Australians hoping to come home for Christmas may remain stuck overseas because they are not considered fully vaccinated if they have had different doses of approved vaccines.
Since the Australian federal government announced international borders would reopen to fully vaccinated citizens, permanent residents and their families, some overseas have received conflicting advice about their immunisation status.
Tim and Sharyn Nilsen have been living in Vietnam for the past two years after becoming stranded during their travels. Ms Nilsen told ABC Radio Brisbane they were only offered an AstraZeneca jab and Pfizer for the second shot during the country’s vaccine rollout, partly because of a supply issue.
Ms Nilsen said it was good to have had the mixed vaccines in order to be fully vaccinated, especially at a time when Ho Chi Min City was recording thousands of cases a day.
To quote a frequent medical mantra “the best vaccination is the one that is available.”
When the Australian government announced international borders would reopen, Ms Nilsen checked the Services Australia website and with the Australian embassy in Vietnam about vaccine certification. The embassy told her that having two different vaccines was acceptable as long as they were approved varieties like AstraZeneca or Pfizer.
So she booked tickets to visit her and Mr Nilsen’s parents in rural New South Wales, who they have not seen for almost two years. “I went and booked a ticket and that was the Wednesday,” Ms Nilsen said. “On Thursday I told my mum and she was like a blubbering mess, she was so excited.”
But on Friday, she received an update from the embassy that said the rules were changing constantly and people who had mixed shots would be considered “not vaccinated”. A day later, Singapore Airlines advised Ms Nilsen that the flight had been designated as “For Eligible Passengers Only” (FEPO) and that mixed vaccines would not be recognised.
“[The Australian government is] jumping up and down saying, ‘We’re going to get Aussies home,'” Ms Nilsen said. “But they’re not, basically — they’re excluding a whole bunch of people who are in fact fully vaccinated.”
Singapore Airlines, Scoot and Vietnam Airlines all have statements on their websites that customers with mixed vaccine doses are not eligible at this stage. This seems likely to also impact Thai travellers wishing to use these airlines.
The same scenario inevitably affects thousands of Australian citizens in Thailand who have received mixed vaccination doses
Internationally, many countries, including Canada, Spain and South Korea, have introduced mixing doses of vaccines as part of their rollout. While it does not recommend mixing jabs, the United States Centre for Disease Control and Prevention recently updated its guidelines to suggest travellers who have had mixed doses of US or World Health Organisation (WHO) approved vaccines be accepted.
To qualify as fully vaccinated in Australia, you need to have had either
2 full doses at least 14 days apart of
Spikevax (Moderna) or
one dose of Janssen-Cilag (Johnson & Johnson
You won’t be considered fully vaccinated if you received different vaccine types for your first and second dose of a 2 dose course. At least 7 days must have passed since you completed your full course of vaccination.
Experts have not reached a consensus on the safety and efficacy of mixing doses. Katherine O’Brien, the director of the WHO’s Department of Immunisation, Vaccines and Biologicals, recently said there was evidence combining an AstraZenica vaccine dose with either of the MRNA vaccines, Pfizer or Moderna, could produce a “good” immunity response.
But Immunisation Coalition chair Rod Pearce said there were too few studies to be certain about the efficacy and safety of mixing vaccines. Mater Hospital’s infectious diseases director Paul Griffin said authorities should consider whether mixing vaccine doses could be approved.
“There’s been a few clinical trials,” he said. “The numbers are still relatively low, but in the trials it looks like swapping over can increase the protection slightly.”
The Australian Technical Advisory Group on Immunisation (ATAGI) recommends using the same COVID-19 vaccine for the two doses of the primary course. “While there is emerging data about mixed dose schedules, larger studies and longer term follow up are required to confirm the safety of this approach,” a spokesperson said.
“ATAGI continues to monitor and review the evidence for mixed COVID-19 vaccine schedules and provide updated recommendations to government as appropriate,” the spokesperson said. “Travellers that do not meet the definition of fully vaccinated may still be able to travel, but only under the rules of unvaccinated travel.”