Can you mix the Covid vaccines?

Jeremy Corbyn slams ‘rich’ countries over ‘vaccine nationalism’

There are three coronavirus vaccines which have been approved for mass distribution in the UK. More than four million people have now received their first dose of the vaccine, with more than 450,000 having been given their second dose as well. But with three different vaccines available – can you mix the vaccines and is it safe to do so?

The UK was the first nation in the world to approve the use of a coronavirus vaccine.

As of January 18, 4,062,501 people have received their first dose of the vaccine, with 452,301 having received their second dose as well.

Speaking from Downing Street on Monday, Health Secretary Matt Hancock said: “I know the pain that this disease causes – and I’m determined to do everything we possibly can to defeat it, and I know that is what you want too.

“And our vaccine delivery plan is absolutely at the core of this, it is our way out. It’s also the biggest medical deployment in British history and it’s one of the biggest civilian operations that this country’s ever undertaken.

“Our approach is, of course, to save as many lives as possible – as quickly as possible and to reduce the pressure on the NHS.”

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The Health Secretary outlined the UK is on track to vaccinate the most vulnerable groups by the middle of February.

These groups currently account for 88 percent of Covid-related deaths reported in Britain.

From Monday, all those aged above 70 and those under 70 who are clinically extremely vulnerable will begin to be invited for vaccination.

Mr Hancock said: “We’re doing this because it’s the best way both to maximise the pace of the rollout and deliver according to the clinical prioritisation.

“All with the goal of saving as many lives as possible, as quickly as possible and reducing the pressures on the NHS.”

Can you mix the vaccines?

There are three different types of vaccine currently available in the UK.

The Pfizer/BioNTech vaccine, which requires storing at temperatures close to -75C, was the first to be approved in the UK.

The Pfizer/BioNTech jab uses a technology known as mRNA which introduces a messenger sequence which contains the generic instructions for the vaccinated person’s own cells to produce the antigens and generate an immune response.

The final data on this vaccine showed it offers 95 percent protection against the virus after two doses, with a 94 percent effectiveness among adults over the age of 65.

The Oxford/AstraZeneca was the second vaccine to be approved in the UK and it works by smuggling the coronavirus gene into human cells to make the spike protein which the immune system builds up a response to if the real virus enters the body.

The Oxford trial found after two doses, the vaccine was 62 percent effective, but later when people were given a half dose followed by a full dose efficacy rose to 90 percent.

The Moderna vaccine is the latest vaccine to be introduced and it uses the same mRNA technology as the Pfizer/BioNTech vaccine.

Moderna’s response indicates 94.5 percent effectiveness but said trials are ongoing and these final figures may change.

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The official guidance outlines everyone should receive the same vaccine for both doses.

However, in very rare circumstances, if only one vaccine is available or it is unknown which particular vaccine was used for the first dose, a different vaccine can be used.

The Government guidance reads: “JCVI advises that the second vaccine dose should be with the same vaccine as for the first dose.

“Switching between vaccines or missing the second dose is not advised as this may affect the duration of protection.”

Different vaccines will not be mixed in the same dose.

Mary Ramsay, head of immunisations at PHE, told The BMJ that “every effort should be made to give [patients] the same vaccine, but where this is not possible it is better to give a second dose of another vaccine than not at all.”

The UK has been the first country to announce it is prepared to mix and match the vaccines in limited circumstances.

NHS England has been keen to stress people can be given a different second dose from the first when absolutely necessary.

However, the United States in particular, has been critical of this approach.

The US Centers for Disease Control and Prevention said that the authorised Covid-19 vaccines “are not interchangeable” and that “the safety and efficacy of a mixed-product series have not been evaluated. Both doses of the series should be completed with the same product.”

Dr Ramsay’s comments were repeated in a press briefing involving Professor Munir Pirmohamed, chair of the Commission of Human Medicines expert working group.

Professor Pirmohamed said: “We’re not advising mixing different doses of the vaccines because we don’t have any data on that.

“Our advice is that if you have the Pfizer vaccine as a first dose, the second dose should also be the Pfizer vaccine.

“If you have the AstraZeneca vaccine as a first dose, the second dose should also be the AstraZeneca vaccine.”

Trials are currently underway where people receive different vaccines at different times to see how effective it is.

Public Health England said because all the available vaccines are based on the spike protein, it is likely the second dose will help to boost the response to the first dose, even if it is a different vaccine.

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