Dr. E. Kwok administers a COVID-19 vaccine to a recipient at a vaccination clinic run by Vancouver Coastal Health, in Richmond, B.C., Saturday, April 10, 2021. THE CANADIAN PRESS/Jonathan Hayward

Dr. E. Kwok administers a COVID-19 vaccine to a recipient at a vaccination clinic run by Vancouver Coastal Health, in Richmond, B.C., Saturday, April 10, 2021. THE CANADIAN PRESS/Jonathan Hayward

NACI says you can mix-and-match AstraZeneca, mRNA COVID vaccines

People who received AstraZeneca vaccine will have a choice for dose two

The National Advisory Committee on Immunization announced Tuesday (June 1) that Canadians who received AstraZeneca for their first dose can get an mRNA vaccine for their second dose.

“I think it’s good news that people now have that choice,” said chief medical health officer Dr. Theresa Tam.

The advice affects more than two million Canadians who received the Oxford-AstraZeneca vaccine before provinces stopped using it for first doses last month.

The vaccine is potentially linked to a rare but serious blood clotting syndrome.

In Canada, 41 confirmed or suspected cases of vaccine-induced thrombotic thrombocytopenia have been diagnosed and five people have died.

NACI’s published report says AstraZeneca recipients can be offered the same vaccine if they want it, or can be given either Pfizer or Moderna.

They say they are basing their advice on the risk of VITT, and emerging evidence that mixing and matching different types of vaccines is not only safe but may produce a better immune response.

The guidance is not binding but most provincial governments have indicated they were waiting for the information before setting their policies for second doses.

Manitoba didn’t wait for the report to be published, announcing Monday they would offer AstraZeneca recipients Pfizer or Moderna if they wanted.

Quebec currently recommends getting the same vaccine twice but says with informed consent people who got AstraZeneca first can get Pfizer or Moderna.

The province is expected to update this later in the week, along with shortening the wait to get second doses of mRNA vaccines.

NACI’s advice comes after interim results were published in May from two studies looking at mixing and matching vaccines.

A Spanish study concluded a second dose of Pfizer after a first dose of AstraZeneca produced more than twice the antibodies as a second dose of AstraZeneca.

A United Kingdom study reported there were more frequent reports of short-lived side-effects such as fever and fatigue in people whose second dose was a different vaccine. It is still waiting for results on how effective mixing and matching is but as second doses ramp up across Canada, health officials say they need to make decisions now.

Several European countries are giving Pfizer or Moderna as second doses to AstraZeneca recipients, including Denmark, Finland, France, Germany, Sweden, Norway and Spain.

More than two-thirds of Canadians over the age of 12 now have at least their first dose, but only about 10 per cent of them are fully vaccinated. With vaccine supplies limited in the first months of the immunization program, provinces delayed second doses up to four months to try and get more people one dose faster.

The plan has worked to that end, with Canada now one of the most vaccinated countries in the world when it comes to first doses. As of May 30, Canada is now in the top 10 countries for first doses in the world, and is likely to surpass the United Kingdom on first doses by the end of the week.

It’s not even in the top 50 for second doses.

Second doses are starting to be given faster now, with several provinces moving to fully vaccinate the highest risk populations, including seniors and those with compromised immune systems.

Until a week ago, fewer than one-tenth of new doses given out each were for second doses, but over the last week one-sixth of new doses were for second shots.

For some people, getting a different second dose is a supply issue, particularly for Moderna recipients, with that company unable to deliver expected doses on time so far.

For AstraZeneca however it is a question of safety. Provinces stopped using AstraZeneca for first doses in mid-May as the number of Canadians diagnosed with vaccine-induced thrombotic thrombocytopenia grew.

The rare blood clotting disorder believed to be caused by an unexpected immune response to the AstraZeneca vaccine, has occurred in about one in every 53,000 Canadians given the AstraZeneca vaccine as a first dose.

While health experts say the risks of the clots is extremely low and is outweighed by the risks of COVID-19, NACI said people should only get AstraZeneca if they are over the age of 30, and live in an area where they are more likely to be exposed to the virus that causes COVID-19.

Many provinces have been holding off giving second doses of AstraZeneca pending NACI’s advice on whether it should be given as second doses.

NACI has already said people can mix and match vaccines within the same vaccine family — so the mRNA vaccines from Pfizer and Moderna can be mixed and matched, or the viral vector vaccines from AstraZeneca and Johnson & Johnson.

That latter advice was theoretical since Canada hasn’t started using the J&J vaccine at this point. The 300,000 doses received in April remain in quarantine in freezers at Innomar Strategies pending a quality assurance check.

The drug substance in those doses was made at a facility in Maryland that has since been cited for numerous safety violations.

More to come.


Like us on Facebook and follow us on Twitter.

Coronavirusvaccines

Just Posted

Black Press file photo
RCMP seek suspect in Vancouver Island-wide crime spree

Crimes stretched from Deep Bay to Qualicum, Ladysmith, Chemainus and Youbou

Things are looking up for Vancouver Island as zero COVID-19 cases have been reported for the first time since October. THE CANADIAN PRESS/Darryl Dyck
Island records zero new COVID-19 cases for the first time since October

For the first time since October, the province is reporting zero new… Continue reading

The remains of the Mid-Island Co-op in Whiskey Creek along the Alberni Highway on Friday, June 18, after a blaze the day before devastated the gas station. (Michael Briones photo)
VIDEO: Whiskey Creek gas station destroyed by fire after camper van explosion

Nine fire departments responded to the incident, no injuries reported

New Vancouver Island University chancellor Judith Sayers was sworn in at a virtual ceremony June 17. (Submitted photo)
VIU’s new chancellor seeks innovation and equality in post-secondary education

Judith Sayers officially sworn in as Vancouver Island University chancellor

Craft Brewing and Malting program student Ellie Hadley plans to use her newfound skills and knowledge to set up a distillery in Port Alberni. (PHOTO COURTESY LEE SIMMONS)
Something’s brewing with North Island College’s newest program

Port Alberni grad Ellie Hadley hopes to turn new skills into thriving business

A small pod of Pacific white-sided dolphins pass by close to shore in Campbell River June 16, 2021. Still capture from video courtesy of Kimberly Hart
VIDEO: Dolphin sunset captured from Vancouver Island shore

Spectacular setting for view of travelling pod of Pacific white-sided dolphins

Karl and Stephanie Ann Johanson were thrilled to spot a pair of Sandhill Cranes in the Panama Flats this month, an unusual appearance for such birds. (Photo by Stephanie Ann Johanson)
WATCH: Sandhill cranes an unusual, joyful sight in South Island parkland

These birds don’t often touch down on their way between northern B.C. and Mexico

Police are asking for public assistance in locating Anthony Graham who has been charged with the murders of Kamloops brothers Carlo and Erick Fryer. (RCMP photo)
2 charged, suspect at large in killings of B.C. brothers linked to gang activity: RCMP

Kamloops brothers Erick and Carlo Fryer were found deceased in May on a remote Okanagan road

(V.I. Trail/Google Maps)
Now 90% complete, Vancouver Island trail forges new funding parnership

Victoria Foundation takes on Vancouver Island Trail Association; fund valued at $40,000

Albert Health Minister Tyler Shandro and Alberta Premier Jason Kenney unveil an opening sign after speaking about the Open for Summer Plan and next steps in the COVID-19 vaccine rollout, in Edmonton, Friday, June 18, 2021. THE CANADIAN PRESS/Jason Franson
Alberta 1st province in Canada to lift all COVID-19 public health restrictions

70.2% of eligible citizens 12 and older in the province have received a dose of the vaccine

Fraser Health registered nurse Ramn Manan draws a dose of the Pfizer COVID-19 vaccine into a syringe at a walk-up vaccination clinic at Bear Creek Park, in Surrey, B.C., on Monday, May 17, 2021. THE CANADIAN PRESS/Darryl Dyck
‘Honour our fathers’ with COVID-19 vaccine protection, B.C. urges

109 new cases Friday, 75 per cent of 12 and up immunized

Freighters have becomd abundant in the Trincomali Channel on the east side of Thetis Island.
Nanaimo ponders taking on waste from nearby anchored freighters

Vancouver-based Tymac petitioning the Regional District of Nanaimo to accept waste at its landfill

Cannabis bought in British Columbia (Ashley Wadhwani/Black Press Media)
Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

Most Read