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Mix and Match COVID-19 Booster: Which Shot Should You Get?

Covid-19 Mix and Match Booster Graphic
Clinical Contributors to this story:
Thomas Bader, M.D.
Dr. Jerry Zuckerman, M.D.
Updated: 5/31/2022

The U.S. Food & Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) have given green light to safely mix and match the booster shot, which means you may choose which COVID-19 vaccine you receive as a booster. Is it better to stick to the same kind of vaccine you originally received, or are there situations where you should consider getting a different COVID-19 vaccine as a booster?

We connected with Hackensack Meridian Health's Thomas Bader, M.D., chief clinical officer and Jerry Zuckerman, M.D., vice president of infection prevention and control, to understand when you should consider the mix and match approach, and when it doesn't make sense.

Pfizer or Moderna (mRNA) vaccine recipients

If you have received the Pfizer or Moderna vaccine for the first two shots and you meet the booster eligibility criteria, you can receive the COVID-19 booster shot. 

The recipients of the Pfizer and Moderna vaccines have a choice to mix and match, but Dr. Bader is encouraging people to stay with the same vaccine as the initial dose. “If you have already received the mRNA vaccine, there is no strong reason and benefit to mix and match," he says. “If it’s not easy to get the same vaccine you previously had, mixing and matching won’t hurt. What’s most important is that you go out and get the booster shot.”

Johnson and Johnson vaccine recipients 

The recipients of the J&J vaccine also have a choice to mix and match or get a second J&J dose as a booster. Dr Bader is recommending that people who got the J&J vaccine consider Pfizer or Moderna (either mRNA vaccine) for your booster. 

On May 5, 2022, the Food and Drug Administration (FDA) limited the authorized use of the Johnson & Johnson (Janssen) COVID-19 Vaccine to those 18 and older who:

  • Are allergic to an ingredient within the mRNA vaccines, or had a severe reaction after their first dose,
  • Don't have access to the other approved COVID-19 vaccines, or 
  • Who elect to receive the J&J brand and would otherwise not be vaccinated.

The FDA released this recommendation due to the risk of a rare blood clotting syndrome, thrombosis with thrombocytopenia syndrome (TTS). The CDC notes that the risk of TTS occurs at a rate of about 3.83 cases per million doses administered.

Why is it important to get a COVID-19 booster?

Levels of antibodies start to decline eventually after people receive the COVID-19 vaccine, weakening your protection against COVID-19. By getting a booster shot you are increasing your immunity against the virus. Boosters help prevent severe illness or death, particularly amongst older adults and people with pre-existing medical conditions.

Next Steps & Resources: 

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.


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