Doing a Merkel? AstraZenica first, then Moderna

[Jingthing]

Thinking out of the box a little bit.

 

I will be trying to get to Bangkok from Pattaya to get an AstraZenica jab fairly soon, lockdowns notwithstanding. 

 

But I'm hearing that getting the second dose as Moderna is better than two doses of AstraZenica.

 

Angela Merkel receives Moderna as second jab after AstraZeneca shot - BBC News

 

So I'm wondering if it turns out to be possible to get the Moderna in Pattaya in a timely manner, that would save me another trip to Bangkok and also be better medically (what's not to like?). 

 

A few issues:

 

Actually getting a Moderna booking in Pattaya a timely manner.

 

Acceptance of the second hospital to give proof of vaccination based on mixing different brands from two different hospitals. 

 

I'm not sure how vital it's going to be have proof going forward in Thailand or personally for international travel, but I think we're all looking for both, the actual jabs AND the documentation. 

[richard_smith237]

I’ve done it... (the Merkel that is... or rather a pseudo Merkel).

 

AZ in Thailand, beginning of June, followed by Pfizer, overseas at the beginning of this month. 

 

Research has shown that following up a viral vector vaccine with an mRNA vaccine contributes towards a stronger immunity towards Covid-19. 

 

There is the ‘certification’ issue with mixing vaccines, especially if using different hosptials to administer said vaccines (and in my case different hospitals in different countries). 

 

I plan on taking the second Pfizer dose in a few weeks which will mean I’ve had 1 AZ vaccine and 2 Pfizer vaccines - I see no issue with that, its just an earlier booster and secures the vaccination certificate. 

 

Thus: IF getting the AZ (or Sinovac) vaccine in Thailand, then opting to go for an mRNA (Moderna) vaccine a month or so later or whenever it is available that would offer stronger immunity and if the Thai Authorities issue a Vaccine certificate for the ‘dual vaccination’ then great. IF not, the 2nd Moderna dose needs to be administered approx 4 weeks after the first, the vaccine certificate could be obtained then. 

 

The only issue with that (two doses of Moderna) is if Thailand secures enough doses of Moderna for a 1st vaccination, but not enough for a 2nd vaccination. 

 

Thus: With all the uncertainty I’d suggest get what you can when you can - get AZ when you can, then follow up with Moderna if you can, get a vaccine Certificate if you can.

 

 

 

 

 

 

[SooKee]

Pondering the same here.  I have booked and paid for Moderna and, overall, I would rather have two doses of Moderna than a DIY cocktail.  I know it's been done elsewhere but it's still me deciding to it as opposed to being a public health authority (in a country where you can trust such authorities more as opposed to Tin Pot Alley).  The main concern I have though is that there will be a problem with the Moderna booking (e.g. not enough, pilfered by the pigs at Trough Central or whatever) and that it will all fall through.  That will then be 3-5 months wasted by which time AZ could have been built up to a higher degree of protection.  Choosing to risk it and stay out the way for those 3-5 months is still an option, we are pretty much self isolating anyway, but the situation here is deteriorating rapidly and will likely get much worse.  I still do wonder though if this thinking is something I'm doing to persuade myself to go and get an AZ jab first.  On the other hand, waiting for Moderna could be somewhat foolhardy given the situation here, yes we stay out the way but if Covid gets to the stage where it's rampant, even if it's not there already, you could even catch it from a simple food buying trip. 

 

The other concern though is the vaccine record and indeed whether the Moderna hospital will baulk at giving me the Moderna shots (despite having paid) if they know I've had AZ.  I would suspect that your vaccine record will be on a central database (but then again TIT) and while I'm not bothered about what Thailand does or doesn't recognise (or how many dummies they trot out to support covid cocktailing) I am also concerned about whether AZ plus two doses of Moderna would be recognised by other countries as fully vaccinated or whether the AZ shot would be considered to have mucked up the Moderna vaccinations, especially given that it will be the local AZ which, AFAIK, is not on the 'acceptable' list for some countries..  

 

Change my mind daily on it TBH but with all these 'quick, register here for an AZ shot' opportunities I do wonder if that would be the best option.  3 months (minimum) could be a long time in a country where infections are rapidly outpacing vaccinations, even more so if it pans out to 5-6 and Thailand gets into a state of crisis.  Yesterday, I was adamant that I'd just wait for Moderna, staying out the way as normal, today I'll likely change my mind again LOL.  Of course the one very big plus to taking AZ is that if the Moderna deal does fall through, I will at least be vaccinated with AZ (even though it would be with an unacceptable brand of AZ in some countries). 

[CANSIAM]

I think at the moment anyway,  2 AstraZeneca doses will look much better on certificates / travel documentation than a mixed blend.  Mixing with a better juice can be done months after your 2nd AZ,  my forward plan anyway...... ......... 

[SooKee]

11 minutes ago, CANSIAM said:

I think at the moment anyway,  2 AstraZeneca doses will look much better on certificates / travel documentation than a mixed blend.  Mixing with a better juice can be done months after your 2nd AZ,  my forward plan anyway...... ......... 

Could be an option.  AZ now, 2nd dose end September.  Then, provided they'll do it, Moderna in Oct - Dec with 2nd dose Feb to March.  That's some heavy dosing LOL.

 

[Basch]

Also in the same boat and a bit unsure as to what to do.

 

I have chosen to get AZ first (end of July), if Moderna arrives on time and I decide to mix, the second shot would be in October, that's similar to what many fellow Germans are doing. If it doesn't arrive in time, I will have my 2nd AZ shot anyway. 

 

I don't expect anyone to know that I already had AZ when getting my Moderna but I'm not sure of course. I also don't expect anybody to object, it's your own choice? I have a feeling nobody checks anything or knows anything about vaccination statuses, my wife had 2 different reservations for AZ and nobody noticed this. 

 

For me, it will also be completely different hospitals, getting AZ through connections via the wife's family outside of the system, then Moderna will be paid shots at Phiya Thai (I managed to pay 18 minutes past 9am on July 1st and they confirmed it's first come, first served). 

 

I'm also still not sure whether I get two AZ first or mix, depends on the timeline and availability. 

 

As for Germany accepting Thai AZ, as far as I can recall people in this board have confirmed that the latest status is that it's accepted. 

 

As for mixing AZ with Moderna and then getting a second Moderna shot on top of that, of course that should count (as far as they know, you had two Moderna only) but nobody does this in such a short time-frame (yet) so I'd be cautious. You can boost after a year but a third shot, after mixing, so soon? 

 

Currently there seem to be a lot of studies about the mixing so by October we will hopefully have more clarity. 

 

Another option is to do 2 x AZ and then use my 2 Moderna shots as single booster shots 6 months or a year from now, one for me, one for the Mrs. 

 

That way they're not wasted, both of us will have an accepted, valid, non mixed vaccination (AZ) and a proper booster via mRNA shot (Moderna). 

 

 

[SooKee]

I've seen a picture somewhere of what looked like a fairly in depth certificate which had a lot of detail on it.  Question is whether they produce that from a locally held hospital record or whether they have to update a central database, the latter would make more sense, but TIT.  While it would be our choice I suspect, if we pay for Moderna, in my case the payment includes insurance for complications arising.  That might be null and void if doing a DIY cocktail (which the site actually warned against when booking) and if the vac record does come from a central database they may well decline to do it I suppose.  I'd agree though, 2 x AZ and 2 x Moderna within 8-12 months is a lot.  There may well be more clinical trial results to come to on mixing specific brands.

Useful discussion though.  Helps to get the thoughts on paper (albeit virtual).  I think that if I go and get an AZ shot now I'll be glad that I did, when the Moderna arrives however, I'll wish that I hadn't.  At the end of the day I think it's a case of balancing how much at risk you are of being infected (e.g. how often you come into contact with people and how many) whereby AZ, even one dose, will reduce the chances of death or needing to be hospitalised) vs being able to avoid the virus to await a higher quality vaccine that will provide a vaccination record that's acceptable world wide.  The higher the risk of infection the more pressing the reason to get vaccinated ASAP. On balance, think I'll take the risk and wait it out to get two shots of Moderna.  I will be SO bloody mad if it all falls through.  Fingers crossed it's the right decision LOL.

[richard_smith237]

28 minutes ago, Basch said:

As for mixing AZ with Moderna and then getting a second Moderna shot on top of that, of course that should count (as far as they know, you had two Moderna only) but nobody does this in such a short time-frame (yet) so I'd be cautious. You can boost after a year but a third shot, after mixing, so soon? 

The short time frame doesn’t concern me. The mRNA vaccine simply instructs the body to make antibodies (in simple terms). It’s not poison, I don’t see whatsoever about taking three vaccines (AZ x1 then Pfizer x2)  within two months. 

The 2nd Pfizer may simply have less beneficial impact than on someone who didn’t not have an earlier AZ dose.  

 

Advice varies on this, there are a lot of recommendations to boost at 6 months based on studies which show that the antibodies start to diminish after a certain timeframe (6 months).
 

We have taken vaccines all our lives without even thinking about or discussing them. Yes mRNA vaccines are slightly different, but a lot of people seem to be in a panic about them when before we didn’t care about having a tetanus in one arm, MMR in the other arm, Polio by mouth, then Hepatitis & Diphtheria in each butt cheek !!!  All on the same day !!! 
 

 

[Basch]

Thanks everyone for the feedback, would be nice to keep this topic updated. Good luck with the decision and allotment. 

 

Just saw this:

 

https://www.bangkokpost.com/thailand/general/2150439/moderna-shots-to-be-allotted

[samtam]

2 hours ago, CANSIAM said:

I think at the moment anyway,  2 AstraZeneca doses will look much better on certificates / travel documentation than a mixed blend.  Mixing with a better juice can be done months after your 2nd AZ,  my forward plan anyway...... ......... 

Also, when is one likely to get Moderna? I had an offer to buy this morning, but as I haven't had my first AZ yet, (scheduled for tomorrow), and therefore the second in 12 weeks, (October), versus possible Moderna between October 2021 to March 2022, I think it's best to go for what comes first, (without having to buy Morderna with no guarantee of even getting it; it's hugely oversubscribed, so I imagine it will be the usual fiasco getting a refund).

 

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Basch

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Posted 10 minutes ago (edited)

Thanks everyone for the feedback, would be nice to keep this topic updated. Good luck with the decision and allotment. 

 

Just saw this:

 

https://www.bangkokpost.com/thailand/general/2150439/moderna-shots-to-be-allotted

Edited 8 minutes ago by Basch

 

 

[Basch]

6 minutes ago, samtam said:

Also, when is one likely to get Moderna? I had an offer to buy this morning, but as I haven't had my first AZ yet, (scheduled for tomorrow), and therefore the second in 12 weeks, (October), versus possible Moderna between October 2021 to March 2022, I think it's best to go for what comes first, (without having to buy Morderna with no guarantee of even getting it; it's hugely oversubscribed, so I imagine it will be the usual fiasco getting a refund).

 

 

I've asked Medpark and Phiya Thai about this and they said first come first served, if you're only paying for it now (reservations have been open since 9am, July 1st) I have no idea to be honest. 

 

Especially cuz now they're saying there won't be enough. 

[samtam]

4 minutes ago, Basch said:

I've asked Medpark and Phiya Thai about this and they said first come first served, if you're only paying for it now (reservations have been open since 9am, July 1st) I have no idea to be honest. 

 

Especially cuz now they're saying there won't be enough. 

Yes, that's why I hesitated, and then decided I wouldn't register for something of unknown delivery date, or not delivered at all.

 

I need to go to Hong Kong before the end of the year, and assuming travellers from Thailand aren't barred for entry by then, I need to get vaccinations to benefit from the current 7 day quarantine (in Hong Kong).

[CANSIAM]

24 minutes ago, Basch said:

Thanks everyone for the feedback, would be nice to keep this topic updated. Good luck with the decision and allotment. 

 

Just saw this:

 

https://www.bangkokpost.com/thailand/general/2150439/moderna-shots-to-be-allotted

I believe most will NOT have a Moderna shot in their arm in 2021.......goodluck with the 'allotment system' 

[SooKee]

2 hours ago, Basch said:

Thanks everyone for the feedback, would be nice to keep this topic updated. Good luck with the decision and allotment. 

 

Just saw this:

 

https://www.bangkokpost.com/thailand/general/2150439/moderna-shots-to-be-allotted

This is precisely my concern with the Moderna jabs, just how many doses will each of the participating hospitals get AND how far down their queue are you (and do you feature in their unpublished list of priorities if they need to start cutting back other than on a first come, first served basis), worsened by the fact that the Red Cross are suddenly getting 20% of the quota, reducing availability to the private hospitals from 5 to 4 million, assuming there's no-one else going to be chipping away at the delivery.  I thought the Red Cross procurement was on top of the 5 million (originally 9 million) doses the hospitals were expecting. At the moment I'm only 50/50 on my chances of getting what we've paid for.

 

Something else that's dawned on me, I wonder if taking the decision to mix vaccines yourself (outside of what your health authority policy is, which here is either two of the same OR Sinovac plus AZ) would have the potential to invalidate any health insurance you may have should you be unfortunate enough to need a covid related admission? When I booked for Moderna the hospital actually had an advisory warning against taking Moderna on top of another jab.  Unless it's medically necessary AND approved by a registered doctor, anything you take it upon YOURSELF to do could be viewed as increasing your level of risk without the authority of the company should they wish to avoid payment.  Small risk maybe.

[SooKee]

Thinking more about this I just read through the T&C again that I had to acknowledge my understanding of when signing up and paying for Moderna (yours maybe different) at MedPark. Rather than reproduce the whole thing, below are 3 snippets from the T&C:

 

1. The government has allocated vaccines to citizens for free through channels set by the government and you wish to purchase alternative vaccines and receive vaccination services from Med Park Hospital by allowing Medpark Hospital to reserve the full amount of alternative vaccines. and waiting for the appointment of vaccinations from the hospital.

2. Studies are currently underway for the use of MODERNA vaccine as a 3rd and 2nd dose in the United States and the United Kingdom comparing two brands (Heterologous) and single brand (Homologous). The study will take 1 year (starting June 2021). The results of the study are expected to come out periodically. It is not however currently considered to be standard advice. When the results of the study are published the hospital will inform you later.

3. At this time therefore the hospital accepts reservations for the primary series, a 2-dose, single brand (Homologous Prime/Boost) vaccine according to the manufacturer's standards only. If there is a change in the instructions The hospital will inform you in advance from time to time.

First is a bit wishy washy as it's merely pointing out that you're essentially opting out of the Government free route and opting to go private.

Second two are more relevant though, and especially the 3rd point. Essentially saying that while there are studies ongoing the results are not yet conclusive AND that the hospital accepts your registration on the basis of it being for a 2 dose / single brand treatment.  Thus, if you take it upon yourself to go and get AZ I suspect it's possible that the hospital could refuse to give you Moderna as you've breached the T&C.  They will know because the the vaccination database that they update is national, not local to the hospital.  

 

On that basis I plan to wait it out and hope I get lucky with the Moderna order.