PPOZ on mixed vaccination schemes

From January 3 this year new rules for the implementation of the National Vaccine Program against COVID-19 are in force. Although the Minister of Health decided to introduce mixed regimens with AstraZeneca, Pfizer/BionTech, Moderna and COVID-19 Vaccine Janssen vaccines, the homologous regimen using one preparation is still recommended, and in the case of mixed (heterologous) regimens, the following order is recommended: vector vaccine - mRNA vaccine .

Mixed regimens were approved based on the current recommendations of the Medical Council and the Immunization Team, as well as based on the positions of the European Medicines Agency (EMA), the European Center for Disease Prevention and Control (ECDC) and the US Food and Drug Administration. Medicines (FDA).

In line with Scheme I (basic), individuals 18 years of age and older can complete an already initiated immunization schedule with Moderna, Pfizer or AstraZeneca, when a patient needs to be changed - for whatever reason - any other mRNA vaccine available, or AstraZeneca, leaving an interval of at least 28 days between doses. Still the recommended basic regimen is the homologous regimen with the use of one preparation, and in the case of mixed (heterologous) regimens, the following order is recommended: vector vaccine - mRNA vaccine.

The reverse mixed scheme can be implemented in the case of individual indications for such a procedure. In this schedule (II) - in the booster vaccination carried out in persons from 18 years of age, it is recommended to administer the vaccine in the appropriate dosing schedules:

• after vaccination with basic mRNA preparation (Moderna, Pfizer) or AstraZeneca, administration of mRNA vaccine at least 5 months apart,
• after vaccination with COVID-19 VaccineJanssen vaccination with COVID-19 VaccineJanssen or mRNA vaccine (Pfizer or Moderna) with an interval of at least 2 months,
• Vaccine Janssen's COVID-19 booster may be conditionally administered as a heterologous booster dose following primary COVID-19 mRNA vaccination with an interval of at least 5 months after completion of the full COVID-19 vaccination regimen.

The following vaccines may be used in persons vaccinated with a booster dose: Pfizer full dose 0.3 ml; Moderate half dose: 50 µg - 0.25 ml; COVID-19 VaccineJanssen vaccine in the full dose of 0.5 ml (considering first the use of the vaccine given in the basic vaccination schedule or following the sequence of vaccination after the vector vaccine administration of the mRNA vaccine).

- The new regimens offer many different options for vaccination against COVID-19, acceleration of booster vaccinations after 5 months, and after Vaccine Janssen single-dose vaccine after 60 days, i.e. 2 months, always taking into account individual indications. We, primary care physicians, only need to appeal to all unvaccinated people and those who hesitate to take a booster dose. The death rate among the unvaccinated is huge. Let's give ourselves and others a better chance to survive the next COVID-19 attack, and the fifth wave with Omikron, unfortunately, is already peeking at our door - emphasizes Bożena Janicka, president of the Alliance of Healthcare Employers.

Source: PPOZ