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Definition of fully Vaccinated


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In many countries people are provided the option of second doses to be different than the first.  For example, I got AstraZeneca and Pfizer as my second.   I thought it would be accepted by the cruiselines, but on the news today, it was mentioned that some places may not accept two different vaccines.  While they did not give any examples, I find it difficult to believe that this would not be acceptable by a country or cruiseline as long as the two vaccines are approved.

 

we are flying to the U.K. for a September 30 cruise and hope we don’t have to get a third dose.

 

Has anyone heard anything around this?  I know within Canada, it is acceptable.

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8 minutes ago, tert333 said:

In many countries people are provided the option of second doses to be different than the first.  For example, I got AstraZeneca and Pfizer as my second.   I thought it would be accepted by the cruiselines, but on the news today, it was mentioned that some places may not accept two different vaccines.  While they did not give any examples, I find it difficult to believe that this would not be acceptable by a country or cruiseline as long as the two vaccines are approved.

 

we are flying to the U.K. for a September 30 cruise and hope we don’t have to get a third dose.

 

Has anyone heard anything around this?  I know within Canada, it is acceptable.

I did see something ( don’t know where). That some EU companies would not accept proof of vaccination by vaccines not approved in their country. 
 

not sure now because this was a few months ago. 
 

Canada has done things differently re: dosage. So I can see your concern

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I don't know about other states within the USA let alone other countries, but in Delaware we were required to get the 1st and 2nd shot by the same manufacturer. The clinical trials were performed this way. Is there scientific evidence for mixing manufacturers?

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I don’t understand how you got two different types of vaccine?
 

AstraZeneca is a “viral vector” vaccine and Pfizer is a “mRNA” vaccine - just curious as to how the two will work? And if having two different types will even help?
 

Rose

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In the US you are not considered fully vaccinated, as you've just had two different types of 1st doses. Our CDC says, "2 weeks after their second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or, 2 weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine"

 

Both AstraZeneca and Pfizer's sites state you have to have two in their shots to complete the series. If I were you I'd be looking for a way to get that second Pfizer shot to become fully vaccinated.

 

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7 minutes ago, Porky55 said:

I don’t understand how you got two different types of vaccine?
 

AstraZeneca is a “viral vector” vaccine and Pfizer is a “mRNA” vaccine - just curious as to how the two will work? And if having two different types will even help?
 

Rose

It started with the incidents of blood clotting around some Astrazeneca patients.   While the risk is small, some countries such as France, Sweden, Finland and Canada started provided people who received AZ as the first dose, they started offering MRNA vaccines as their second dose.

 

There has been studies out of Spain and the UK where the immune response was actually higher when given an MRNA vaccine as a second dose over the first.  

 

There is a clinical study in the UK which is supposed to publish their results before the end of the month, so we are waiting on it.

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1 minute ago, ChangeOrder said:

Both AstraZeneca and Pfizer's sites state you have to have two in their shots to complete the series. If I were you I'd be looking for a way to get that second Pfizer shot to become fully vaccinated

That’s what I thought 🤔

So the OP will end up with three doses …… interesting.

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1 minute ago, tert333 said:

There is a clinical study in the UK which is supposed to publish their results before the end of the month, so we are waiting on it.

Hope you find the result you are after. 
But either way, it looks like you may still need another dose to be “vaccinated” as per your CDC, the vaccination manufacturer and what individual countries could require of you. 

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54 minutes ago, portiemom said:

I don't know about other states within the USA let alone other countries, but in Delaware we were required to get the 1st and 2nd shot by the same manufacturer. The clinical trials were performed this way. Is there scientific evidence for mixing manufacturers?

Here is a link to one of the studies. They say that you get a better response by mixing the two. https://www.nature.com/articles/d41586-021-01359-3

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The CDC considers you fully vaccinated if you have had the prescribed number of doses of vaccines approved by either the WHO or the US FDA.  They say nothing about the doses having to be the same vaccine.  The key passages are as follows:

 

 

Have You Been Fully Vaccinated?

In general, people are considered fully vaccinated: ±

  • 2 weeks after their second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or
  • 2 weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine

If you don’t meet these requirements, regardless of your age, you are NOT fully vaccinated. Keep taking all precautions until you are fully vaccinated.

 

± This guidance applies to COVID-19 vaccines currently authorized for emergency use by the U.S. Food and Drug Administration: Pfizer-BioNTech, Moderna, and Johnson & Johnson (J&J)/Janssen COVID-19 vaccines.  This guidance can also be applied to COVID-19 vaccines that have been authorized for emergency use by the World Health Organization (e.g. AstraZeneca/Oxford).

 

 

 

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html

 

You will need to find similar guidance from the UK.

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Very interesting question.  

Currently if you have had a reaction to the ist dose of one of the mRNA Vaccines such as Pfizer or Modern, it is recommended that in place of the 2nd or booster dose, you get an alternative Vaccine such as the DNA/Adenovirus Vaccine manufactured by J&J.  

Can you mix Pfizer and Moderna, or one of the first two and in place of the booster get the second from J&J, especially if you did not have a reaction which justified the change.  

The answer is clear.

If you are asking based on Science...the answer is....we don't know.

If you are concerned about being denied entry into a country, or denied permission to fly or travel, and if you have not had a reaction to any of the vaccines, I would obtain a second or booster from the same manufacturer.

 

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9 minutes ago, stevenr597 said:

Very interesting question.  

Currently if you have had a reaction to the ist dose of one of the mRNA Vaccines such as Pfizer or Modern, it is recommended that in place of the 2nd or booster dose, you get an alternative Vaccine such as the DNA/Adenovirus Vaccine manufactured by J&J.  

Can you mix Pfizer and Moderna, or one of the first two and in place of the booster get the second from J&J, especially if you did not have a reaction which justified the change.  

The answer is clear.

If you are asking based on Science...the answer is....we don't know.

If you are concerned about being denied entry into a country, or denied permission to fly or travel, and if you have not had a reaction to any of the vaccines, I would obtain a second or booster from the same manufacturer.

 

Thanks for the great responses.   I am going to give it a few weeks.   Hopefully, there will be more information coming from the various studies that are underway.   I agree to be safe, it probably makes sense to take a third.   We are starting to get a good volume of vaccines in Canada.  I am sure I would not be able to get a third vaccine before it is offered to everyone else.  However, that should be by August, which gives me time.

 

I hope that this issue gets more coverage as I would hate to see people show up at the airport and be denied flight to another country, because of mixed doses that was recommended by the health agency/physician, for whatever reason.

 

 

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4 hours ago, tert333 said:

In many countries people are provided the option of second doses to be different than the first.  For example, I got AstraZeneca and Pfizer as my second.   I thought it would be accepted by the cruiselines, but on the news today, it was mentioned that some places may not accept two different vaccines.  While they did not give any examples, I find it difficult to believe that this would not be acceptable by a country or cruiseline as long as the two vaccines are approved.

 

we are flying to the U.K. for a September 30 cruise and hope we don’t have to get a third dose.

 

Has anyone heard anything around this?  I know within Canada, it is acceptable.

I have read this thread and I understand the cautionary posts.  IDK when you might be able to get a third shot in ON since none of the systems are setup to book a third shot.  Also, based on what you have written, you will know that Canada has no protocol nor recommendations that a third dose is even recommended, let alone required.

 

But, did you not get an email from the vaccine provider containing an Ontario MOH notice?  Here is an excerpt of my first one:

 

Name/Nom: Fred Flintstone
Health Card Number/Numéro de la carte Santé: ######9999
Date of Birth/Date de naissance: 1960-09-30
Date/Date: 2021-06-15, 10:52 a.m.
Agent/Agent: COVID-19_mRNA
Product Name/Nom du produit: PFIZER-BIONTECH COVID-19 mRNA
Diluent Product: PFIZER Diluent 0.9% Sodium Chloride
Lot/Lot: ZZ1111
Dosage/Dosage: 0.3ml
Route/Voie: Intramuscular / intramusculaire
Site/Site: Left deltoid / deltoïde gauche
You have received 1 valid dose(s) / Vous avez reçu 1 dose(s) valide(s)
Vaccine Administered By/Vaccin Administré par: BETTY RUBBLE, Registered Practical Nurse
Authorized Organization/Organisme agréé: Bedrock Hospital Corporation

 

 

There's more to the document, but you should recognize this.  We are getting our second shot next week.  I expect to receive a similar document and I expect the yellow highlight section to read "2 valid doses".  If you have this single document, that should suffice for proof of vaccination as it indicates 2 doses and the date received.  Add 14 days and you are good to go. 

 

This is what ON is using so far - an 8.5"x11" document.  No vaccination card update.  Most certainly, your OHIP system record will show details of both shots, but no one is going to ask you for the other paper.  They won't even know there is necessarily another document and it won't likely even occur to anyone that you might have had a different first dose.  My recommendation to you is do not stir the pot for now because if ON and Canada recognize you as fully vaccinated, then that should suffice. 

 

If, someday, you are offered another Pfizer shot, well why not take it?  It certainly seems to be outperforming AZ and pretty much anything else.  We may find out we need boosters anyway in future.

 

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The doctor is away, but the timing of doses might have something to do with the mess. Through at least some point in our county, if you waited too long for the second dose, they were starting you from dose one.

 

again, the doctor is away. I’m a stupid CPA. 

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10 hours ago, Steelers36 said:

I have read this thread and I understand the cautionary posts.  IDK when you might be able to get a third shot in ON since none of the systems are setup to book a third shot.  Also, based on what you have written, you will know that Canada has no protocol nor recommendations that a third dose is even recommended, let alone required.

 

But, did you not get an email from the vaccine provider containing an Ontario MOH notice?  Here is an excerpt of my first one:

 

Name/Nom: Fred Flintstone
Health Card Number/Numéro de la carte Santé: ######9999
Date of Birth/Date de naissance: 1960-09-30
Date/Date: 2021-06-15, 10:52 a.m.
Agent/Agent: COVID-19_mRNA
Product Name/Nom du produit: PFIZER-BIONTECH COVID-19 mRNA
Diluent Product: PFIZER Diluent 0.9% Sodium Chloride
Lot/Lot: ZZ1111
Dosage/Dosage: 0.3ml
Route/Voie: Intramuscular / intramusculaire
Site/Site: Left deltoid / deltoïde gauche
You have received 1 valid dose(s) / Vous avez reçu 1 dose(s) valide(s)
Vaccine Administered By/Vaccin Administré par: BETTY RUBBLE, Registered Practical Nurse
Authorized Organization/Organisme agréé: Bedrock Hospital Corporation

 

 

There's more to the document, but you should recognize this.  We are getting our second shot next week.  I expect to receive a similar document and I expect the yellow highlight section to read "2 valid doses".  If you have this single document, that should suffice for proof of vaccination as it indicates 2 doses and the date received.  Add 14 days and you are good to go. 

 

This is what ON is using so far - an 8.5"x11" document.  No vaccination card update.  Most certainly, your OHIP system record will show details of both shots, but no one is going to ask you for the other paper.  They won't even know there is necessarily another document and it won't likely even occur to anyone that you might have had a different first dose.  My recommendation to you is do not stir the pot for now because if ON and Canada recognize you as fully vaccinated, then that should suffice. 

 

If, someday, you are offered another Pfizer shot, well why not take it?  It certainly seems to be outperforming AZ and pretty much anything else.  We may find out we need boosters anyway in future.

 

Good point.  I have reviewed the sheet and it does say "Received 2 valid doses".  No reference to AZ, but only references Pfizer.

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Another thing to keep in mind  for your  upcoming trip  are the travel restrictions that are still in place.  Travel  to  the UK  is still HIGHLY restricted.   Keep on top of what is going  on  to find out  what the latest is, when you need to arrive, if you need to quarantine when you arrive, and  what testing is  required.

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19 hours ago, tert333 said:

 

Has anyone heard anything around this?  I know within Canada, it is acceptable.

The WHO says it is acceptable and they do not recommend a 3rd dose, ie (I added the emphassis): 

 

"Interchangeability with other vaccines

It is currently recommended that the same product should be used for both doses. If different COVID-19 vaccine products are inadvertently administered in the two doses, no additional doses of either vaccine are recommended at this time. Heterologous (mixand-match) studies are ongoing with regards to the interchangeability of this vaccine with other COVID-19 vaccines. Preliminary results from a heterologous priming schedule where BNT162b2 was given as the second dose following a first dose of ChAdOx1- S [recombinant] vaccine showed a slightly increased but acceptable reactogenicity with superior or similar immunogenicity results, thus supporting the use of such a heterologous priming schedule in settings where the second dose for the ChAdOx1-S [recombinant] vaccine is not available due to vaccine supply constraints or other concerns (17, 18)."

 

Link to the document:

 

https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccines-SAGE_recommendation-BNT162b2-2021.1

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In the US, it is simple. 14 days after any of the following:

 

  • J&J vaccination date
  • Moderna's 2nd dose vaccination date
  • Pfizer's 2nd dose vaccination date

As for other countries, I would do not know. For cruises leaving the US, I would not want AstraZeneca considered as a vaccine nor that garbage one from China. 

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21 minutes ago, BoozinCroozin said:

In the US, it is simple. 14 days after any of the following:

 

  • J&J vaccination date
  • Moderna's 2nd dose vaccination date
  • Pfizer's 2nd dose vaccination date

As for other countries, I would do not know. For cruises leaving the US, I would not want AstraZeneca considered as a vaccine nor that garbage one from China. 

Why would you not want AstraZeneca considered a vaccine?  In Canada they had to sent back many J&J because of contamination. The UK has had very good results with the AatraZeneca vaccine.

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21 hours ago, portiemom said:

Is there scientific evidence for mixing manufacturers?

 

We barely have enough of a study of any of the vaccines, let alone a mix n match. 

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1 hour ago, nbsjcruiser said:

Why would you not want AstraZeneca considered a vaccine?  In Canada they had to sent back many J&J because of contamination. The UK has had very good results with the AatraZeneca vaccine.

AZ has not been approved in the US for various reasons. Record keeping (not using most current records for some results), dose packaging issues, which include how about 5K people in Phase 3 testing only got half dose the first time, and actually get a better antibody response on half a dose. That little issue required an entirely different Phase 3 test.

 

Plus the bloodclotting issue. And the fact the US approval process is more thorough than the European methods.

 

I had not heard any J&J was sent back. I had heard that a lot of J&J never was shipped in the first place because if issues.

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3 minutes ago, CruiserBruce said:

AZ has not been approved in the US for various reasons. Record keeping (not using most current records for some results), dose packaging issues, which include how about 5K people in Phase 3 testing only got half dose the first time, and actually get a better antibody response on half a dose. That little issue required an entirely different Phase 3 test.

 

Plus the bloodclotting issue. And the fact the US approval process is more thorough than the European methods.

 

I had not heard any J&J was sent back. I had heard that a lot of J&J never was shipped in the first place because if issues.

Our province last week said that they had to send the j&j back because of the issues with quality control.

The province had 3 people die from blood clots and made the decision to stop using it. They waited for the studies on mixing different doses and the results came back the there was no issues found. In most of the studies the results said that mixing doses gave people better coverage. There a quite a few countries doing the mixing of doses. Here is a link to one study. https://www.nature.com/articles/d41586-021-01359-3

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We don't know what we don't know.  The scientists don't know what they don't know about the mixing of vaccines for doses #1 and #2.  Studies are being done.  It's too early for any judgments to be made in my opinion.  

 

I am fully vaccinated with two doses of the Pfizer vaccine.  If I require a booster this Fall/Winter, at this point in time, I will do whatever I can do to get another Pfizer shot.  Unless data appears that shows:  the mixing of vaccines is of no concern.

 

How many of us are aware of the manufacturer of the annual flu vaccine that we receive?  It may be from drug maker ABC one year and DEF the next year.  So what?  

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Mixing vaccines, especially if there becomes a requirement for boosters is a possibility in the US depending on how the approval process goes for the Novavax vaccine and how the unknown future plays out.  I’ve read that the Novavax vaccine is likely to be the booster shot of choice as the technology used for the AZ and J&J vaccines get reduced effectiveness with subsequent shots and the side effects from the mRNA vaccines generally get worse with subsequent shots.

 

Will be interesting to see how this plays out as some countries decided to stop using the AZ vaccine and there are likely many in the same boat as the OP.

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