Mixed Shots - Safe?

[mrwebb8825]

With all the threads on covid, variants and vaccines, I've been hugely curious about what will/does/could happen with a set of mixed shots. I mean. as stupidly as these vaccines have been rolled out, what are the effects (side or otherwise) of getting a 1st shot of Astra and a 2nd shot of Sinovac? Do you get to see the vial as they draw the vaccine into the syringe to be sure what you're getting? I would think the odds of a bad side effect would be lower for say 1st shot Pfizer and 2nd shot Moderna.

What prompted me to finally make this post was seeing on the news that A.) Thailand is getting 1.5 million doses of Pfizer from the US, B.) Sinovac is proven nearly worthless against the new variant, C.) Thailand is making plans to reinject it's healthcare workers with Pfizer after initial injections of Sinovac.

This will be an experimental cocktail of 2 Sinovac shots and 1 Pfizer shot. As mentioned in other threads they are not made the same way and could cause a whole new spike in deaths by virtually "infecting" people in 2 different fashions.

Any scientists or scientifically well-read folks in here?

[clivebaxter]

German chancellor had AZ then pfiser, so I think we can take that as pretty safe

[internationalism]

since december the AZ is experimenting with mixing with sputnik, moderna, pfizer. They actually making them into one dose.

Also china declared they are also experimenting with mixing different vax.

So they are ahead of just taking different jabs each time.

There are in thailand now contracted and shortly delivered some 30.5mln sinovac, with AZ lagging probably only 11mld to the end of July, so your chances would be first sinovac 2 doses and hoping for the booster with AZ or later on some other one (privately they are more likely to be liberal with timing or whatever restrictions might be).

In europe they gradually discontinuing the AZ (2 countries withdraw them) , so the second is pfizer or moderna.

Thailand is not yet at point of discontinuing sinovac or the AZ - far from it, there is acute shortage of them and remote chances for sinopharm, and the rest. Thailand has conservative mindset and not going to experiment, just follow world trends.

No, mixing different vax doesn't cause spike of deaths. But all covid vax are still experimental, so long term effects are unknown.

A ) donation pfizer 1 mln from the USA likely to be end of year and only 300k for foreigners (likely american first, with allied to them brits). So can be forgotten if you are not from those countries. 

 

 

Edited July 9, 2021 by internationalism

[Oxx]

Yes, it's safe.  The body is exposed to a myriad different antigens every day and responds - usually without your even noticing it.

 

What is perhaps a more important question is "is it effective?".  The logic of two dose vaccinations is that with the first dose the body responds half-heartedly to the antigen (after all, it might never see it again), then with the second it thinks "this really is something that I need to deal with" and ramps up the level of immunity.  Now, each of the available vaccines uses a different antigen, so if you have two different vaccines, you don't get the full multiplying effect of the second dose.  Ergo, it's better that the first and second doses are the same.  After that immunity should be fully established for the first antigen.  With a third dose of a different vaccine you're establishing immunity to a different antigen, so are adding to your overall immunity.

[TheFishman1]

I just like to be able to get a dose this rollout for foreigners is just terrible

[Old Nomad]

Some combinations result in improved protection and the recommended interval between shots may be shorter.
I had my first shot with AstraZeneca and my second with BionNTech (mRNA). This is a good combination,
See https://www.nature.com/articles/d41586-021-01805-2.

 

[DogNo1]

There is a YouTube channel - drbeen.com - that discusses every topic imaginable about COVID vaccines.  He covers mixed vaccines very well. Mixing seems to increase immunity to the virus.

[scorecard]

9 hours ago, internationalism said:

since december the AZ is experimenting with mixing with sputnik, moderna, pfizer. They actually making them into one dose.

Also china declared they are also experimenting with mixing different vax.

So they are ahead of just taking different jabs each time.

There are in thailand now contracted and shortly delivered some 30.5mln sinovac, with AZ lagging probably only 11mld to the end of July, so your chances would be first sinovac 2 doses and hoping for the booster with AZ or later on some other one (privately they are more likely to be liberal with timing or whatever restrictions might be).

In europe they gradually discontinuing the AZ (2 countries withdraw them) , so the second is pfizer or moderna.

Thailand is not yet at point of discontinuing sinovac or the AZ - far from it, there is acute shortage of them and remote chances for sinopharm, and the rest. Thailand has conservative mindset and not going to experiment, just follow world trends.

No, mixing different vax doesn't cause spike of deaths. But all covid vax are still experimental, so long term effects are unknown.

A ) donation pfizer 1 mln from the USA likely to be end of year and only 300k for foreigners (likely american first, with allied to them brits). So can be forgotten if you are not from those countries. 

 

 

Australia's Chief Medical Officer was talking about boosters maybe 10 days ago.

 

He did mention that there's no reason not to get (just an example) 2 shots of AZ then a third (booster) shot of Pfizer.

 

He indicated there's no possibility of the 2 vaccines reacting against each other.  

[expat_4_life]

When I saw this thread title, I thought surely this was to be a discussion about the ills of mixing

shots of vodka and Jagermeister, or gin and whiskey, or some other cringe worthy hangover

laden mixture.

[Tony125]

Pfizer COVID-19 booster shot extends strong protection, company says, vaccine being updated to target Delta variant

 

https://www.msn.com/en-us/news/us/pfizer-covid-19-booster-shot-extends-strong-protection-company-says-vaccine-being-updated-to-target-delta-variant/ar-AALVYK3

 

Basically you can take  Pfizer as a booster to any other shot/shots  you have had whether it was Sinovac, AZ, Moderna or J and J

[khunPer]

16 hours ago, mrwebb8825 said:

Any scientists or scientifically well-read folks in here?

There are report from Europe about mixed vaccinations, as a number of countries either stopped using AZ, or stopped using AZ for younger people than 60/65 year of age. Most cases have been with 2nd shot from Pfizer. If you search, you should be able to find reports.

[l4ml4m]

Could it be more dangerous than injecting any of these krap ?

 

Let's see in 20 years ! But I understand that many people are already too old to know what happens in 20 years...

 

[Tony125]

Vaccinated people can transmit the delta variant—and 3 other things to know about the dominant Covid strain

 

https://www.msn.com/en-us/money/companies/vaccinated-people-can-transmit-the-delta-variant—and-3-other-things-to-know-about-the-dominant-covid-strain/ar-AALY0ZX?li=BBnb7Kz

[inThailand]

Wouldn't you follow almost any advice other than from a Thai expert?

Edited July 9, 2021 by inThailand

[KKr]

Netherlands approved Astra followed by Pfizer on July 5, as did some other European Countries earlier.

https://www.rijksoverheid.nl/actueel/nieuws/2021/07/06/de-jonge-mix-en-match-met-astrazeneca-is-net-als-twee-keer-astrazeneca-veilig-en-effectief

"Randomises Trial" preliminary results (Google translated)
 

Heterologous vaccination

Four different vaccines are available for the vaccination program against COVID-19. AstraZeneca, BioNTech/Pfizer and Moderna vaccines require two doses for adequate protection. The Ministry of Health, Welfare and Sport asked the Health Council to assess whether it is possible to combine two different vaccines.

Last week the results of a randomized trial were published, investigating the immune response when combining different vaccines. Participants received either two doses of the same vaccine or a combination of AstraZeneca first and then BioNTech/Pfizer or vice versa. After a first dose of AstraZeneca, vaccination with BioNTech/Pfizer resulted in at least as good or even higher levels of antibodies compared to two doses of AstraZeneca. Based on the results, good protection against infection and disease is expected; The practical effects of heterologous vaccination on protection against hospitalization or death are not yet known. However, the combination of two different vaccines did lead to fever, fatigue, chills, headache and muscle pain in more study participants than when vaccinated with the same vaccine twice. However, those complaints disappeared within a few days.

An initial dose of BioNTech/Pfizer followed by a dose of AstraZeneca resulted in lower levels of antibodies than two doses of BioNTech/Pfizer. Insufficient data are yet available about a possible combination with the Moderna vaccine.

https://www.gezondheidsraad.nl/organisatie/vaccinaties/documenten/adviezen/2021/07/05/heterologe-vaccinatie 

Edited July 10, 2021 by KKr

[oldcpu]

On 7/9/2021 at 6:41 AM, clivebaxter said:

German chancellor had AZ then pfiser, so I think we can take that as pretty safe

I think it was AZ then Moderna ... which I find encouraging.  There have been a few studies conducted looking at AZ/Pfizer, but I have not seen any yet of AZ/Moderna, so Merkel's confidence in this suggests to me she may have had some expert consultation prior to her doing so.

 

Studies I have noted that state the AZ/Pfizer combination (in that order) works well :

*  https://www.isciii.es/Noticias/Noticias/Paginas/Noticias/Presentación-resultados-preliminares-CombivacS.aspx (spanish study)

* https://www.sciencedirect.com/science/article/pii/S0140673621011156 (UK study)

* https://www.uni-saarland.de/fileadmin/upload/aktuell/pdf/2021/PM_111a_Impfstoffvergleich_Sester.pdf (German Study (English translation (PDF file))

[portlandtree]

On 7/9/2021 at 8:33 AM, Oxx said:

Yes, it's safe.  The body is exposed to a myriad different antigens every day and responds - usually without your even noticing it.

 

What is perhaps a more important question is "is it effective?".  The logic of two dose vaccinations is that with the first dose the body responds half-heartedly to the antigen (after all, it might never see it again), then with the second it thinks "this really is something that I need to deal with" and ramps up the level of immunity.  Now, each of the available vaccines uses a different antigen, so if you have two different vaccines, you don't get the full multiplying effect of the second dose.  Ergo, it's better that the first and second doses are the same.  After that immunity should be fully established for the first antigen.  With a third dose of a different vaccine you're establishing immunity to a different antigen, so are adding to your overall immunity.

just wondering where you got this info. because ive read one gets better protection if shots are mixed especially against the new varients ones , now iam not saying your wrong there is so much misinformation out there one dont know whats good anymore. first i got one in thailand (astrazenca) second scheduled for in usa when i get there 8/1 with pfizer, now i wonder if all is bull$hit and a conspiracy lol

[Lorry]

On 7/9/2021 at 8:33 AM, Oxx said:

it's better that the first and second doses are the same

That's not true.  What you write is just too much of an over-simplification.

Heterologous vaccination are probably a good idea for many diseases, but who wants to do (and pay) the research? 

 

In the case of covid 19, AZ and mRNA vaccines do not produce different antigenes, as you seem to think.  Both work by having the human body produce viral spike protein. Quite a bit of research has been done (especially in the UK) and the results generally favor "match and mix". Pfizer after AZ has very good results. Better than AZ after AZ.

The German chancellor got Moderna after AZ, and in Germany everybody who got AZ now gets a 2nd shot with mRNA.

 

 

 

 

[motdaeng]

On 7/9/2021 at 6:41 AM, clivebaxter said:

German chancellor had AZ then pfiser, so I think we can take that as pretty safe

the second shot was moderna.

canadien pm trudeau did the same,

first astra and second moderna.

 

[Thomas J]

https://theconversation.com/covid-vaccines-combining-astrazeneca-and-pfizer-may-boost-immunity-new-study-163667

[jomtienisgood]

On 7/9/2021 at 6:41 AM, clivebaxter said:

German chancellor had AZ then pfiser, so I think we can take that as pretty safe

In case of doubt try mixing Sang Som and Lao Kao. 555555

[jomtienisgood]

16 hours ago, expat_4_life said:

When I saw this thread title, I thought surely this was to be a discussion about the ills of mixing

shots of vodka and Jagermeister, or gin and whiskey, or some other cringe worthy hangover

laden mixture.

Same here, that's why I refer to my previous post. 55555

[drenddy]

Mixing vaccines is not accepted yet by Thai Government and you risk being denied COE.

I, myself, I took AZ and Moderna and hope, WHO will recommend/accept it as well, because we know very well, thais have no scientific authority, no disrespect.They follow WHO guideline.And China, of course.

 

(In the event, Thailand will open its borders to fully vaccinated travellers, not this shambles, we see in Phuket)

 

When I said yes to Moderna as second jab, I thought, if that cougar from Germany took it, surely this combo will be accepted by WHO.

[placeholder]

On 7/9/2021 at 5:09 PM, Old Nomad said:

Some combinations result in improved protection and the recommended interval between shots may be shorter.
I had my first shot with AstraZeneca and my second with BionNTech (mRNA). This is a good combination,
See https://www.nature.com/articles/d41586-021-01805-2.

 

The one problem with this is as of now, most (all?) countries won't accept that you are fully vaccinated. So you would have to take another shot provided your last shot of biontech was within a 42 day window. Otherwise, you'd have to start all over again. Of course, if you have not plans to do international travel, no problem.

[samtam]

On 7/9/2021 at 5:09 PM, Old Nomad said:

Some combinations result in improved protection and the recommended interval between shots may be shorter.
I had my first shot with AstraZeneca and my second with BionNTech (mRNA). This is a good combination,
See https://www.nature.com/articles/d41586-021-01805-2.

 

What's the recommended interval between 1 & 2? If I'm offered Sinovac only, and I get 2 shots, I'm thinking of flying to Hong Kong to get a booster of Pfizer. but I don't know how long between 2nd Sinovac and booster Pfizer.

[samtam]

On 7/9/2021 at 6:06 PM, scorecard said:

Australia's Chief Medical Officer was talking about boosters maybe 10 days ago.

 

He did mention that there's no reason not to get (just an example) 2 shots of AZ then a third (booster) shot of Pfizer.

 

He indicated there's no possibility of the 2 vaccines reacting against each other.  

What's the recommended interval between 1 & 2? If I'm offered Sinovac only, and I get 2 shots, I'm thinking of flying to Hong Kong to get a booster of Pfizer. but I don't know how long between 2nd Sinovac and booster Pfizer.

[Lorry]

15 minutes ago, samtam said:

What's the recommended interval between 1 & 2? If I'm offered Sinovac only, and I get 2 shots, I'm thinking of flying to Hong Kong to get a booster of Pfizer. but I don't know how long between 2nd Sinovac and booster Pfizer.

Nobody knows. 

Many people who got 2 shots of Sinovac or Sinopharm now get a shot of mRNA, eg in Bahrain and now in Thailand. These are desperate measures as authorities realize Sinowhatever is useless in the face of delta, and is useless in stopping the pandemic anyway. 

AFAIK Bahrain started this,  maybe UAE. Try to get information from there. 

[oldcpu]

46 minutes ago, samtam said:

What's the recommended interval between 1 & 2? If I'm offered Sinovac only, and I get 2 shots, I'm thinking of flying to Hong Kong to get a booster of Pfizer. but I don't know how long between 2nd Sinovac and booster Pfizer.

As mentioned already to you, nobody really knows (yet).

 

Earlier this week, when trying to register for Moderna my wife (who has received 2 Sinovac jabs in May) noted the Phuket Bangkok Hospital web site recommended the Moderna jab be given 3 to 4 months after the last Sinovac jab (and Astra Zeneca 4 to 6 months)..  The web site was also inconsistent - where in one place it stated for Sinovac to get 2 Moderna jabs as suggested for a booster (jabs separated by 4 weeks) but elsewhere it stated maximum 1 Moderna jab for a booster after Sinovac. My wife called the hospital, and was advised the Thai medical community is still considering this, where initially they thought 2 jabs best (for the booster after Sinovac), but they have now switched to recommending only 1 Moderna jab for the booster after Sinovac.  After AstraZeneca they have been consistent recommending only 1 booster jab.

 

I don't think any formal published studies have been done/published yet that assess a Pfizer booster or a Moderna booster after Sinovac, ...  although the general 'consensus' in various news articles (based on NO published studies) is that the booster is a good idea.

 

Given also there are no published studies (wrt Sinovac 2-jabs followed by Pfzier booster) I think its anyone's guess as to the best time separation, where hopefully those in the medical profession have a reasonable assessment. And as noted - Bangkok Hospital web site stated 3-to-4 months afterward (but my guess is that is 'tentative' and could change).

 

Have you checked the quarantine requirements for Hong Kong ?  I had thought they were only 2 weeks for some cases, and could be as much as 3 weeks duration for other cases.

[internationalism]

UAE started to use sinopharm for medics in September.

Only in May they decided to do mrna booster, so after 6 months.

"On May 18, amid concerns over the vaccine’s effectiveness, the U.A.E. announced that it would provide booster shots to those who have received two doses of BBIBP-CorV. Bahrain followed with a similar announcement on June 3"

https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html#jnj

 

In thailand sinovac started to be used on a larger scale in April. Now doing pfizer booster - so only 3 months gap.

 

Probably very much depends on individual antibodies. Before deciding on timing of booster would be worth to check it. However, tests might be more expensive, than vaccination itself, so this step will be likely skipped. 

Probably those 20mln contracted pfizer coming in about 6 months will be used as a booster for those some 30mln doses (15mln patients) being done now with sinovac. 

 

If you are still waiting for sinovac, there is a small chance, that they will swap it with AZ. Always worth asking even on day of vaccination.

There is also a small chance, the the second dose will be AZ, and not sinovac.

Only after the second shot would be worth planning in 3-6 month for a booster in Singapore (or possibly some arab country, which would take sinovac tourists without quarantine). While taking this afford of travelling abroad, I would think about 2 doses of booster - for a good measure. And be done for a year, possible longer. And have them all in covid passport

Edited July 10, 2021 by internationalism

[Old Nomad]

4 hours ago, samtam said:

What's the recommended interval between 1 & 2?

In Germany the official interval between two AstraZeneca shots is 12 weeks between 1st AtraZeneca and 2nd mRNA is 4 weeks.
See https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2021/27/Art_02.html