Doctors: Vaccine Mix and Match Irresistible and Requires Preliminary Arrangements 醫生:混打疫苗將成必然 需提早因應

While the WHO still warns against the mix-and-match of COVID vaccines, many countries are already weighing, or have decided to adopt, such a solution. Domestic experts we interviewed say they believe mixing doses provides a more well-rounded protection and the trend is "inevitable" in the near future. The government needs to face this sooner rather than later.


As Taiwan's government won't allow mixed doses of COVID-19 vaccines, many seniors that got AZ for their first dose are taking matters into their own hands by going to mass vaccination stations to get Moderna for their second dose. 

Doctors say COVID-19 will become seasonal shortly, which means mixed vaccine doses are inevitable and necessary. They say the Tsai administration needs to face facts sooner rather than later.

Wang Jen-hsien, Chair, Taiwan Counter Contagious Diseases Society:”AZ vaccines are recombinant adenovirus vector vaccines. Preexisting adenovirus antibodies in the body will go after the adenovirus from the second dose, so in theory, two doses of the AZ vaccine aren't as effective as a combination of AZ and BNT vaccines.”

Doctors say while AZ vaccines can produce both adenovirus and COVID-19 antibodies, Moderna and Pfizer only produce the latter. Therefore, many countries are experimenting with mixed doses of AZ with one of the other two. 

Mixed doses are the trend in many countries. Doctors are therefore calling on the Central Epidemic Command Center to establish relevant guidelines, including the recommended amount of time between two differing vaccines.

Huang Li-min, Honorary Chair, Infectious Diseases Society of Taiwan:”The current belief is that the first dose of AZ followed by a second dose of an mRNA vaccine, especially BNT, provides the same level of protection as two doses of BNT. However, a mixed dose of AZ and BNT appears to offer a much higher level of protection than two doses of AZ.”

Research reports show that the first dose of AZ followed by a second dose of BNT or Moderna produces significantly more antibodies than two doses of AZ. Doctors say with so many people unwilling to get AZ vaccines in Taiwan, allowing mixed doses would greatly boost the willingness of people to get vaccinated and Taiwan's overall coverage rate.

 

 

國內新冠疫苗陸續到貨,國人施打疫苗的速度也開始加快,但也亂象頻傳,由於台灣尚未開放新冠疫苗可混打,卻有長輩明明打過AZ疫苗,卻還闖關快打站,混打第二劑莫德納疫苗。

究竟混打可不可行,國內有醫師就認為,新冠肺炎未來將流感化,混打疫苗將成必然,政府須提早因應。

中華民國防疫學會理事長 王任賢:「AZ疫苗它是個所謂的腺病毒載體的疫苗,你追加了腺病毒載體疫苗進去後,前面的腺病毒抗體,會抓掉我們後來的腺病毒的疫苗。所以原則上來講,AZ加AZ的追加效果沒有AZ+BNT的追加效果要來的好。」

醫師表示,目前AZ疫苗可同時產生腺病毒與新冠肺炎疫苗抗體,莫德納跟輝瑞都只是單純產生新冠肺炎抗體,所以目前各國嘗試混打的方式,都是以AZ疫苗搭配另兩種疫苗。希望兩種不同疫苗讓體內產生的抗體更強大,混打已經是趨勢,指揮中心應考慮訂定規範,包括混打時間要隔多長。

台灣感染症醫學會名譽理事長 黃立民:「目前的看法是如果第1劑打AZ,劑打mRNA疫苗尤其是BNT的話,的效果看起來跟2劑都打BNT的效果,沒有差很多。可是比2劑都打AZ的效果好,抗體上是高很多。

醫師認為,國外已有研究證實,在第一劑打了腺病毒載體的AZ疫苗後,不管第二劑是打BNT或莫德納是可顯著提高抗體,目前國內主要的疫苗是AZ,且部分民眾對AZ有疑慮,若能開放混打,將可提高民眾的接種意願。

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