Can You Mix And Match For The COVID Bivalent Booster Shot?

Pfizer and Moderna now both have new bivalent COVID booster shots that not only target the original strain of coronavirus, but also the highly contagious omicron subvariants that are dominant throughout the country.

These booster shots are readily available at pharmacies and doctor’s offices throughout the United States. You’re able to get one if you’re at least two months out from your last COVID shot or two months out from a COVID infection.

“[These] vaccines are widely available,” said Dr. Laolu Fayanju, an Ohio-based family medicine specialist with Oak Street Health. “We are a long way from the early days of 2021 when the vaccines were just rolling out.”

But if you notice that your local pharmacy only has one kind of shot available (either just Pfizer shots or just Moderna shots), do you need to look elsewhere to find the same shot maker you had last time? Here’s what to know:

Adults can get either bivalent booster.

According to Dr. Onyema Ogbuagu, an infectious diseases specialist and associate professor of medicine at the Yale School of Medicine, just like with the last COVID booster, you can get either the Pfizer shot or the Moderna shot no matter what shot you got for your primary vaccine series or your last booster.

“We’ve seen that there’s no harm from prior studies in mixing and matching mRNA [vaccines], they’re one in the same approach with subtle differences,” Ogbuagu said.

So, if your local pharmacy is only giving out shots of Pfizer, there is no reason to go search far and wide for Moderna — or vice versa. You’re good to get either shot. “Anyone should feel comfortable getting the Pfizer vaccine after Moderna and Moderna after Pfizer,” Ogbuagu said.

However, keep in mind that this only goes for people over the age of 18. The Moderna bivalent booster is not currently authorized for people age 12 to 17. Those age 12 to 17 can only get the Pfizer booster. Fayanju noted that it’s perfectly safe for people in this category to get the Pfizer booster even if they’ve only had Moderna shots previously.

Kobus Louw via Getty Images

It’s safe for adults to get either the Moderna or Pfizer bivalent booster shot, no matter what COVID vaccine you had previously.

There may even be benefits to mixing and matching your shot.

Research conducted on previous booster shots showed that mixing and matching your vaccine manufacturer may provide a stronger immune response than sticking with the shot-maker you got originally. Experts suspect the same holds true for the bivalent shot.

Additionally, previous studies show that the Moderna vaccine produces a higher immune response than the Pfizer vaccine. This is likely because of the differences in the dosing of each shot. According to Ogbuagu, the Pfizer shot is 30 micrograms and the Moderna shot is 50 micrograms, “so there [are] differences in the number of antigens being used,” he said.

The higher dosage of the Moderna shot links it to this higher antibody response. But keep in mind that the overall amount of additional protection is nominal — both shots provide protection from severe outcomes like hospitalization and death.

If you got Johnson & Johnson for your primary vaccine, you’ll have to switch manufacturers for your booster.

It has also always been the recommendation that people who got the Johnson & Johnson vaccine follow it up with an mRNA booster, Ogbuagu said.

In the case of the bivalent booster, there is not a Johnson & Johnson equivalent, so it’s perfectly fine (and the only option) for those who got the Johnson & Johnson shot to get either the Pfizer or Moderna bivalent booster.

If you’re unsure, talk to your doctor.

Your physician will know what’s best for you based on your health history. For example, some doctors may encourage men ages 18 to 39 to get the Pfizer booster instead of Moderna if it’s available. In very rare cases, the Moderna vaccine caused temporary heart issues in men in this age group. But, according to the American Heart Association, contracting COVID-19 is way more likely to result in heart issues than the Moderna vaccine ― so it’s still a good idea for folks in this category to get the bivalent booster.

The bottom line is that both shots are excellent ways to protect yourself from the dominant omicron subvariants. You really can’t go wrong with either ― the best approach is to get whichever one you’re able to get ASAP.

Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.