Different vaccines to protect against the new coronavirus should not be combined, despite Britain’s recent decision to allow the use of the practice on a few occasions, according to health experts.
The mix of different coronavirus vaccines without any data suggesting the safety and effectiveness of the practice is “a huge gamble,” said Dr. Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto. .
“I think it’s irresponsible … it’s unethical because we don’t know what this does,” he said. “We don’t know what the effectiveness is, we don’t know what the side effects are.”
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Dr. Isaac Bogoch, a member of the Faculty of Infectious Diseases at the University of Toronto, said that while there may be “some theoretical reasons” about why the vaccine mix “can provide decent protection against infections by COVID-19 “, the data are not yet conclusive.
“Until we see better data to support this, I think we will not see any such activity in Canada,” he said.
The comments come after Britain released new guidelines on New Year’s Eve that will allow people seeking their second dose to receive vaccines from different COVID-19 vaccines on a few occasions.
“(If) the same vaccine is not available or if the first product received is unknown, it is reasonable to offer a dose of the product available locally to complete the schedule,” according to the guidelines.
Mary Ramsay, head of vaccinations at Public Health England, said this would only happen on extremely rare occasions and that the government did not recommend mixing vaccines, which require at least two separate doses several weeks.
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He said “every effort should be made to give them the same vaccine.
“But when that’s not possible, it’s better to administer a second dose of another vaccine than not,” he said.
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What did Health Canada say?
Currently, Health Canada’s National Vaccination Advisory Committee (NACI) recommends that the vaccine series “be completed with the same COVID-19 vaccine product”.
“There is currently no data on the interchangeability of COVID-19 vaccines,” the agency’s website reads.
However, according to NACI, if the vaccine used for a previous dose “is not known or is not available, an attempt should be made to complete the vaccine in series with a similar type of COVID-19 vaccine (eg vaccine mRNA) “.
“In the context of the limited supply of COVID-19 vaccines and the lack of evidence on the interchangeability of COVID-19 vaccines, the above dose can be counted and there is no need to restart the series,” the website read.
The agency said that “active monitoring of the effectiveness and safety of this mixed program will be important in these people,” adding that “an accurate record of vaccines received will be crucial.”
According to the NACI, the agency will “continue to monitor the tests” and update its recommendations as needed.
To date, Health Canada has approved two coronavirus vaccines for use nationwide. Both are mRNA vaccines and require two doses to provide around 95% COVID-19 protection.
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The Pfizer-BioNTech vaccine requires two shots to be administered 21 days apart, while doses of the Modern vaccine will be administered 28 days apart.
Bogoch said we have “good data” on these vaccines and how they should be administered.
Asked if there are any circumstances in which Canada should allow different vaccines to be combined before data are available, Bogoch said “no.”
“I’m not entirely sure outside of a clinical trial what the role would be in carrying out such activities,” he said.
Furness also said vaccines should not be mixed unless they are in a research environment, where participants have given their informed consent.
“If you want to do a test to test them, sure,” he said. “But that will take many months.”
Anything else, Furness said, would be “experimental.”
“Human history is very full of experimenting with people without understanding that they are experiencing,” he said. “And it’s really not okay.”
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For now, Bogoch said we should focus on deploying approved vaccines as soon as possible, in the way they should be administered.
“Tthe goal is to have as few vaccines as possible in the freezers and get the needles in the arms as fast as possible in the highest risk groups and prevent death and suffering, ”he said.
–With Reuters files
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