Some Who Got Johnson & Johnson Vaccines Are Seeking Booster Shots As Delta Variant Spreads, Despite CDC Guidance

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07/20/2021

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Earlier this year, Erkin Peksoz wanted a COVID-19 vaccine so badly that he drove 640 miles round trip from Chicago to Quincy to get a Johnson & Johnson shot.

Peksoz was happy with that decision — until recently, when the more contagious delta variant of the virus emerged. Now, he’d like to get a shot of a Moderna or Pfizer vaccine, in hopes of increasing his protection.

“Until delta, I was not worried at all,” said Peksoz, a consumer data consultant. “I feel like I’m half-vaccinated now.”

In clinical trials before the delta variant began to spread, the Johnson & Johnson vaccine was found to be 66 percent effective at preventing COVID-19, while Pfizer and Moderna were 95 percent and 94 percent, respectively, although all three were found to be highly effective at preventing hospitalization and death from the illness.

The Centers for Disease Control and Prevention and most experts are not recommending that people who received Johnson & Johnson vaccines, or any other vaccine, get booster shots. Still, a number of individuals who got Johnson & Johnson shots are starting to wonder if a booster might be a good idea, given the rapid spread of the delta variant, a handful of experts who’ve publicly recommended it and what they’re seeing in other countries.

It’s become a topic of discussion on social media, and patients are asking their doctors for advice. Some have already gone to local pharmacies and gotten Moderna and Pfizer vaccines, even though they previously received Johnson & Johnson shots.

“We’re well aware of this going on,” said Dr. Mia Taormina, chair of the department of infectious disease at DuPage Medical Group. “What’s happening here is people are not being forthcoming. They’ve received Johnson & Johnson, they’re worried, and they’re just showing up at CVS and Walgreens and not even disclosing they received the Johnson & Johnson (vaccine).”

Both CVS Health and Walgreens say they follow CDC guidance, but neither answered questions about whether they have any way of knowing if a person seeking a vaccine has already been vaccinated. Illinois’ largest health insurer, Blue Cross and Blue Shield of Illinois, said it isn’t aware of any claims for vaccines being denied because the second dose of a vaccine came from a different manufacturer than the first.

Doctors say there are good reasons for people to follow CDC guidance and not seek out boosters for Johnson & Johnson vaccines now. 

“If you’re under 65, and you’re otherwise healthy, in all probability you’ve developed protective antibodies,” Taormina said.

Also, it’s unknown whether getting a Pfizer or Moderna vaccine, on top of Johnson & Johnson, might cause problems, said Dr. Michael Angarone, an associate professor in the department of medicine and division of infectious diseases at Northwestern University Feinberg School of Medicine.

“We know that vaccines are not without side effects,” Angarone said. He worries that for people who have autoimmune diseases, extra doses of vaccine could trigger flare-ups of those illnesses. “I think when we don’t know the benefit, and we know there’s potential risk, in my mind, that is a risk I don’t think we want to put people under.”

The focus should be on inoculating people who have not yet been vaccinated at all, not giving booster shots to those who’ve already rolled up their sleeves, he said. The makers of all three vaccines say they offer protection against the delta variant though Pfizer has said it plans to ask the U.S. to authorize a booster.

Still, in recent weeks, several prominent health experts made headlines for publicly encouraging people who received Johnson & Johnson to get Moderna and Pfizer shots.

Dr. Vin Gupta, a faculty member at the Institute for Health Metrics and Evaluation at the University of Washington and an NBC News analyst, tweeted late last month that people who got Johnson & Johnson should get a Moderna or Pfizer shot as a booster. “Most I know who got J&J are doing it and are telling others the same — since two seems better than 1 (regarding) delta,” he tweeted.

Dr. Angela Rasmussen, a virologist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan, also tweeted last month that she got a Pfizer vaccine to “top off the J&J vaccine I received in April.”

“I think I did the right thing to make sure I am as protected as possible from the delta variant and thus am protecting others who only have one shot,” she tweeted. “Sometimes public health requires making tough decisions without a complete data set to support it.”

Many people have also been looking at what other countries are doing with booster shots.

Canada’s National Advisory Committee on Immunization last month said that a first dose of the AstraZeneca vaccine should be followed up with a dose of Pfizer or Moderna, partly to elicit a better immune response. Germany has made a similar recommendation.

Though the AstraZeneca vaccine is not the same as the Johnson & Johnson vaccine, they rely on similar technology.

And even among experts who don’t recommend the general public get a booster shot, some are recommending boosters for select patients.

Taormina, with DuPage Medical Group, said in the last couple of months she’s recommended Pfizer or Moderna shots to about half a dozen patients who had already gotten the Johnson & Johnson vaccine but are immunosuppressed and didn’t develop antibodies after getting it.

Doctors and health experts are hopeful more data in coming months will help show who, if anyone, needs boosters.

Some people, however, don’t want to wait, now that the delta variant is spreading. The delta variant now comprises more than half of new COVID-19 cases in the U.S., though Illinois had only 288 known cases due to delta as of Wednesday.

Peksoz, who is in his 40s, has already lost one close friend to COVID-19. Though Peksoz is healthy, the illness’s unpredictable nature makes him nervous. “I’ve seen very unhealthy friends have it and not even know it, and healthy friends who are in the hospital for 10 days,” he said.

Though Peksoz wants a shot of Pfizer or Moderna, he said he won’t likely get one at the moment. He doesn’t want to be dishonest about the fact that he already got a Johnson & Johnson vaccine, which he would potentially have to do to get another shot.

“I just don’t want to lie,” Peksoz said. “It’s a very upsetting situation where we have a surplus of vaccines, and a third of the country doesn’t even want vaccinations, and people who want to have better protection can’t get it.”

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