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Mix-n-match COVID-19 vaccine boosters may result in fewer infectionsPeople who received a different brand of COVID-19 vaccine booster than they did in the primary series had lower rates of infection than those who received the same brand, according to a study in Singapore published late last week in JAMA.The study also found that participants who received a booster of any vaccine brand after the primary Pfizer/BioNTech series had lower rates of severe COVID-19 than did their unboosted peers.

In a similar study earlier last week, US scientists writing in the New England Journal of Medicine found better booster protection only among those who initially received the Johnson & Johnson COVID vaccine.The Singapore team analyzed rates and severity of COVID-19 infections among participants 60 years and older from Sep 15 to Oct 31, 2021, amid a surge of cases that the authors said was related to the relaxation of public health measures.

In response to the surge, that age-group was invited to receive a Pfizer or Moderna vaccine booster.Of 703,209 eligible people, 576,132 received boosters; 59% of them were 60 to 69 years old, 29% were 70 to 79, 11% were 80 and older, with 53% were women.The incidence of COVID-19 infection and severe disease among participants who received Pfizer for both their primary series and booster (homologous vaccination) were 227.9 and 1.4 per million person-days.

In contrast, the incidence of infection and severe disease among those receiving a different booster (heterologous) were 147.9 and 2.3 cases per million person-days, respectively, with incidence rate ratios (IRRs) of 0.18 (95% confidence interval [CI], 0.14 to 0.23) and 0.08 (95% CI, 0.01 to 0.56).For recipients of a homologous Pfizer series, the

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