Mixed Vaccines

[jack168]

@Matt posted an article about cruise line policies regarding mixed vaccines and it says Royal Caribbean is not one of them, however, someone just posted this on reddit. I guess Royal Caribbean is requiring both doses to be from the same brand ?

[Matt]

Thanks for sharing

[JSB_Z51]

Wow Surprised by that OP.  I believe in Canada some started with Astrazenca and then it may have been paused and second doses by Pfizer were being administered.  Good luck if you are impacted by that.  

[jack168]

25 minutes ago, JSB_Z51 said:

Wow Surprised by that OP.  I believe in Canada some started with Astrazenca and then it may have been paused and second doses by Pfizer were being administered.  Good luck if you are impacted by that.  

I live in Canada, but I was lucky and got both doses Pfizer  

[DJsMrs]

I just pulled this from the RCCL FAQ vaccine page - it states it will accept any vaccine recognized by the US FDA and/or the WHO.   I'm pretty sure mixed vaccine recipients will be fine.  Keep in  mind the US FDA never approved Astra Zeneca - but RCCL is accepting AZ recipients as fully vaccinated.

Pulled from the WHO website:

 

The WHO's Strategic Advisory Group of Experts on vaccines said in June the Pfizer Inc (PFE.N) vaccine could be used as a second dose after an initial dose of AstraZeneca (AZN.L), if the latter is not available.

 

 

Pulled from RCCL FAQ:

Acceptable Proof of Vaccination For Ports Where Vaccines Are Required

In order to present proof of vaccination for our cruises, the guest must show eligible documentation on boarding day at the terminal in the form of the vaccination record issued by either (1) the country’s health authority that administered the vaccination (e.g., U.S. CDC's Vaccination Record Card) (2) electronic vaccination records where country policy requires the use of electronic documentation via app or health agency site (e.g. UK NHS App, NHS Certificate, Israel Green Pass, EU Digital COVID Certificate), or (3) a letter from the guest's medical provider that administered the vaccination, which meets the following criteria: 

• The Proof of Vaccination must include the name of the vaccinated person matching the registered cruise guest with date of birth (DoB), the dates of the completed vaccination cycle, the administering physical or medical services provider, and the manufacturer of the vaccine issued. 
• The full vaccination cycle must be completed at least 14 days before your sail date (e.g., received the second dose in a two-dose series such as Pfizer or Moderna or a single dose of J&J).
• The vaccine is recognized and approved by the U.S. Food and Drug Administration (U.S. FDA) and/or the World Health Organization (WHO).

NOTE: Royal Caribbean will accept a laminated original vaccine card from your country’s health authority as acceptable proof of vaccination, providing it meets all the aforementioned criteria.

[JasonOasis]

This saddens me because here in Chicago and throughout the suburbs we've heard of large clusters of individuals who were mistakenly given the wrong second dose by the pharmacy.  This was no fault of their own they presented their CDC card and the pharmacist didn't read the card and administered the wrong shot as their second dose.  

Now these cruise lines are saying they can't cruise that's not right. If they are considered fully vaccinated by the CDC then that should be enough to cruise. 

[Vancity Cruiser]

28 minutes ago, JSB_Z51 said:

Wow Surprised by that OP.  I believe in Canada some started with Astrazenca and then it may have been paused and second doses by Pfizer were being administered.  Good luck if you are impacted by that.  

I am in Canada and had on opportunity to get my first dose Astra Zeneca much earlier than Pfizer or Moderna. I was torn because I really wanted to get vaccinated but was hesitant because Astra wasn't approved in US and my motivation was to go cruising and I worried it wouldn't be accepted. I decided to wait and am now fully vaccinated with 2 doses of Pfizer. Glad I dodged that bullet. I feel bad for my fellow Canadians who were just trying to do their part to raise vaccination rates and may now be facing this problem. 

[cruisinghawg]

Does anyone know what they (cruise company's) are basing this on?

[DJsMrs]

I'd calm down and take the written word on their website rather than the word of a rep in a conversation that was posted on Reddit.   I think we all know that if we talk to three different people we will get three different answers - especially when the rules are fluid and changing constantly.   

 

See above - there are source documents (from Royal and WHO) stating that mixed vaccines will be acceptable.

 

 

[smokeybandit]

I don't think mixed vaccines are WHO recognized are they?

[TXcruzer]

15 minutes ago, smokeybandit said:

I don't think mixed vaccines are WHO recognized are they?

WHO recognizes mixed vaccines as long as they are the same type.  Pfizer and Moderna mixed are OK because the are both mRna, Mixing an AZ and a mRna dose would not be considered fully vaccinated by the WHO. 

[TXcruzer]

4 hours ago, DJsMrs said:

I'd calm down and take the written word on their website rather than the word of a rep in a conversation that was posted on Reddit.   I think we all know that if we talk to three different people we will get three different answers - especially when the rules are fluid and changing constantly.   

 

See above - there are source documents (from Royal and WHO) stating that mixed vaccines will be acceptable.

 

 

Written word on the RCL FAQ just updated. NO mixed vaccines

 

[dswallow]

Considering it seems many cruise lines made this update at roughly the same time, I have to believe that somewhere behind the scenes someone at the CDC made them do it.

[smokeybandit]

1 hour ago, TXcruzer said:

WHO recognizes mixed vaccines as long as they are the same type.  Pfizer and Moderna mixed are OK because the are both mRna, Mixing an AZ and a mRna dose would not be considered fully vaccinated by the WHO. 

Then RC should accept that

[DJsMrs]

1 hour ago, TXcruzer said:

WHO recognizes mixed vaccines as long as they are the same type.  Pfizer and Moderna mixed are OK because the are both mRna, Mixing an AZ and a mRna dose would not be considered fully vaccinated by the WHO. 

This isn’t true.    WHO suggests that if you’ve had AZ first and cannot get a second AZ then by all means to go ahead with an mRNA vaccine - which is actually showing an excellent (perhaps even stronger) immunity response than 2 AZ or 2 mRNA 

I know RCCL has this policy now - but so did Barbados and they updated it to include mix and match  very quickly.     It’s like trying to catch water with a sieve right now in  pinning down and keeping track of constantly changing information as more and more research becomes available.  

Quote from Reuters story - I’m not inclined to disagree with the WHO strategic advisory group of experts   I wish I was that smart   I’ve looked them up and they are impressive    
 

 

 

 

The WHO's Strategic Advisory Group of Experts on vaccines said in June the Pfizer Inc (PFE.N) vaccine could be used as a second dose after an initial dose of AstraZeneca (AZN.L), if the latter is not available.

A clinical trial led by the University of Oxford in the UK is ongoing to investigate mixing the regimen of AstraZeneca and Pfizer vaccines. The trial was recently expanded to include the Moderna Inc (MRNA.O) and Novavax Inc (NVAX.O) vaccines.

 

[Carotthat]

In Germany sadly no second dose of AZ is any more available, so you have to accept mRNA as second vaccine.

To my best knowledge, Germany was the first country to start mixed (heterolog) vaccination schemes.

[TXcruzer]

18 hours ago, DJsMrs said:

This isn’t true.    WHO suggests that if you’ve had AZ first and cannot get a second AZ then by all means to go ahead with an mRNA vaccine - which is actually showing an excellent (perhaps even stronger) immunity response than 2 AZ or 2 mRNA 

I know RCCL has this policy now - but so did Barbados and they updated it to include mix and match  very quickly.     It’s like trying to catch water with a sieve right now in  pinning down and keeping track of constantly changing information as more and more research becomes available.  

Quote from Reuters story - I’m not inclined to disagree with the WHO strategic advisory group of experts   I wish I was that smart   I’ve looked them up and they are impressive    
 

 

 

 

The WHO's Strategic Advisory Group of Experts on vaccines said in June the Pfizer Inc (PFE.N) vaccine could be used as a second dose after an initial dose of AstraZeneca (AZN.L), if the latter is not available.

A clinical trial led by the University of Oxford in the UK is ongoing to investigate mixing the regimen of AstraZeneca and Pfizer vaccines. The trial was recently expanded to include the Moderna Inc (MRNA.O) and Novavax Inc (NVAX.O) vaccines.

 

Yet it was quotes from the WHO's own advisory panel that has initiated all of this concern, and not only with cruise lines, some Caribbean islands have updated their entry requirements to reflect this policy.

[MrMarc]

I think RCCL has been handling this as well as they could, given all the changing obstacles in their way. But I think they blew it on this one.  I have actually had 2 full vaccinations of different brands, I wonder how they would classify me.  I am not going until december, so maybe non of this will matter by then.

[DJsMrs]

22 minutes ago, MrMarc said:

I think RCCL has been handling this as well as they could, given all the changing obstacles in their way. But I think they blew it on this one.  I have actually had 2 full vaccinations of different brands, I wonder how they would classify me.  I am not going until december, so maybe non of this will matter by then.

I’m in this boat with you.    We also sail in December and have had 2 different vaccines.    I feel like they’re going to have to revisit the science on this and realize that their policy doesn’t reflect facts and people can receive 2 different vaccines (under the advice of doctors, scientists around the world) and still be vaccinated.    It’s disappointing in the mean time.  

[DJsMrs]

2 hours ago, TXcruzer said:

Yet it was quotes from the WHO's own advisory panel that has initiated all of this concern, and not only with cruise lines, some Caribbean islands have updated their entry requirements to reflect this policy.

And the WHO subsequently clarified their quote after the message was not correctly conveyed.    The WHO was not advising people to avoid mixing vaccines under the advice from scientists.   They were answering a question about whether a third vaccine was needed after Pfizer announced its application with the FDA about a booster shot.  The advice was to encourage people to not decide by themselves to get a third shot or to receive extra doses.  
 

The quote did not apply to people who have had AZ-mRNA, Pfizer-Moderna and the like and part of their vaccination programme.     The headlines did not accurately reflect what was said, nor did they reflect the true message being conveyed by the WHO.  The tragedy here is that the unintended consequence of this click bait will result in people not being vaccinated.   And the decision by cruise lines will have an impact on people holding out for vaccines if there is uncertainty about whether or not people will have access to two of the same type of vaccine when scientific evidence is showing that it is safe to do so.  
 

 

[Royal Blue]

Gotta think the call centre employee went off script on this one. Mind you for once I get a win IF this really is true. Double AZ vax - the charlie brown of vaccines. Major countries are approving of mix and match and then WHO comes in for the buzzkill. This is going to keep dragging on until we get 85% + full vax rates. Tough to say but we need more quick deaths in the unvaxxed to really drive home the narrative to get this under control. Nothing greater in marketing than fear to get the sale done.

[stevendom57]

Question. Has this mixture of vaccines (e.g. Moderna & Phizer) actually been tested for it's effectiveness? If not, they made the right call.

[MrMarc]

I just got a Facebook reply to my question about this that says the rule is "pending further review" and to "stand by for further communications".

[MrMarc]

21 hours ago, DJsMrs said:

I’m in this boat with you.    We also sail in December and have had 2 different vaccines.    I feel like they’re going to have to revisit the science on this and realize that their policy doesn’t reflect facts and people can receive 2 different vaccines (under the advice of doctors, scientists around the world) and still be vaccinated.    It’s disappointing in the mean time.  

But I've had 2 doses of moderna  earlier this year and 1 J&J Friday, so I have two total vaccinations.  I know it' strange, but it's something my doctor and I decided was best.  I am afraid I will confuse them.

[SpeedNoodles]

They've removed that information from the website.

https://www.royalcaribbeanblog.com/2021/07/19/royal-caribbean-removes-mixed-vaccine-policy-its-website

[JeffB]

22 hours ago, MrMarc said:

But I've had 2 doses of moderna  earlier this year and 1 J&J Friday, so I have two total vaccinations.  I know it' strange, but it's something my doctor and I decided was best.  I am afraid I will confuse them.

First, I've read some of the literature on the efficacy of a "normal" two dose regimen of the mRNA vaccines and a booster with the J&J product. For certain cohorts it is believed that this approach is promising. The thinking is that it boosts your immune response and protects against reinfection by existing and future variants.

It's not for everyone. Let me be clear. Don't go out and seek a third shot. If you think you might have had a muted immune response due to an exiting medical condition, talk to your health care provider about your concerns. Let them make the call.

MrMarc, if I were you, I'd just present the vaccination record for your two Moderna shots. Don't even mention you have had a third. Maybe you were just joking about confusing staff who are checking vaccination records but if you weren't your concern that they might be confused is entirely legit.   

[Royal Blue]

well guess I was wrong.

https://globalnews.ca/news/8047816/canadian-travellers-us-cruise-mixing-covid-19-vaccines/

Looks like they are following the guidelines of the departing country. For now at least. Once this is over, the pandemic playbook needs a rewrite to have one vax and one set of guidelines for the whole world. It will never happen , but it should.