at prompting the production of antibodies that target the virus.”

“If you mixed the two, could you get the best of both vaccines and get a really great antibody response coupled with a really strong T cell response?” said Kristen E. Lyke, director of the Malaria Vaccine and Challenge Unit at the University of Maryland School of Medicine’s Center for Vaccine Development and Global Health in Baltimore. “And then, how would that affect the vaccine efficacy?”

She said: “It is a tried-and-true approach that we do with vaccine testing all the time, but it hasn’t gotten to primetime, where there is a licensed vaccine combination that intentionally has a mixed platform.”

Whether or not the approach should get to “primetime,” however, needs further study.

In a statement earlier this month, the World Health Organization cautioned against mixing and maxing vaccines during the initial two-dose administration – but said it was still unsure about using different shots for third doses, or “boosters”.

“WHO recommends that the same vaccine product should be used for both doses,” in a primary two-dose schedule, the statement said. “If different Covid-19 vaccine products are inadvertently administered in the two doses, no additional doses of either vaccine are recommended. At present, mix and match schedules constitute off-label use of respective vaccines and as such should only be used if benefits outweigh the risks such as in situations of interrupted vaccine supply.”

Dr Murthy’s comments on Sunday – and the government statement earlier in the week – keep reiterating the same things: further study is needed because Covid is an unravelling mystery, and no one has all the answers.

“Our top priority remains staying ahead of the virus and protecting the American people from Covid-19 with safe, effective, and long-lasting vaccines especially in the context of a constantly changing virus and epidemiologic landscape,” the health department statement read.

“We will continue to follow the science on a daily basis, and we are prepared to modify this plan should new data emerge that requires it.

“We also want to emphasise the ongoing urgency of vaccinating the unvaccinated in the U.S. and around the world. Nearly all the cases of severe disease, hospitalization, and death continue to occur among those not yet vaccinated at all.”