How to decide among the COVID-19 booster options

» I am a 65-yearold man in good health. In March 2021 I received the Johnson & Johnson vaccine. I understand I am eligible to receive a booster. I also understand that the Centers for Disease Control and Prevention says I may receive any of the three vaccines, but that they do not recommend one over the other.

I am torn on which one to receive. I hear that the Moderna booster will boost the antibodies multiple-fold over receiving another J&J shot. I also read somewhere that the J&J shot seems to offer longer protection, although less of it. Is that true? Also, I don’t believe there are any longterm studies on the effects of mixing the two type vaccines.

Is there any proof that having more antibodies protects one better? So, if it got the Moderna booster, I’d be protected better than if I got the J & J booster? What are your thoughts?

— C.M.

Antibody tests showing immunity to COVID-19 are not yet standardized, and we don’t know what level is protective. I don’t order antibody testing, as I’m just not sure how to interpret the results.

A recent study presented in October at the Advisory Committee on Immunization Practices, the external advisory committee to the CDC, did show that both the Moderna vaccine and the Pfizer vaccine dramatically increased antibody levels in people who had had the J&J vaccine (the Moderna 76-fold; the Pfizer 35-fold).

As far as duration of immunity, other studies have shown that the Moderna and Pfizer vaccines seemed to have longerlasting protection than the J&J vaccine, although these data are relatively new and not yet confirmed by other studies.

Based on the ACIP data, I am recommending my patients who had the J&J vaccine to get either of the mRNA vaccines (Moderna or Pfizer). This recommendation is based on fairly preliminary data and may change when new studies are published.