Saturday, January 23

Analysis: is it prudent for England to mix and match Covid vaccines? | Vaccines and immunizations


The UK is setting the pace around the world in the approval and use of Covid vaccines but, while other countries watch closely, not all are prepared to adopt what seems like public health pragmatism rather than strict adherence to the evidenc It

Britain is the first country in the world to approve and use the Oxford / AstraZeneca vaccine, just as it was for the first time with the Pfizer / BioNTech vaccin It In a further groundbreaking decision, it is to give everyone a first injection of those vaccines, with the second injection delayed to 12 weeks later rather than the three- or four-week interval in the trials.

And now it has emerged that NHS staff have permission, in limited circumstances, to mix and match vaccines. Since two different vaccines are used and supplies are not guaranteed, particularly that from Pfizer, which is in high demand around the world, England’s NHS has said that people may receive a second dose different from the first, if it is necessary. Therefore, those who received the Pfizer vaccine for the first time could receive the AstraZeneca version, if supplies ran out (or if there is no record of which one was the first), says their Green Book for Healthcare Personnel on the use of vaccines. Scotland is doing the same, although Wales says no.

But in the United States in particular, which has already been critical of the UK’s approach to vaccines, there is skepticism.

No trials of the combination approach and combination of reinforcements have been performed, although they are planned. At New York TimesJohn Moore of Cornell University commented that British officials “seem to have dropped science entirely now and are just trying to figure out how to get out of the mess.”

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

The New York Times article sparked a transatlantic dispute, and the BMJ demanded a prominent retraction of a headline that suggested the vaccine combination was officially approved. That was “seriously misleading,” said BMJ editor Dr. Fiona Godle It

It is not an official policy, said Dr Mary Ramsay, head of immunizations for Public Health England. “We do not recommend mixing Covid-19 vaccines; if your first dose is the Pfizer vaccine, you should not receive the AstraZeneca vaccine for your second dose and vice versa.”

But on the “extremely rare occasions” in which the same vaccine is not available or it is unknown which injection the patient received, it is “better to give a second dose of another vaccine than not to give it.”

That and the 12-week spacing are real-world responses to an epic crisis, in an attempt to give as many people as possible some immunity to the new variant of the coronavirus as quickly as possibl It

The United States has already had doubts about the UK’s approach. Neither the United States nor Europe is rushing to authorize the use of the Oxford / AstraZeneca vaccin It They both appear to be waiting for more evidence from a grand trial taking place in America. Both were also skeptical of the UK rush to license the Pfizer vaccine, although now they have done so too. The United States also approved the Moderna vaccine, designed and manufactured in the United States, with substantial funding from Operation Warp Speed. It is a similar vaccine to Pfizer’s and will help increase the vaccination effort.

Europe has granted emergency vaccine authorization from Pfizer, while the faster procedure used by the UK Medicines and Health Products Regulatory Authority means that each batch must be tested and certified as it is delivered. The same goes for the AstrSenecaca vaccine, so the NHS only has 530,000 doses to use this week, out of the 4 million promised.

The availability of vials and syringes around the world can also set things back. As vaccines are approved and production accelerates, demand for them will increas It Other countries may also be forced to make pragmatic decisions like the UK.

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www.theguardian.com

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