Thread by @EricTopol

A big mix and match vaccine report in 458 participants with Pfizer, Moderna, J&J, then getting another vaccine 12 weeks later: markedly increased neutralizing antibody response by mixing (up to 76-fold) w/ these 9 combinations (Figure)
medrxiv.org/content/10.110… (not Delta strain)

The big takeaway from this dataset is the response to J&J vaccine with a Moderna or Pfizer booster, taking that vaccine with low levels of neutralizing antibodies to close to parity with the mRNAs
(also worked in reverse, J&J boost to mRNA, middle panel)

A few add’l points:
1. 100 μg dose of Moderna booster used here is not (2X) 50 μg proposed by their EUA for FDA tomorrow
2. In prior reports, Astra Zeneca 1st, then mRNA had superior levels of nAbs over mRNA 2 doses, not seen here w/ J&J
3. Assessments were w/ D614G, not Delta

Here are data for neutralization with AZ, then Pfizer, showing that was superior vs 2 AZ or 2 Pfizer doses for Alpha & Beta variants
thelancet.com/journals/lanre…
Preprint today: look at neutralization not binding Abs; yes Moderna -> more boost than Pfizer to J&J, but w/ 100 μg dose

The new mix and match study makes the headline for tomorrow
nytimes.com/2021/10/13/hea… by @carlzimmer @noahweiland