One chart shows the most common COVID-19 booster side effects from Pfizer, Moderna, and J&J’s vaccines

healthcare worker in mask, smiling, getting booster shot.
A Thai healthcare worker receives a booster dose of Pfizer’s vaccine in Bangkok on August 9, 2021.

Second and third doses of COVID-19 vaccines generally produce similar side effects but there are some slight differences.

In September, the Centers for Disease Control and Prevention (CDC) gave the first comparison between booster shots of all three vaccines available in the US: Pfizer and Moderna (both mRNA shots), and Johnson & Johnson (an adenovirus vaccine).

It’s one of the most comprehensive looks at how people are responding to boosters to date.

Broadly, the CDC found that people who’d received three doses of either Pfizer or Moderna saw more local reactions — pain, itchiness, redness, or swelling at the injection site — after dose three compared to dose two. Other side effects such as fatigue, muscle aches, or headaches were less common, affecting 74% after their third dose, compared with 77% after dose two.

A second dose of J&J’s vaccine yielded the fewest side effects of all: Only 10% of J&J booster recipients said their side effects prevented them from performing normal daily activities — usually on the day after their booster shot — while the rest said they were able to go about their day as normal.

By comparison, 28% of Pfizer or Moderna booster recipients said the shots hindered their daily routine. However, the study included far more data on mRNA boosters — 12,000 people, compared to 48 who received two J&J doses.

The following table shows how booster shots affected people who got three doses of Moderna, three doses of Pfizer, or two doses of Johnson & Johnson’s vaccine, according to CDC data.

Aside from local reactions at the injection site, fatigue was most common among people who received a Pfizer or Moderna booster.

Overall side effects were more prevalent after Moderna's third dose: Half of Moderna booster recipients reported muscle aches and headaches, and around 60% reported fatigue.

Meanwhile, less than 40% of Pfizer booster recipients reported muscle aches and headaches and around 50% reported fatigue.

Just one-quarter of those who received a J&J booster had injection site reactions, compared with 70% who got a Pfizer booster and 80% who got a Moderna booster. And 20% of J&J booster recipients reported muscle aches and headaches.

The CDC recommends boosters for all adults and allows you to mix and match

The CDC now recommends booster shots for all Americans ages 16 and older. People who received two doses of Pfizer's or Moderna's vaccine should get boosted at least six months after their second shot, the CDC advises, whereas J&J recipients can get boosted as early as two months after their first dose.

The CDC has also approved a "mix and match" approach so people can select a booster of a different vaccine type or different manufacturer than their original dose.

An October study funded by the US National Institutes of Health (which has yet to be peer-reviewed) found that mix and match boosters yielded similar side effects to initial vaccine doses. More than half of the study's 458 participants reported malaise, headaches, and muscle aches after their booster while more than 70% experienced mild arm pain. 

A UK study similarly identified fatigue, headaches, and pain at the injection site as the most common side effects. The study looked at nearly 2,900 people who had received two doses of Pfizer or AstraZeneca, followed by one of seven different COVID-19 boosters. Overall, side effects from boosters were more common in people ages 30 to 69 than those ages 70 and up, the study found — regardless of which vaccines the participants received.

Fatigue, headaches, and muscles aches were also common after first and second doses

The mRNA vaccines from Pfizer and Moderna instruct the body to produce a harmless viral protein, then develop antibodies against it. The first dose of these vaccines generally produces the mildest side effects, since our bodies are being introduced to the instructions and the resulting protein for the first time.

By the time we receive a second and third dose, our bodies have learned to recognize that protein quickly, so are ready to attack it. That's why side effects are generally more pronounced. (If you've had COVID-19 before, though, your first dose may yield more intense side effects than your second or third, according to one preprint.)  

The following chart shows common vaccine side effects based on your age group, vaccine manufacturer, and which dose you received. Data is from each vaccine's clinical trial.

As with a booster shot, fatigue, headaches, and muscles aches were common after doses one and two.

In general, older people experience fewer side effects than younger adults because immune responses gradually weaken with age. That's also the reason why older people are in particular need of boosters: While vaccines still protect against severe disease for now, the Omicron variant seems to increase the risk of reinfection relative to other coronavirus strains.

It's also better than the original virus at evading antibodies from two vaccine doses, early lab studies suggest.

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Retail pharmacists say they are overworked and burned out due to short-staffing and the increased demand for COVID-19 shots

covid vaccine empty pharmacy
An empty vaccine waiting area at a Walgreens in Miami Beach, Florida.

  • Six current and former pharmacists told Insider about their experiences during the pandemic.
  • Pharmacists described feeling stretched thin distributing medications and COVID-19 vaccines.
  • Walgreens, CVS, and Rite Aid say they are recruiting more workers to meet increased demand. 

In August 2021, Bled Tanoe was working as pharmacy manager in an Oklahoma Walgreens when she saw morale was flagging among her staff. She told them she would bring in pizza to perk the team up, when she realized a free pizza was nowhere near what she would need to fix the situation for her overworked staff.

“The state of pharmacies right now is beyond gift cards, jeans, or free pizza,” she told Insider, referencing some of the things companies have offered to pharmacists this year. That day, she went home and posted her reflections under the hashtag “pizzaisnotworking.” When she woke up the next morning, she was shocked to see it had been reposted over 500 times by other pharmacists sharing their own experiences. 

“I was grateful for the support, but very sad that so many people in the industry felt this way,” she told Insider. 

Insider spoke to 6 current and former pharmacists at CVS, Walgreens, and Rite Aid. Clinicians said they experienced burnout from high workloads and did not receive adequate support from the pharmacies to handle increased workload from COVID-19 vaccines.

Walgreens locations in Idaho recently shortened pharmacy hours due to lack of staff. Pharmacy patients said they experienced longer wait times at CVS, Walgreens, and Walmart locations in Indiana, Colorado, Kentucky, and Connecticut, according to local news reports.

The problem worsened as more people became eligible for COVID-19 vaccine and booster shots, The Wall Street Journal reported. The Food and Drug Administration authorized a Pfizer jab for kids aged 5 to 11 last month, and the Centers for Disease Control and Prevention recently recommended all adults get a booster shot once eligible. 

“We are endlessly proud of Rite Aid pharmacists and pharmacy techs, as well as their peers at retail pharmacies across the country, for their integral role in the battle against COVID-19,” Rite Aid Chief Pharmacy Officer Jocelyn Konrad told Insider in a statement, noting that the company is “aggressively recruiting” new hires. 

A Walgreens representative recently told Insider the company was recruiting pharmacists in the fall to support demand for COVID-19 vaccinations, testing, and flu shots. The company raised its minimum wage for hourly workers to $15 this August, and offered technicians who become certified to administer flu and COVID-19 vaccines a $1,000 reward. 

CVS told Insider the firm is in the process of onboarding 20,000 new retail employees, including pharmacists and pharmacy technicians. The retail chain has also “begun the process of” adding pre-scheduled, daily break times.

Tanoe told Insider that the intense working conditions left her feeling like she might cause harm without having adequate time to do everything a pharmacist is supposed to do, like review all of a patient’s medications and check allergies before distributing a prescription.

Several other workers, who asked to remain anonymous, echoed Tanoe’s sentiments.

“We are expected to fill hundreds of medications per day, with less and less support staff, and more workload,” a former CVS pharmacist in Connecticut told Insider. “COVID has exacerbated this already inhumane situation.”

Another former CVS pharmacist in New York said she left in the fall due in part to fatigue and stress from the job. (Insider verified employment records of the pharmacists who asked to remain anonymous to protect their identities.)

At the start of the pandemic, the pharmacist said she had been the busiest in her entire career. But customers expressed gratitude for pharmacists working during the early months that made her job enjoyable. 

The pharmacist said she worked extra hours and still fell behind on filling prescriptions — and that was before the FDA authorized vaccines. After people began coming in for vaccinations, pharmacists struggled being the only clinicians who needed to check every prescription and administer vaccines. 

CVS told Insider thousands of stores operate vaccine clinics with a separate team of pharmacists who do not fill prescriptions or counsel patients.

Still, the pharmacist recalled some patients who grew agitated as stores got busier, including some people who ripped syringes out of her hands to “check it” due to misinformation-induced fear of microchips or other non-vaccine ingredients. 

“You could either focus on filling people’s prescriptions or you can focus on doing vaccines, but there was literally no way that you could do both,” the pharmacist told Insider. 

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Fauci pleads with parents to get their children vaccinated as fewer than 1 in 5 eligible American children are protected against COVID-19

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, speaks during the daily briefing at the White House in Washington, Wednesday, Dec. 1, 2021.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, speaks during the daily briefing at the White House in Washington, Wednesday, Dec. 1, 2021.

  • The number of COVID-19 cases in children ages 5-11 has hit 2 million, Dr. Anthony Fauci said.
  • Only 16.7% of US children ages 5-11 have received at least one dose of a COVID-19 vaccine.
  • COVID-19 vaccination rates for children vary by state, mirroring the trend of the adult demographic.

Citing statistics that fewer than 1 in 5 US children ages 5-11 have been vaccinated against COVID-19, ABC’s “This Week” host George Stephanopoulos asked Dr. Anthony Fauci what message he has for reluctant parents during an interview on Sunday.

“If your child is five years of age and older, please get them vaccinated. We need to protect the children,” Fauci said. “This idea that children are not vulnerable at all is not so, George.”

Although children are statistically less likely to develop severe COVID-19 infections compared to adults and the elderly, Fauci said that the number of COVID-19 cases in children ages 5-11 sits at 2 million, which has resulted in nearly 10,000 hospitalizations and well over 100 deaths.

“It’s not only good for the health of the child but also to prevent the spread in the community. We have a very safe and highly effective vaccine for everyone, including children 5-11, and that’s the reason why we encourage parents to get their children vaccinated,” Fauci told Stephanopoulos.

As of December 5, estimates show that only 4.7 million of the 28 million children in the US ages 5-11, or 16.7%, have received at least one dose of a COVID-19 vaccine, according to the Centers for Disease Control and Prevention and Kaiser Family Foundation. Only 4.3% of children are considered fully vaccinated, KFF stated.

“Overall, we find that after an initial period of high demand, vaccination progress among those ages 5-11 has slowed significantly,” KFF stated. “The rate of vaccination among 5-11 year-olds has slowed considerably, a drop that preceded the Thanksgiving holiday and has continued since.”

Similar to COVID-19 vaccination trends in adults, data shows that vaccination rates for children vary depending on the state. While the four states with the highest COVID-19 vaccination rates of children are in the northeastern US,  the four states with the lowest vaccination rates are in the South, according to data from the CDC COVID Data Tracker.

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Amtrak set to reduce service in January unless more employees adhere to COVID-19 vaccine mandate

Amtrak
Travelers make their way to board an Amtrak train ahead of the Thanksgiving Day holiday at 30th Street Station in Philadelphia, Pa., on November 24, 2021.

  • Amtrak is set to reduce service on some lines in Jan. due to the federal COVID-19 vaccine mandate.
  • Roughly 95% of employees have received at least one dose of the vaccine, per Amtrak president Stephen Gardner.
  • Ridership on the passenger railroad service has rebounded to 70% of its pre-pandemic level.

Amtrak will have to reduce passenger service beginning in January unless more employees abide by the federal COVID-19 vaccine mandate which takes effect in January, according to The Associated Press.

Amtrak president Stephen Gardner told House lawmakers on Thursday that while roughly 95% of the rail system’s workers have received at least one dose of the vaccine, the remaining employees face the January 4 deadline that the corporation put into place, mirroring the deadline that President Joe Biden enacted for employees of federal contractors.

In a setback for the administration, a judge on Tuesday blocked the federal vaccine mandate for employees of federal contractors.

However, the White House says that it will vigorously stand up for its mandate for employees of federal contractors in court.

An Amtrak spokesperson told The Wall Street Journal that if the mandate was still blocked on January 4, then the rail system’s mandate would remain in effect for that date.

Gardner on Thursday detailed scheduling issues that are likely to arise until more employees are fully vaccinated.

“We anticipate proactively needing to temporarily reduce some train frequencies across our network in January to avoid staffing-related cancellations — with our plan to fully restore all frequencies by March, or as soon as we have qualified employees available,” he told lawmakers at a hearing of the House transportation subcommittee on railroads, pipelines and hazardous materials.

White House press secretary Jen Psaki on Thursday brushed off any substantial impact on Amtrak caused by the vaccine mandate, emphasizing that staffers have overwhelmingly been inoculated against the coronavirus and noted that several weeks remain until the deadline.

“What we have conveyed to employers is post-deadline, we expect employers will follow their standard HR process,” she said during a press briefing. “That means if an employee’s not in compliance they’ll go through education, counseling, accommodations, and enforcement. That would be what the process would be to play out.”

She continued: “We don’t expect these requirements will cause disruptions to services that people depend on. There is some time to implement it.”

The development comes as the passenger railroad service will receive an unprecedented $66 billion in funding as part of the newly-signed $1.2 trillion bipartisan infrastructure bill that was championed by Biden, an Amtrak loyalist who took the train religiously between his Delaware home and Washington DC when he served in the Senate.

At the start of the COVID-19 pandemic last year, Amtrak sharply curtailed its service due to low ridership; at one point, ridership on the passenger railroad service was a 4% of its pre-pandemic level.

Gardner stated that Amtrak has restored the majority of its service and now has roughly 70% of its pre-pandemic traffic, but noted that it’s going to take several years for ridership to resemble figures from 2019.

Much of the traffic rebound will depend on business travel, according to Gardner.

During the 2021 fiscal year, Amtrak ridership was 12.2 million, compared with 32.5 million riders in 2019.

For the 2020 fiscal year, ending on September 30, Amtrak transported 16.8 million passengers to destinations across the United States.

Amtrak hopes to hire roughly 2,500 to 3,500 employees by September 2022, but the company currently lacks the human resources personnel needed to screen and hire future employees, according to its own inspector general.

In August, Amtrak said that employees would need to be vaccinated against COVID-19 or face weekly testing.

In September, Biden originally issued his mandate for federal workers and employees of federal contractors to be fully vaccinated by December 8, before the deadline was pushed to January 4.

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A 60-year-old’s birthday party in the UK turned into a potential Omicron superspreader event, even though everyone was vaccinated — but all the cases were mild

woman with '60' baloons standing behind smiling man with cake, celebrating his 60th birthday at a table with friends in the kitchen
File image — not the actual party.

  • A 60-year-old’s birthday party turned into a likely Omicron superspreader event.
  • 15 of the 18 party-goers tested positive for COVID-19 after the party. All were vaccinated, and many were boosted.
  • “It’s highly unlikely that Delta would behave like that,” said epidemiologist Tim Spector, who suspects it was Omicron. 

A 60-year-old’s birthday party in the UK has turned into a coronavirus superspreader event — and it’s likely that the Omicron variant is to blame, according to a leading epidemiologist.

Tim Spector, who heads up the highly regarded Zoe COVID study in the UK, says the partygoers (who wished to remain anonymous) were some of the first people to use a new Omicron-tracking feature in his COVID-logging app, which hundreds of thousands of people in the UK access daily to record any COVID-19 symptoms.

Though it’s impossible at this point to know for sure that everyone who got sick after the party definitely had Omicron, here’s what we do know:

  • The party guests were all older adults in their 60s and 70s;
  • Everyone was fully vaccinated, and some were boosted too;
  • Most had used the UK’s free, rapid, lateral flow tests before the party, and nothing came up positive.

But, shortly after the party was over, they found out that a schoolmate of one of the partygoers’ children had a “probable” Omicron case, as determined by PCR testing. Soon, the parent tested positive too, and within just a few days, 15 of the 18 who’d been at the party were also COVID-positive. 

“It’s highly unlikely that Delta would behave like that,” Spector told Insider, adding “it was two days” from exposure to symptoms. With Delta, Spector would expect a longer delay between exposure and positive test, and wouldn’t expect so many fully vaccinated and boosted people to test positive after one exposure.

The UK, similarly, says that Omicron is “displaying a growth advantage” over Delta, and that the new variant is “likely to out-compete Delta in the UK and predominate.” 

“It means that nearly everyone’s going to get this,” Spector said. “Even if you’re double or triple vaxxed, it’s still not preventing infection.” 

Spector is canceling his own holiday parties, in light of Omicron 

piece being cut from a birthday cake on a platter

The good news is that early indications suggest Omicron isn’t especially dangerous to vaccinated people, compared to other versions of the virus we’ve seen before. 

“Most people will have thought they had a bad cold,” Spector said.

Among the party-goers, for example, most cases were mild, like seasonal colds, with nausea, headache, and sore throats. Two of the 15 people had to take off work for a few days, ran fevers, and lost their sense of taste. But no one sought care from a doctor, or had to go to the hospital. The story is a testament to how well the vaccines we have work against severe COVID-19, even among vulnerable, older adults, who are more susceptible to bad outcomes.  

For the most part, the symptoms the partygoers had reflect what’s been seen in the US and across Europe so far with Omicron. Reported infections have been mild, and less frequently include the characteristic loss of taste, smell, and fevers previously seen with coronavirus infections. No deaths have been recorded yet. 

Still, the worry is that because of how quickly Omicron is taking off, it could still overwhelm hospitals, especially as more unvaccinated people are exposed. 

“By the time people know they’ve definitely got it, they may have spread it,” Spector said.

In a video shared on YouTube about the birthday party, he said it “just shows you how easily one person can infect many others in a close situation, which is a worry.” 

Already, he’s making some modifications to his own holiday schedule, calling Omicron a “good argument” for reducing gathering sizes, and canceling big events. 

“Sadly we had to cancel our Christmas parties at King’s [College] and also at Zoe, which upset a lot of us,” he said. 

“This is not a reason to be really relaxed with Omicron because it’s not just like a cold, you can pass it on to other people and could still kill them.”

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Pfizer should have helped low-income countries better distribute COVID-19 vaccines, CEO said

Pfizer CEO Albert Bourla
Pfizer CEO Albert Bourla

  • Pfizer could have helped low-income countries better distribute COVID-19 vaccines, the CEO said.
  • CEO Albert Bourla said he should have helped improve vaccine-distribution infrastructure.
  • Just 6.3% of people in low-income countries have received a shot, according to Our World in Data.

Pfizer CEO Albert Bourla acknowledged the pharmaceutical giant could have worked better to ensure low-income countries got enough COVID-19 vaccines.

Bourla said low-income countries have asked Pfizer to stop sending additional doses because they “cannot process them,” or the countries lack infrastructure to distribute many shots at once. 

In retrospect, Bourla said he would have worked with governments and nonprofits in low-income countries well in advance to ensure they had the infrastructure to distribute doses. 

“We are using drones to drop vaccine supplies in remote areas,” Bourla said during the Wall Street Journal’s CEO Council Summit on Tuesday. “We should have done it better, many other organizations should have done it better.”

Though more than half of the world’s population has received at least one dose of a COVID-19 vaccine, just 6.3% of people in low-income countries have received a shot, according to Our World in Data, a research project from Oxford University.

As poor nations lack vaccines, some rich countries are scrambling to get rid of their surplus. This summer, Israel was on the cusp of throwing away hundreds of thousands of doses set to expire before donating them to South Korea. 

The World Health Organization is asking wealthier nations to prioritize sending vaccines to other nations instead of bolstering booster shot campaigns. The Centers for Disease Control and Prevention recently recommended all US adults get a COVID-19 booster once eligible. 

Bourla touted Pfizer’s decision to sell vaccines at a higher price to rich countries and at low or no cost to less wealthy ones. The company, he added, ramped up manufacturing to ensure they could produce vaccines quicker than they had predicted.

Bourla said vaccinating the global population will inhibit the virus from mutating into variants, and help society return to a relatively normal life. 

“Once we get people vaccinated, once we get the politics out of the equation…we can live normal lives,” he told the WSJ’s Jamie Heller.

Pfizer, along with other major pharmaceutical companies, has opposed a ruling that would remove protections on the company’s intellectual property of the COVID-19 vaccine.

Former world leaders, including 100 Nobel laureates, penned a letter to President Joe Biden asking him to suspend vaccine patents. The move would enable manufacturers in poorer nations to make Pfizer or Moderna’s vaccine without fear of reprisal. 

Read the original article on Business Insider

The labor shortage is reportedly creating longer COVID-19 vaccine wait times at CVS and Walgreens

flu shot elderly
High demand for booster shots and COVID-19 vaccines are leading to long lines at CVS and Walgreens, The Wall Street Journal reports.

  • Patients in some states are waiting weeks to get a COVID vaccine at CVS and Walgreens, per WSJ.
  • The Omicron variant and new vaccine rules for kids is creating higher demand for jabs.
  • Retail pharmacies in states like Connecticut and Kentucky are facing staff shortages.

As demand for vaccines and booster shots increases, retail pharmacies are struggling to get Americans vaccinated quickly, according to a new Wall Street Journal report. 

CVS, Walgreens, and Walmart — stores facing staffing shortages in some states — have day- to week-long wait times for COVID-19 vaccines, per the Journal. The White House said on Thursday retail pharmacies are providing two-thirds of all COVID-19 vaccines.

“We have the inventory and capacity to meet COVID-19 vaccine needs, including in areas of high demand,” a CVS spokesperson told Insider. CVS is encouraging patients to make a vaccine appointment on the CVS app or on the company’s website. 

Walgreens told Insider the firm has recruiting for positions in its pharmacies. The company said it increased incentives by bumping up minimum hourly wages to $15 an hour and by giving $1,000 rewards to technicians who become certified to administer flu and COVID-19 vaccines.

Are you a retail pharmacist with information on the labor shortage? Contact Insider reporters aakhtar@insider.com and mmeisenzahl@insider.com.

Still, retail pharmacies are facing staffing shortages in some states, according to local news reports. Patients reported having to wait longer to fill prescriptions and get vaccine shots in Indiana, Colorado, Kentucky, and Connecticut due to short staffing.

Companies in food service, retail, and healthcare have been struggling to fill positions this year.

Experts say a mismatch between industries hiring and the types of workers seeking jobs have contributed to the labor squeeze. Workers are taking advantage of the labor squeeze by pushing for better working conditions and more pay.

The increased demand for COVID-19 shots comes after The Food and Drug Administration authorized the Pfizer shot for kids aged 5 to 11. The Centers for Disease Control and Prevention also recently said all adults over 18 are eligible to get an additional vaccine jab six months after their full Pfizer or Moderna series, or two months after a Johnson & Johnson shot. 

The CDC recommendation for boosters follows the World Health Organization labeled the Omicron variant, which the US has identified in California and New York, a “variant of concern.” Researchers are currently working to determine whether the Omicron variant is more dangerous than the more-transmissible Delta variant.

Walmart was not immediately available for comment.

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How to choose which booster shot is right for you, between Pfizer and Moderna

Pfizer and Moderna vaccine vials - moderna's is slightly bigger
Vials of the Moderna (R) and Pfizer (L) COVID-19 vaccines.

  • Most people who’ve gotten booster shots in the US have stuck with the same brand of vaccine they had initially.
  • But, it’s also fine to switch it up. Some early studies suggest that Moderna’s vaccine is slightly stronger than Pfizer’s.
  • “To be honest, I’m not sure there’s really a big difference between those two,” one expert said.

Now that free booster shots are being offered to all adults in the US, many are wondering which is the best one to get.

Truth is, all of the three authorized COVID-19 vaccines do a good job, and you can decide to boost with whichever vaccine you want. All three have been deemed safe and effective

But, there are some small differences in the vaccines that could be a factor in your decision making — particularly for older adults, who may choose to prefer the mRNA boosters, especially Moderna’s, based on the available data. 

Generally speaking, Moderna’s vaccine tends to prompt slightly stronger immunity, and it also seems to elicit slightly higher antibody levels than the other two vaccines. That doesn’t mean it’s a dramatically better vaccine in the long run, but the extra protection it provides in the immediate term does seem to eke out Pfizer, at least a little bit.

“To be honest, I’m not sure there’s really a big difference between those two,” Dr. William Moss, who directs the International Vaccine Access Center at Johns Hopkins University, said of Pfizer and Moderna, saying he doesn’t see any strong argument for picking one mRNA vaccine over the other. “I would probably say, you know, whichever is more convenient to get.” 

Most US adults have stuck with their original brand — except for J&J users

All adults are advised to get a booster shot six months after their initial series — except for those who’ve gotten Johnson & Johnson’s single shot vaccine, who have been advised to get a booster at any time past two months after their initial shot. 

Federal data on booster shots suggest most people who got Moderna or Pfizer end up sticking with their initial brand when they boost.

Johnson & Johnson takers, however, seem to have a slight preference for Moderna boosts. There is evidence to suggest that J&J users might benefit from this “heterologous” boosting strategy — i.e. switching vaccine platforms — meaning they would add an mRNA vaccine (Pfizer or Moderna) on top of their adenovirus vaccine (J&J). 

cdc chart showing what % of people who get each shot boost with the same shot.
Most people who’ve gotten mRNA boosters have stuck with their original brand, but J&J vaccinees seem to have a preference for Moderna boosts. (Data from December 1, 2021.)

Moderna’s shot is a bigger dose than Pfizer’s

Moderna’s booster is a half-dose of the original vaccine, with 50 micrograms of mRNA inside. (Half-dose boosters are common for many vaccines, and they work well.)

Pfizer’s booster, in contrast, is exactly the same size as the first two shots administered from that manufacturer, with 30 micrograms of mRNA in it. 

Like Moderna’s vaccine, Pfizer’s provides a strong jolt to antibody levels, meaning that people who get boosted with it reap the benefit of some increased protection against infection for at least a few months afterwards. (How long the extra protection lasts and exactly how good it is is something scientists are still figuring out.)

Moderna’s vaccine may be slightly more powerful than the others

There is some emerging clinical data that suggests Moderna’s vaccine performs slightly better at keeping older people out of the hospital.

One Veterans Affairs study published on December 1 showed that from January to May 2021 (before the emergence of the Delta variant) Moderna’s vaccine was associated with a 21% lower risk of confirmed infection, and a 41% lower risk of hospitalization than Pfizer’s. And in a more recent federally-funded mix and match COVID-19 vaccine trial of more than 450 adults, Moderna’s vaccine elicited the most robust antibody responses post-boost, while Pfizer’s was marginally lower, and Johnson & Johnson took third place. 

That’s why some experts say it might be a better booster for elderly adults, who are generally more vulnerable to severe outcomes, and need more frequent and potent boosters of all kinds.

How the side effects differ

Getting a third shot of Moderna’s vaccine is a lot like getting a second one, according to a presentation the company recently made to the Centers for Disease Conrol and Prevention. The same is true for Pfizer. 

But because Moderna’s vaccine tends to be a little more reactogenic than Pfizer’s, people who switch to it for their booster may notice the severity of their Moderna side effects is a little higher. The most widespread complaint people have after either booster shot is some pain at the injection site. Headaches, fatigue, and muscle aches are also common.

For Moderna, the one issue people in the company’s clinical trial tended to complain of more often after their booster shot was some armpit swelling or tenderness. Pfizer trial recipients also reported a bit more swelling (lymphadenopathy) after their boosts.

People who got Johnson & Johnson’s shot, and stuck with the same brand for boosters, tend to report very similar, albeit slightly milder side effects for a second shot, compared to their first. 

But all of these adverse effects of booster shots are mild to moderate and temporary, usually not lasting for more than a day or so after vaccination. 

Many experts say it doesn’t matter what booster you get, it’s all the same

With time, over the next several months and years, it will become clearer what the very best COVID-19 vaccination strategy truly is. In the meantime, infectious disease experts stress, don’t overthink it too much. Regardless of which booster shot people choose, they are better protected against the virus than people with just one (J&J) or two (Pfizer, Moderna) shots. 

“Right now, don’t make it complicated,” Dr. Anthony Fauci, the nation’s top infectious diseases expert, recently told Insider. “The effect of boost is very, very favorable to preventing people from getting infected.”

Bottom line: It’s generally agreed (especially with the Omicron variant circulating) as reasonable for all adults to go ahead and get boosted with whichever shot they may choose to, ahead of the holiday gathering season.

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Judge blocks Biden’s COVID-19 vaccination mandate for federal contractors in Kentucky, Ohio, and Tennessee

President Joe Biden speaks at Dakota County Technical College, in Rosemount, Minn., Tuesday, Nov. 30, 2021.
President Joe Biden speaks at Dakota County Technical College, in Rosemount, Minn., Tuesday, Nov. 30, 2021.

  • President Joe Biden issued a COVID-19 vaccination requirement for federal contractors.
  • US District Judge Gregory Van Tatenhove granted a request to halt Biden’s mandate on Tuesday.
  • Tatenhove said Biden exceeded his authority when he issued the mandate.

The Biden administration’s COVID-19 vaccination requirement for federal contractors received another blow from US District Judge Gregory Van Tatenhove, who granted a request Tuesday to block the federal mandate in three additional states: Kentucky, Ohio, and Tennessee.

“Once again, the court is asked to wrestle with important constitutional values implicated in the midst of a pandemic that lingers,” Tatenhove wrote in his ruling, which was obtained by CNN. “But right now, the enforcement of the contract provisions in this case must be paused.”

By issuing the mandate, Tatenhove determined that Biden exceeded his authority under the Federal Property and Administrative Services Act, even for a “good cause” like slowing the spread of COVID-19.

“While the statute grants to the president great discretion, it strains credulity that Congress intended the FPASA, a procurement statute, to be the basis for promulgating a public health measure such as mandatory vaccination,” Tatenhove wrote in his ruling.

The decision is the latest in a string of rulings against the vaccination mandate.

On Monday, Judge Matthew Schelp of the Eastern District of Missouri issued a preliminary injunction for workers at Medicare- and Medicaid-certified medical facilities in 10 states. Another ruling from a US federal appeals court in early November froze Biden’s mandate requiring businesses with at least 100 employees to get vaccinated or tested weekly.

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The US probably has 2,000 Omicron cases already, according to ‘dirty math’ from a COVID expert who often advises the White House

Charity Dean Headshot
The Public Health Company cofounder and CEO Dr. Charity Dean.

  • The CDC says Omicron is not in the US yet.
  • But Dr. Charity Dean, a former top health official in California, who warned about the spread of COVID-19 in the US early on in the pandemic and long before federal experts did, says there’s no way that’s true.
  • “Our case ascertainment rate is zero,” Dean said, but she has “no doubt that there are in fact cases here.”

Dr. Charity Dean has a solid track record of knowing what’s up when it comes to watching the coronavirus move around the world, and then forecasting what that means for how the virus is spreading through the US.

Dean, a former top-tier official at the California Department of Public Health, was one of the first people to sound the alarm that the coronavirus was alive and moving around the US in early 2020, among people with no travel history to China, where the coronavirus was first discovered.

Her warnings in those early days of the pandemic became so prescient that she was chosen to star in Michael Lewis’s latest book, “The Premonition.”

White House staffers in the Trump Administration, as well as the nation’s top infectious disease advisor, Dr. Anthony Fauci, listened in on briefing calls where she sounded the alarm as early as February 2020.

Now that Omicron is on the scene, a new variant with a dizzying number of fresh mutations, Dean is once again attempting to warn people that the new viral variant might already be in their backyard.  

“I have no doubt that there are in fact cases here in the US right now,” Dean told Insider of Omicron. “In fact, my dirty math based on a number of assumptions, including international travel — I would estimate there’s around 2,000 cases in the US right now.” 

Dean bases that assumption on the fact that the Omicron variant has already been found at least 20 countries around the globe, including South Africa, Botswana, Hong Kong, the Netherlands, Canada, and the UK. At least 226 cases have already been confirmed, according to the White House. Given that wide spread, Dean suspects the only real reason the US hasn’t found Omicron within its borders yet is simply because the country is not looking hard enough for the new variant. 

“The challenge for the United States is we are not doing a sufficient amount of genomic sequencing to have detected that,” Dean said.  

The US is “not quite there yet” when it comes to sequencing 

a man using a pipette to genetic sequence a coronavirus sample
Dr. Carlos Ortega at the University of El Salvador Virology Center works on coronavirus genome sequence on October 27, 2021.

America’s viral surveillance has ramped up significantly since the early days of the pandemic, when the US was sequencing less than 1% of coronavirus cases.

Dean says this means “the United States is on the right path” when it comes to viral surveillance, “but we’re not quite there yet.” 

Over the past six months, the US has sequenced and shared nearly 7% of its positive COVID-19 tests, though sequencing capabilities are unevenly spread across the country, meaning surveillance is far better in some areas than in others. Recently, labs haven’t been doing as much sequencing as they once were, either. After all, sequencing machines cost hundreds of thousands of dollars to procure, and once health departments do, it generally takes at least 24 to 48 hours to sequence a single sample.

“So many labs ramped down their sequencing efforts, understandably, throughout the Delta surge, when everything was the Delta variant,” Dean said.

That cost-saving move means it’s harder to be on alert for Omicron now. 

“The challenge with having an inadequate amount of genomic sequencing in the US is it makes it much harder to detect a novel variant when it emerges,” she said.

The UK and southern Africa have more efficient systems to track Omicron

The Centers for Disease Control and Prevention is confident that the country is standing ready to find the new variant as soon as it may arrive.

“We are actively looking for the Omicron variant right here in the United States,” CDC Director Rochelle Walensky said during a White House COVID-19 briefing on Tuesday. “Our variant surveillance system has demonstrated we can reliably detect new variants.”

But the reality is that other nations (including South Africa and the UK) have far better health systems in place, to not only sequence the virus, but then link up that information with a person’s vaccine status, as well as whether or not they’re hospitalized, and how severe their case is. 

“Right now, there is no evidence of Omicron in the United States, the Delta variant remains the predominant circulating strain, representing 99.9% of all sequences sampled,” Walensky said.

Dean, however, interprets the same finding quite differently. 

“Right now, the US has zero detected cases of Omicron, which means our case ascertainment rate is zero,” she said. “Genomic sequencing and genomic epidemiology is the disease control of the future.”  

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