Vaccines expert says doctors should NOT 'mix and match' Covid jabs

Britain is NOT opting for a mix and match vaccination approach and giving patients two different doses is ‘not recommended’, insist health officials

  • Health officials deny report that UK is moving to ‘mix and match’ approach 
  • News comes after wait for second vaccine dose was extended to 12 weeks
  • Vaccine expert said the wait can actually improve protection against Covid-19 

Health officials have insisted that Britain is not opting for a ‘mix and match’ Covid-19 vaccination approach, and have said it is not recommended to give patients two different doses.

The warning came after Britain’s guidance for its coronavirus vaccine rollout was updated to say that a ‘mix and match’ approach to vaccine administration is ‘reasonable’ to complete the two-dose schedule in rare, specific circumstances. 

In a statement given to the MailOnline, Dr Mary Ramsay, Head of Immunisations at Public Health England, said: ‘We do not recommend mixing the COVID-19 vaccines. If your first dose is the Pfizer vaccine you should not be given the AstraZeneca vaccine for your second dose and vice versa.

‘There may be extremely rare occasions where the same vaccine is not available, or where it is not known what vaccine the patient received. Every effort should be made to give them the same vaccine, but where this is not possible it is better to give a second dose of another vaccine than not at all.’     

Two vaccines have been given the emergency green-light in the UK – one developed by Pfizer and the other by AstraZeneca with Oxford University. 

Both are shown to be more effective at protecting a person against Covid-19 when administered through a two dose programme. 

Scientists have warned against a ‘Mix and Match’ approach that has been called ‘reasonable’ in PHE guidance – that could see an interchangeable approach to vaccine administration in some instances when an individual returns for a second dosage

Updated guidance – first reported in the New York Times on Friday – states that it is ‘reasonable’ for an individual to have a different type of vaccine for their second dose in the event the same vaccine that was given first is not available, or unknown. 

‘Individuals who started the schedule and who attend for vaccination at a site where the same vaccine is not available, or if the first product received is unknown, it is reasonable to offer one dose of the locally available product to complete the schedule,’ guidance from Public Health England now reads.

Deputy chairman of the Joint Committee on Vaccination and Immunisation (JCVI), Professor Anthony Harnden

However, scientists and experts have spoken out against the guidance that contradicts information from other countries’ health bodies – including the United States’ Centre of Disease Control (CDC). 

Speaking on BBC Radio 4’s Today programme on Saturday, Deputy chairman of the Joint Committee on Vaccination and Immunisation (JCVI), Professor Anthony Harnden said: ‘Our current advice is to use the same vaccine for both doses. 

‘However we have studies ongoing to look at mixing vaccines and when we see the data for those and are secure about the data, then we may be recommending mixed vaccines,’ he added.

On the Interchangeability of COVID-19 vaccine products, the CDC states: ‘These mRNA COVID-19 vaccines are not interchangeable with each other or with other COVID-19 vaccine products. 

‘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,’ the CDC says.

John Moore, a vaccine expert at Cornell University, told the New York Times that there is ‘no data on this idea whatsoever,’ adding that officials in Britain ‘seem to have abandoned science completely now and are just trying to guess their way out of a mess’. 

When asked to comment by the New York Times, officials at Public Health England reportedly pointed to similarities between the two vaccines that have been approved, adding that clinical trials into the approach would start later this year. 

Pictured: Margaret Keenan – the first person to receive the Pfizer coronavirus vaccine – returned to hospital this week to receive her second round of the Covid-19 vaccine

Vaccine firms have rejected the Government’s warnings of jab supply gaps lasting months, claiming there will be enough doses to hit the Government’s ambitions targets (file image)

Speaking on the Today programme, Professor Harnden also defended Government plans to delay the second dose of the Pfizer/BioNTech coronavirus vaccine from three weeks to 12 weeks after the first jab, saying a longer wait can protect patients more effectively. 

Prof Harnden told the show that patients he had dealt with accepted the move, stating: ‘When it was explained to them that the vaccine offers 90% protection for one dose, and the priority was to get as many people vaccinated in the elderly and vulnerable community as possible, they understood.

‘I think the country is all in this together. And, I think we really, really want to pull together to try and do the best strategy possible.’  

He went on to explain that it a delayed second dose has been shown to be better at protecting patients: ‘It’s clear from looking at the data that from the Pfizer vaccine after one dose after 14 days is 90 per cent,’ he said.

‘If you actually look at the Oxford vaccine data it looks like the protecting is better the longer the second dose is delayed.’

Chairman of the Royal Institution and Imperial College Healthcare Sir Richard Sykes, also speaking to the Today programme, said he had ‘no problem’ with the new strategy of having patients wait longer for the second dose.

‘It’s all in their diaries and I think the decision to give two dose, one then another 12 weeks apart, is absolutely fine. I have no problem with that strategy.

‘I just think it’s a bit strange to make it retrospective when you’ve got all the system in place to deliver those vaccines when those people were told quite categorically ”you have to come back here in 21 days time to receive your second injection”.

‘So I can understand why there’s some anguish here. It’s not good.’  

Chief medical officer Professor Chris Witty, who warned that vaccine availability issues will ‘remain the case for several months’, pictured speaking during a coronavirus media briefing

The news comes as Britain struggles with a mutant variant of ‘super’ coronavirus.

On Thursday, it was confirmed that the B117 strain has been found to be more infectious than previous variants, just as scientists feared, in a new study. 

Imperial College London researchers found that the new variant that’s been wreaking havoc in the UK and arrived in the UK may be nearly 50 percent more transmissible, based on samples taken from nearly 86,000 Britons.  

What is the ‘mutant COVID strain’ and why are experts concerned?

Coronaviruses mutate regularly, acquiring about one new mutation in their genome every two weeks. 

Most mutations do not significantly change the way the virus acts.

This super strain, named B.1.1.7, was first identified in the UK in November.

It has since been found in France, Spain, Italy, Iceland, Japan, Singapore, Australia and now the United States. 

The new COVID-19 variant has a mutation in the receptor binding domain (RBD) of the spike protein at position 501, where amino acid asparagine (N) has been replaced with tyrosine (Y). 

It is more infectious than previous strains and potentially more harmful to children. 

It is not, however, believed to be any more lethal.  

Public Health England researchers compared 1,769 people infected with the new variant, with 1,769 who had one of the earlier strains of the virus. 

Forty-two people in the group were admitted to hospital, of whom 16 had the new variant and 26 the wild type. 

Twelve of the variant cases and 10 of the ‘older’ virus cases died within four weeks of testing. 

Neither the hospitalization nor the mortality differences were statistically significant.

Meanwhile, Pfizer and AstraZeneca have rejected Government warnings of months-long vaccine supply gaps, claiming there will be enough doses to hit the country’s ambitious targets.

England’s chief medical officer Professor Chris Whitty this week warned that vaccine availability issues will ‘remain the case for several months’ as firms struggle to keep up with global demand.

Sir John Bell, a regius professor of medicine at Oxford University and member of SAGE (Scientific Advisory Group for Emergencies), has also said that insufficient investment in the capacity to make vaccines has left the UK unprepared.

In a bid to ration supplies, the Government has pledged to give single doses of the Pfizer vaccine to as many people as they can – rather than give a second dose to those already vaccinated.

But manufacturers of both the Pfizer and Oxford/AstraZeneca jabs have rubbished concerns, saying there is no problem with supply.

Sir Richard Sykes, who led a review of the Government’s Vaccines Taskforce in December, added that he is ‘not aware’ of a shortage in supply.

The comments come after a further 53,285 people tested positive in Britain on Friday – marking four days in a row with more than 50,000 positive tests announced.

And 613 more people have died with the virus – including an eight-year-old child – taking the total official death toll to 74,125.

The eight-year-old died in England on December 30 and had other health problems, the NHS said.

At least one million Pfizer doses and some 530,000 Oxford doses will likely be given to patients across the country next week, The Daily Telegraph reports.

Earlier this month, AstraZeneca boss Pascal Soriot promised the firm will be able to deliver two million doses a week by mid-January – meaning 24million could be immunised by Easter.        


Pfizer warned yesterday there is ‘no data’ to show a single dose of its coronavirus vaccine provides long-term protection after the UK scrapped its original jab rollout plan.

The UK medical regulator is now recommending Covid jabs are given in two doses three months apart, rather than four weeks apart, to allow millions more people to be immunised over a shorter time period.

The strategy will apply to both Pfizer/BioNTech’s vaccine and the newly approved jab by Oxford/AstraZeneca, despite limited data around the effectiveness of the initial doses.

It is a direct response to spiking Covid cases and hospitalisations across the UK that are being driven by a new, highly infectious strain that emerged in the South East of England in September.

Virtually the whole of England is facing brutal lockdown until the spring, with Covid vaccines the only hope of ending the devastation.

Health bosses now want to give as many people as possible an initial dose, rather than holding back the second doses, so more of the population can enjoy at least some protection.

AstraZeneca praised the move and revealed it had tested the three-month strategy on a small sub-group of trialists in its studies.

But Pfizer said there was ‘no data’ in its studies to show its vaccine protects against Covid when taken 12 weeks apart.

In a thinly-veiled swipe at the UK, the US firm warned that any ‘alternative’ dosing regimens should be closely monitored by health authorities.

‘Data from the phase three study demonstrated that, although partial protection from the vaccine appears to begin as early as 12 days after the first dose, two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95 per cent,’ Pfizer said in a statement.

‘There are no data to demonstrate that protection after the first dose is sustained after 21 days.’ 

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