Decision to mix vaccines could cause international travel difficulties for millions of Canadians – .

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Decision to mix vaccines could cause international travel difficulties for millions of Canadians – .


Travelers pushing luggage on trolleys pass through Vancouver International Airport in Richmond, British Columbia on July 30, 2021.

DARRYL DYCK / The Canadian Press

Canada’s decision to mix COVID-19 vaccines as part of a strategy to rapidly immunize as many of the population as possible could present travel challenges for millions of people who have received different doses.

While research has shown that mixing a viral vector vaccine, such as AstraZeneca, followed by an mRNA vaccine, such as Pfizer, produces a significant immune response, some countries, including many members of the Union European Union, do not recognize certain vaccines and vaccine combinations. .

This means that those given mixed doses may not be considered fully vaccinated and may require additional COVID-19 security measures such as testing and quarantine. Cruise lines can also deny boarding to passengers.

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As of Monday, 67.6 percent of eligible Canadians are fully immunized, including an estimated 3.6 million people who have received a combination vaccine.

Conservatives urge federal government to ensure Canadians who have received COVID-19 mixed vaccines can travel abroad

In Ontario, Sid Van Abbema and his family are careful to plan their trip since all three members have been fully immunized.

After canceling several family trips due to the pandemic, the factory manager of an automation company booked a Caribbean cruise for February 2022, departing from Fort Lauderdale, Florida. Longer term, the family is considering a trip to Europe, with Denmark as a potential stop.

Mr Van Abbema received two doses of Pfizer-BioNTech, his wife received AstraZeneca and Covishield, and their daughter received Pfizer and Moderna. Princess Cruises, through which the family booked their trip, allows mixing of vaccines as long as they are of the same type – either both mRNA or viral vector – meaning that all members of the the family should be allowed to sail.

But Mr. Van Abbema wonders about the local requirements on the various islands for which shore excursions are scheduled. The Bahamas, for example, does not currently recognize Covishield, the version of the AstraZeneca vaccine produced by the Serum Institute of India that his wife received a dose of. Neither does Denmark, which only accepts vaccines approved by the European Medicines Agency, which are currently Pfizer, Johnson & Johnson, Moderna and AstraZeneca.

“We took the first thing that was given to us, trying to be good citizens, because we believe in vaccinations – protecting others as well as our own protection,” Van Abbema said. “But travel was going to be part of our long term plans and it will have an impact for us. “

Last week, Quebec’s health ministry made the unusual decision to offer an extra dose of mRNA vaccine on an exceptional basis to people who have planned essential travel and need to meet vaccination requirements. But a spokesperson for the department said it was up to recipients to seek advice on safety to receive an additional injection.

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“The person needs to be properly counseled to be made aware of the potential risks associated with this extra dose versus the benefits of the planned trip,” Robert Maranda said in an email.

While previous evidence has shown that additional booster doses of vaccines may be needed when immunity wanes, the National Advisory Committee on Immunization says “there is currently not enough evidence to identify possible risks for people who might receive a third dose of the same or different COVID-19 vaccine.

No other province currently offers a third dose. On July 25, Ontario Health Minister Christine Elliott and Solicitor General Sylvia Jones wrote to Intergovernmental Affairs Minister Dominic LeBlanc to tell him that those who received two doses of a vaccine approved by Health Canada are considered fully immune and should be treated as such both at home and abroad.

“This clarification is important, and we look forward to the outcome of discussions with your US counterparts and those in other jurisdictions, including across the European Union,” the letter said. “We call on the Government of Canada to work with the [World Health Organization] update its guidelines to international partners that the vaccine mix should be internationally accepted as a complete vaccine schedule. “

In British Columbia, provincial health worker Bonnie Henry said the problem “is evolving” and urged people to be patient.

“I expect that as more and more information becomes available on the safety and effectiveness of different calendars, countries will adapt to accept these calendars,” she said. July 27.

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In an email, a spokesperson for the World Health Organization (WHO) said that anyone fully vaccinated with any of the vaccines on the WHO’s emergency use list (EUL ) should be treated the same regardless of the vaccine received. Regarding the mixture, however, the WHO Strategic Advisory Group of Experts has only currently granted a permissive recommendation to use Pfizer as a second dose, after a first dose of AstraZeneca, if a second dose of AstraZeneca. AstraZeneca is not available.

“With the exception of the permissive AZ / Pfizer recommendation, there is currently not enough data on the immunogenicity or effectiveness of other ‘mix and match’ regimens,” the email said. “COVID-19 vaccines with EUL have only been evaluated as single product regimens. “

WHO added that countries should prioritize limited vaccine supplies for the first and second doses, and that offering third doses when many countries have not even received a primary series yet risks exacerbating inequalities.

As for Mr. Van Abbema, he is above all happy that he and his family are now fully immune and that travel plans are secondary. He hopes for more clarity from the cruise line before the November deadline to pay in full or cancel.

“If I don’t have an answer, then I won’t roll the dice on this,” he said. “Before I put any money in, I want to make sure we can go. “

With a report from the Canadian Press

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