The BOTTOM LINE: Myeloma patients are recommended to get a booster shot. Talk to your doctor about the pros and cons of choosing the Moderna vaccine as a booster
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This week’s “Ask Dr. Durie” comes from a patient who is very anxious to get a booster for the COVID-19 infection. This patient had the J&J vaccine as the first vaccination, and now, wants to know what should they do about the booster?;
Well, the first thing is it’s just so important for myeloma patients to go ahead and get that booster shot because it can increase the antibody levels much more to fight the COVID-19 infection.
However, it is a very good question in terms of which vaccine might be the best as a booster? So, the first point is that all the three vaccines have now been approved by the FDA and the CDC as boosters. So, J&J has an approved booster, as does Pfizer, and Moderna, so that’s the first point.
But the second, very important point, is that both the FDA and the CDC have approved, what they call, “mix and match.” Depending on which one you got first, you can use one of the other vaccines later.;
And so, this does open possibilities for this patient. Because, in the mix-and-match testing, it turns out that there is an important difference in terms of the boost that you get with a second J&J, or a booster, which is a third vaccine that’s either Pfizer or Moderna.
It turns out that with a J&J booster, you have four times increase in your antibody level. If you get a Pfizer booster, you have an increase in antibodies times about forty, or so. If you get a Moderna booster, you get ;an increase in antibodies up to 76 times.;
There really is a much stronger boost with the Moderna, the mRNA vaccine, in patients who received the J&J.
For myeloma patients, every antibody level makes a difference to get to that higher level that can fight off infection. Although it would be okay to take any of the vaccines, I would suggest that you talk to your doctor. But I would consider getting the Moderna as a first choice, Pfizer as a second choice, and then of course, you can get a J&J booster vaccine.
The main thing is boosters are so important for patients with myeloma, particularly patients who have had active myeloma and are taking ongoing treatment. So, get that booster, and talk to your doctor about the pros and cons about maybe getting a Moderna versus just following on with that J&J vaccine.
Professor of Medicine, Hematologist/Oncologist, and Honoree MD at the University of Brussels, Dr. Brian G.M. Durie is a co-founder of the IMF.
