Indian Weekender speaks to a Kiwi-Indian who took mixed jabs in India and New Zealand and a leading NZ vaccinologist
Navdeep Kaur Marwah & Dev Nadkarni
As the Delta variant hit our shores here in New Zealand, the sudden surge in vaccine demand has taken the government off guard, scrambling to get additional doses of the Pfizer-BioNTech vaccine, which is the only one used so far in New Zealand. However, because of the spike in demand, there have been reports of the government considering other makes of vaccine such as Astra Zeneca to build up enough contingency stock.
But is it safe to mix vaccines – is it safe for the two doses administered to individuals to be from different vaccine makers? While the jury seems to be out on this important question, a growing list of countries including Bahrain, Bhutan, Canada, Italy, South Korea, Thailand, and the United Arab Emirates have already begun mixing vaccines as policy. This is despite a World Health Organisation warning on July 12 that there was little data about the health impact.
Australian Technical Advisory Group on Immunisation Co-chair Prof Allen Cheng, who is also an epidemiologist and infectious diseases physician in Melbourne, told The Guardian this week, “the clinical trials for two doses of the same vaccine have tens of thousands of people, and many millions of people have received two doses of the same vaccine, whereas the experience with mixed schedules is much more limited.
However, there seems to be growing evidence that mixing vaccines might actually be a good thing. A UK-based safety study of over 800 participants, published in the respected journal Lancet, found that those who received the first dose of the AstraZeneca vaccine tolerated Pfizer’s shot as their second dose quite well. Another study in Spain points out that people who received the AstraZeneca vaccines benefited from taking Pfizer as their second dose, generating higher levels of antibodies than with shots of the same vaccine.
Indian Weekender’s Navdeep Kaur Marwah spoke to Shobhit, a 41-year-old Kiwi-Indian who had his first dose of the Astra-Zeneca vaccine in India and his second of the Pfizer vaccine after his return to New Zealand last month. While he became unwell enough to be hospitalised, it has not been determined whether his illness was a result of mixing the vaccines or a documented side effect of any one of the vaccines. Indian Weekender also spoke to leading vaccinologist Dr Petousis-Harris on his case.
Shobhit’s story
Shobhit, currently hospitalised in Auckland City Hospital after a condition he developed after receiving his second dose here in Auckland upon his return from India, has a word of caution if you are planning to mix doses of Covid 19 vaccines.
“I went to my hometown Bareilly in the month of March to be with my mother who was hospitalised. It was the month of April, when the second wave was in full swing in India, that I was diagnosed as Covid positive. However, after self-isolating and taking the necessary medical advice and medication, I thankfully recovered within weeks.”
He continues, “I continued to stay in India till my mother recovered. And finally, I booked my ticket back for Auckland for 29 July. It was on 20 July when I had my first dose of vaccination in India (CoviShield as the Oxford–AstraZeneca COVID-19 vaccine is known) in Bareilly. After the dose, I had no side effects – and I was feeling fit.
“I travelled through Doha and Brisbane and reached Auckland on 31 July after nearly a journey of 40 hours. Luckily, I was exempted to spend 14 days in a green zone country as being parent of a NZ citizen.”
The IT professional who migrated to NZ in 2016, continued: “After I got here, I went to the MIQ facility named Sebel in Manukau and came out of there on the 14 August.
“On 17 August, I went to get my second dose of vaccination after getting an online booking, but before getting the jab, I had informed the vaccinator that I had got a CoviShield dose in India. I had a long discussion regarding the same and I was assured that it is not a problem, and I can go ahead with my second jab.
“To be honest, I had no immediate side effects after the second dose and then the lockdown happened, and I started working from home. It was on 25 August that I started feeling something unusual when I went out for a routine walk. I felt unusually tired.
“This continued for a few days – I noticed I was getting tired very early. But on the afternoon of 30 August, my heart was just like pumping too fast. Since I regularly take blood pressure medicine, I thought it may be due to fluctuation in my BP, so I checked my blood pressure, it was okay. Even then I had half a tablet as a precaution. But when my situation got out of control and worsened, my wife called the ambulance, and I was admitted to Auckland City Hospital.
“It was at the hospital where they did the D-Dimer bllod test to check if there were any blood clots. After going through numerous tests and scans, got to know that I have a massive clot in lungs with higher side of D-Dimer test values. Even though doctors are trying to get to the root cause of that level of clotting and supporting me on each step to get cured, I do feel that it is due to mixing of vaccination,” says Shobhit, who is currently on blood thinners.
“I want to inform people coming from India/Pakistan/Bangladesh/Nepal to either they have both doses in India or have both doses here and for sure to have D-Dimer test before travelling to New Zealand, to make sure there is no clotting though. I don’t want anyone to be in my situation,” says Shobhit, who hopes to get discharged from hospital by next week.
‘No evidence’ that mixed vaccines could be responsible
Indian Weekender consulted vaccionolgist Dr Helen Petousis-Harris, University of Auckland’s Associate Professor in the Department of General Practice and Primary Health Care, and Director of the Vaccine Datalink and Research Group whether mixing separate vaccines could have issues.
Dr Petousis-Harris whose team is involved in research on the safety and effectiveness of Covid-19 vaccines across the world, says, “First, as a viral vector vaccine, Covishield is associated with a rare side effect. This is a syndrome of thrombosis (blood clots) and thrombocytopaenia (bleeding). This is seen mainly in younger women and has some specific characteristics (by and large). There is no established association between the mRNA vaccines like The Pfizer vaccine and thrombosis.”
She adds, “I cannot see a mechanism for a mixed vaccine schedule to do this and there is no evidence that it does. These mixed schedules are generally viewed as positive and many people are having different vaccine types as part of their immunisation.
“Second, blood clots are an established risk associated with long haul flights with onset within the month or so of the flight. It is very important to report this to the centre of adverse reaction monitoring (CARM) as the case should be assessed by experts with all the information.
It would be good if the health professional could make the report so as to include important medical details but also this report can be made by the individual.”
Though Shobhit wants everyone to be cautious about mixing vaccines, at the time of writing there seems to be little evidence that there is an issue with this. In fact, countries are increasingly looking at doing exactly that encouraged by early tests that it might actually help the efficacy of the vaccines.
Meanwhile, the Indian Weekender wishes Shobit a speedy recovery.
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