Dealer’s choice - The Orca

Dealer’s choice

Rob Shaw 2

Rob Shaw: Reassured for months that mixing vaccines is fine – and that AstraZeneca is a good option – news from the US is brewing confusion in BC.

B.C. health officials are doing everything they can to convince British Columbians to get vaccinated, especially in the province’s northern communities where vaccine uptake is much slower than in urban centres.

The message is: Take whatever vaccine is offered to you, be it Pfizer or Moderna, and you’ll be well-protected as we return to near-normal in the next few months.

For the most part, the public is responding: Almost 81 per cent of eligible adults in B.C. have got a first dose as of July 20, and 57.8 per cent have already been jabbed with their second.

It shouldn’t matter what vaccine brand you get, only that you take the important step to protect yourself, your family, and your community from COVID-19.

But news out of the U.S. could throw a monkey wrench in that otherwise simple messaging.

Some American cruise ship operators are refusing to accept Canadian passengers who received one dose of Pfizer and another dose of Moderna, saying the U.S. Centres for Disease Control does not recognize that combination as full vaccination.

The declaration could put pressure on B.C.’s mass vaccination system, which is built around the idea that the two mRNA vaccines are virtually identical and so it can interchange Pfizer or Moderna shots depending on whatever brand the province has more of at any particular time.

Not so, says the U.S. CDC.

“COVID-19 vaccines are not interchangeable,” the agency writes on its website. “The safety and efficacy of a mixed-product series have not been evaluated. Both doses of the series should be completed with the same product.”

Already, Canadians hoping to book trips on U.S. cruise ships for this fall are reporting problems.

Major cruise lines are posting policies that ban people with certain mixed vaccinations from being eligible to board at U.S. ports.

For Norwegian cruise lines, eligibility to sail requires two of the same brand of shot.

“Mixed vaccination protocol will not be accepted (i.e. Pfizer + Moderna or AstraZeneca + Pfizer, etc),” Norwegian posted on its website.

Carnival and Princess Cruise lines will let you mix and match Pfizer and Moderna, but if you got an AstraZeneca shot you are out of luck.

“Guests who have received one single dose of a vector vaccine (e.g. AstraZeneca) and one single dose of a mRNA vaccine (e.g. Pfizer/BioNTech, Moderna) will not be considered fully vaccinated,” Princess Cruise lines posted on its website.

“Canadian or other international guests who received a combination of AstraZeneca and Pfizer are considered unvaccinated by the CDC,” wrote Carnival.

That’s another punch to the gut for people who signed up to get an early AstraZeneca shot earlier this year (full disclosure, I was one of them).

Not only did those folks get the rug pulled out from under them after their first shot when Ottawa abruptly changed its recommendations to say only Pfizer or Moderna were “preferred” due to AstraZeneca’s small risk of blood clots, but now some businesses in the U.S. aren’t recognizing AstraZeneca as a valid vaccine at all.

The U.S. CDC had muddied the waters even further, saying two doses of AstraZeneca do count as “fully vaccinated” but one dose of AstraZeneca and one dose of mRNA – which several studies have shown produce an even better immune response than two AZ doses – aren’t recognized.

Dr. Bonnie Henry has said in the past she expects the Americans to eventually fall into line and accept World Health Organization guidelines on vaccines, which recognize AstraZeneca as valid and are more forgiving over mixing and matching of brands.

But the problems persist, it could boomerang back to put pressure on B.C.’s vaccination system.

If you plan on taking a cruise from the U.S. in the future, why wouldn’t you demand that B.C. give you the same Pfizer or Moderna shot you received for dose one, just to avoid the headache of navigating the American rules?

If you’ve already got two mixed doses, are you supposed to go back to your doctor in B.C. and demand a third shot of a matching brand so that you qualify to take a cruise in the United States?

And what about the 278,174 British Columbians who got a first dose of AstraZeneca and now face a complicated future of whether it’s even recognized by Americans?

Vaccine shopping by brand is frowned on in B.C. We didn’t design our system to let people pick shots. And we don’t necessarily have the supply to allow it either.

Let’s hope the Americans – who are stalled on their own vaccination efforts – wake up to align themselves with international guidelines on vaccines.

Otherwise, the future of B.C.’s mass vaccination system could get a lot more complicated.

Rob Shaw has spent more than 13 years covering BC politics, now reporting for CHEK News and writing for The Orca. He is the co-author of the national best-selling book A Matter of Confidence, and a regular guest on CBC Radio.


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