Syringes containing the Pfizer-BioNTech COVID-19 vaccine sit in a tray in a vaccination room. Doctors said more evidence was needed to support idea of mixing vaccines. AP Photo/Jae C. Hong)
Syringes containing the Pfizer-BioNTech COVID-19 vaccine sit in a tray in a vaccination room. Doctors said more evidence was needed to support idea of mixing vaccines. AP Photo/Jae C. Hong)
Syringes containing the Pfizer-BioNTech COVID-19 vaccine sit in a tray in a vaccination room. Doctors said more evidence was needed to support idea of mixing vaccines. AP Photo/Jae C. Hong)
Syringes containing the Pfizer-BioNTech COVID-19 vaccine sit in a tray in a vaccination room. Doctors said more evidence was needed to support idea of mixing vaccines. AP Photo/Jae C. Hong)

Coronavirus: Doctors state 'no evidence' mixing vaccines is safe


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Vaccines from different manufacturers should not be combined, doctors in the UAE said in response to UK trials giving people two different jabs in exceptional circumstances.

A mix-and-match approach has been considered in the UK to help manage limited supplies and reach as many people as possible with the Pfizer/BioNTech vaccine and the alternative Oxford/AstraZenica jab.

It's advisable people avoid mixing vaccines until we have done clinical trials

That approach has been rejected in the UAE, where doctors only have access to the Chinese made Sinopharm and Pfizer vaccines, each different in their construction.

“The recommendation is to give two doses of the same vaccine,” said Dr Dirar Abdallah, consultant and chairman of internal medicine at Prime Hospital.

“If someone takes a first dose of Sinopharm, Pfizer, AstraZenica or Moderna - it should be followed by the same vaccine.

“There have been some controversies after the UK announced it would allow the mixing of vaccines in exceptional circumstances.

“Scientists in the US and elsewhere did not agree, but the UK later clarified it would only be done in exceptional circumstances when the second dose of the same vaccine was not available.”

The Pfizer/BioNTech vaccine, given as two doses a few weeks apart, offers up to 95 per cent protection against the virus.

Researchers in the UK wanted to explore whether the immune response can be strengthened further and made more durable with a "heterologous boost" approach by mixing different vaccines.

While the Oxford/AstraZeneca vaccine works in a slightly different way to the Pfizer jab, doctors said it could make a good companion for pairing.

The Pfizer vaccine uses a small amount of genetic code from Covid-19 to teach the body how to ward off infection, while the Oxford alternative is a genetically modified virus altered to not cause infection.

The Oxford vaccine does, however, carry crucial information on how the body can fight off the pandemic virus.

Scientists said the process could bolster the immune system by producing responses in antibodies and T-cells, the body’s natural armoury against disease.

UK authorities have since stated mixing vaccines would only be done in exceptional circumstances.

“We do not recommend to mix the vaccines in the UAE either,” said Dr Abdallah, who also advised people to wait a month after taking a flu jab before having a Covid-19 vaccine.

“Both Pfizer and AstraZenica vaccines are made with the same mechanism, so there is an assumption they could complement each other.

“This does not apply here in the UAE as the Pfizer and Sinopharm vaccines are constructed with very different mechanisms, either by using a spike protein or an inactive virus.

“Because of this we do not recommend to mix vaccines at all here.”

Experts from the World Health Organisation recommended intervals between Pfizer-BioNTech vaccinations could be extended by up to six weeks, to help ease logistical issues.

WHO said the “pragmatic approach” could be considered as a response to “exceptional epidemiological circumstances.”

It said countries seeking to extend the interval should make sure that vaccinated patients still have access to a second dose.

“WHO’s recommendation at present is that the interval between doses may be extended up to 42 days (6 weeks), on the basis of currently available clinical trial data,” it said.

“Should additional data become available on longer intervals between doses, revision of this recommendation will be considered.”

WHO also said no data is available yet on the interchangeability of the Pfizer-BioNTech vaccine with other COVID-19 vaccines. It also cited a lack of evidence about whether vaccination reduces the risk of transmission of the virus to other people.

Elsewhere, health officials said a lack of research into multiple vaccines and their efficacy prevented the same UK advice being adopted in the UAE.

  • Ellen Prosser, known as Nell, who is 100 years old, receives the Oxford/AstraZeneca COVID-19 vaccine from Dr Nikki Kanani at the Sunrise Care Home, amid the coronavirus disease pandemic in Sidcup, Britain. Reuters
    Ellen Prosser, known as Nell, who is 100 years old, receives the Oxford/AstraZeneca COVID-19 vaccine from Dr Nikki Kanani at the Sunrise Care Home, amid the coronavirus disease pandemic in Sidcup, Britain. Reuters
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    An anti-lockdown protester is arrested by police officers in Parliament Square outside the House of Commons in London, England. The UK Parliament has been recalled today to debate and vote on the new regulations needed to reimpose the England-wide lockdown that was announced by Prime Minister Boris Johnson on Monday night. Getty Images
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    Zac applauds in the snow during the Clap for Heroes campaign, outside his house in Keele, Staffordshire, Britain. Reuters
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    Primary school teacher Marzio Toniolo's pupils, wearing masks, sitting at a distance from each other attend a lesson as they return to the classroom as part of Italy's coronavirus disease regulations after the holidays, in Santo Stefano Lodigiano, Italy. Toniolo has been documenting what life has been like for a small cluster of northern Italian towns since they were put on lockdown weeks before the rest of the country in February last year. Reuters
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    A person feeds pigeons at Piazza Navona, as the region enters the 'yellow zone' after the government relaxed some of the coronavirus disease curbs on weekdays following a strict lockdown over the holidays, in Rome, Italy. Reuters
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    Pedestrians, wearing protective masks against COVID-19, stand in strong wind in Tokyo, Japan. Reuters
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  • Staff state health worker prepares a Pfizer coronavirus vaccine to administer for residents and health workers at San Jeronimo nursing home, in Estella, around 38 kms (23 miles) from Pamplona, northern Spain. Spain plans to receive over 4.5 million doses of the vaccine over the next three months, enough it says to immunize just over 2.2 million people. The government estimates that this first phase will be enough to cover nursing home residents and workers, followed by health workers in general and people with disabilities. AP Photo
    Staff state health worker prepares a Pfizer coronavirus vaccine to administer for residents and health workers at San Jeronimo nursing home, in Estella, around 38 kms (23 miles) from Pamplona, northern Spain. Spain plans to receive over 4.5 million doses of the vaccine over the next three months, enough it says to immunize just over 2.2 million people. The government estimates that this first phase will be enough to cover nursing home residents and workers, followed by health workers in general and people with disabilities. AP Photo

“Covid-19 vaccines are new and limited in number, subsequently there are no studies to shed light on the results of taking different vaccines,” said Dr Adil Sajwani, a family medicine specialist at the Ministry of Health and Prevention and member of the national awareness team for Covid-19.

“In theory, one can take different vaccines, we have been doing that against flu, measles, hepatitis B and other illnesses.

“But as coronavirus is a new disease and its vaccines have just been announced, it’s advisable people avoid mixing vaccines until we have done clinical trials.”

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Develop an innovative business concept

Have the ability to differentiate yourself from competitors

Put in place a business continuity plan after Covid-19

Prepare for the worst-case scenario (further lockdowns, long wait for a vaccine, etc.) 

Have enough cash to stay afloat for the next 12 to 18 months

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Be prepared to use Covid-19 as an opportunity for your business

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