No “large scale studies” on safety of mixing, matching Pfizer with Moderna: NFLD chief medical officer

No “large scale studies” on safety of mixing, matching Pfizer with Moderna: NFLD chief medical officer
THE CANADIAN PRESS/Sarah Smellie
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Newfoundland and Labrador’s chief medical officer of health, Dr. Janice Fitzgerald, admitted that there are no large scale studies on the safety of mixing and matching Pfizer with Moderna vaccines, and that it's “hard to tease out” whether vaccines or lockdowns make more of a difference in reducing COVID case counts.

Fitzgerald made the comments earlier today during a press conference with Health Minister John Haggie.

Yesterday, Newfoundland and Labrador announced that they would drop self-isolation requirements for Atlantic Canada residents on June 23, while aiming to open up to the rest of Canada on July 1. Entrants from the non-Atlantic provinces may only skip self-isolation if they have completed their vaccine schedule.

When asked about accelerating the province's reopening plan, Fitzgerald talked about how lockdowns cause COVID case counts to drop “dramatically” and that we haven't seen the “impact of vaccinations” yet:

“I think right now where we are is... you know it's very difficult actually to say that. You know, if we find that cases plummet and continue to do so with one vaccine, and as... bigger provinces start to reopen, we don't see a resurgence in cases, you know that bodes very well but I think, you know it's hard to predict that at this point we really need to see what's going to happen over the next few weeks and what will happen through July. 

You know it's very important for us to make sure that we get our vaccination rates up, and having... 80 per cent of the population, eligible population fully vaccinated, I think is really a requirement for that — you know, free and easy movement in the larger groups.

“And so if we're able to get there faster, and we see that the epidemiology is favourable, those are conversations that we will consider at that time. But I think... it will be unfair for me to predict anything at this point. ”

Fitzgerald then explained why, if vaccines make a difference, the province would uphold different standards for the soon-to-be-opened Atlantic Bubble compared to the rest of Canada:

“We don't know exactly, it's hard to tease out exactly what's making the difference right now. Is it vaccines or is it that, you know, a lot of these provinces that [had] really high case counts brought in some strict measures, public health measures that brought the case counts down as well?

“And we have seen this... second wave, when we didn't have the vaccination rates that we have now, that when we lock down the cases drop dramatically. So there's a combination of things happening.

“Number one, we've got the public health measures... that are in place that are bound to reduce the cases just by that, but then we have vaccinations in place as well and I think as we open up some of these bigger provinces especially, I think, we'll really start to see the impact of vaccinations, at that time because we'll watch and see what happens with the case counts...”

When asked about the efficacy and safety of “mixing and matching Pfizer and Moderna”, Fitzgerald admitted that the “evidence is still evolving” and that there are no “large scale studies” on taking two different vaccines:

“You know, what we look at, for interchangeability, really is to look at... why was the vaccine approved, for what reason... so you know, we know these two vaccines were approved for the same indications, approved in the same groups of people, by and large, and have very similar efficacy, safety, and some real world experience data with regards to vaccine effectiveness... their side effect profiles... produce very similar, when you get the vaccine, your body produces an antibody to... very similar antigens. In fact, almost identical antigens.

“So... based on the principles that we know about vaccines, um, vaccine science, there is certainly everything in place that these vaccines can be interchangeable. 

With regard to large scale studies, uh, showing effectiveness? There aren't any available right now... the evidence is still evolving, but based on what we know, and uh, based on vaccine science, I think it is... quite safe to be able to... get a different vaccine the second time around.

Confronted over the possibility that vaccines are causing heart problems, Fitzgerald stated that the establishment of a casual relationship has “not been answered” yet.

“Yes, so there is some concern and there has been a signal, I guess, that has come up [with regard to] inflammation in heart tissue, or the tissue surrounding the heart.

“So we call that myocarditis, pericarditis. And what we know right now is that it does appear to be happening in people who are younger and males more so than females. We know that it appears that the... vast majority of cases are actually quite mild and people recover usually fairly quickly afterwards.

“...is there a casual relationship there between having the vaccine and... the actual inflammation... that question has not been answered as this time.

“Uh, what we know about this type of condition is that, you know, as opposed to the VITT [Vaccine-Induced Immune Thrombotic Thrombocytopenia] that we saw before, with the viral vector vaccines, this one is not quite as rare in the general population.

Fitzgerald went on to assure the media that the vaccine is “still safe”:

“Is there a plausible biological mechanism by which this, the vaccine could cause this condition — those questions haven't been answered yet. Most of the evidence is coming out of the United States and Israel who are doing quite intense surveillance for this.

As well, and so what we have, learned from that to date and the evidence is still evolving, is that it appears to be work — you know more so after second dose and that — it seems to be a mild condition that resolves on its own in the vast majority of people.

You know, the vaccine is still safe, these are still very rare events that are happening most important to remember in the millions of doses of vaccine that have been given.

You know we're not talking about a large number of... cases at all so these are still very rare events and the vaccine is safe and you know we still would recommend that people get vaccinated with two doses of a COVID-19 vaccine.

Children ages 12-18 will “still have to stick with Pfizer” for both their first and second dose, added Fitzgerald, saying that they hope Moderna would soon be recommended for youth as well.

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