Chloe Ramirez
The definition of fully vaccinated is a constantly moving target as new variants of COVID-19 emerge and vaccine efficacy wanes over time. While mixing vaccines has been shown to provoke potent immune responses, some countries and cruise lines do not consider individuals with mixed vaccines to be fully vaccinated. For example, the New York State Department of Health does not consider people who have a mix of AstraZeneca and an mRNA vaccine as fully vaccinated. Similarly, Norwegian Cruise Line (NCL) and Royal Caribbean do not recognize people with mixed vaccine doses as fully vaccinated.
| Characteristics | Values |
|---|---|
| Are mixed COVID-19 vaccines considered fully vaccinated? | It depends on the location and the organization. For example, some countries, U.S. states, and cruise lines do not consider people with mixed COVID-19 vaccines to be fully vaccinated. |
| Are mixed vaccines effective? | A slew of studies suggests that mixing vaccines provokes potent immune responses, but scientists still want answers on real-world efficacy and rare side effects. |
| Are there any recommendations for mixed COVID-19 vaccines? | The CDC recommends that people who were previously vaccinated against COVID-19 get one dose of any updated vaccine if their previous vaccination was before a certain date (depending on the vaccine). |
| Are there any new COVID-19 vaccines? | The CDC recommends getting an updated 2023–2024 COVID-19 vaccine to protect against newer variants and serious illnesses. A 2024-2025 COVID-19 vaccine is expected to be released in the fall of 2024. |
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What You'll Learn
Mixed doses may not be recognised by certain countries
While mixing COVID-19 vaccines can trigger a potent immune response, some countries do not recognise mixed vaccine doses as valid. This means that individuals with mixed doses may face obstacles when travelling abroad, as they may not be considered fully vaccinated in their destination country. For example, some travellers with mixed doses have had to quarantine in Barbados because they were not recognised as fully vaccinated.
Similarly, some cruise lines do not recognise mixed vaccine doses. For instance, Norwegian Cruise Line (NCL) and Royal Caribbean do not consider individuals with mixed doses as fully vaccinated. This has caused issues for some travellers, who have had to cancel their trips.
In the United States, the CDC does not consider individuals with a mix of AstraZeneca and an mRNA vaccine as fully vaccinated. This can create problems for Canadians travelling to the US, as Europe has approved Vaxzevria (the European-manufactured version of AstraZeneca), but has not authorised COVISHIELD (the Indian-made version).
As a result, individuals with mixed vaccine doses may need to be aware of the regulations in their destination country and plan their travels accordingly. It is important to note that vaccine recommendations may change in the future as new data becomes available.
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The CDC does not consider mixed AstraZeneca and mRNA vaccines as fully vaccinated
The CDC does not consider people with a mix of AstraZeneca and mRNA vaccines as fully vaccinated. This has created problems for some travellers, particularly those from Canada, as some countries and cruise lines require full vaccination for entry. For example, some travellers with mixed doses have had to quarantine when visiting Barbados because they were not considered fully vaccinated. Similarly, some cruise lines, such as Norwegian Cruise Line (NCL) and Royal Caribbean, do not recognise people with mixed doses as fully vaccinated and have barred passengers from boarding.
Several studies suggest that mixing vaccines provokes a potent immune response, and mixing the Oxford-AstraZeneca jab with the Pfizer-BioNTech vaccine triggers an immune response similar to or even stronger than two doses of either vaccine. However, scientists still want answers on real-world efficacy and rare side effects.
The CDC's position on mixed vaccinations may change in the future as additional data becomes available. Currently, the CDC recommends a 2024–2025 COVID-19 vaccine for most adults aged 18 and older, regardless of previous vaccination history. This includes people who have received a COVID-19 vaccine, people who have had COVID-19, and people with long COVID. It is important to get the 2024–2025 COVID-19 vaccine because protection from the COVID-19 vaccine decreases over time, and the updated vaccines target the currently circulating strains.
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Mixing vaccines provokes potent immune responses
Mixing vaccines may provoke potent immune responses, according to several studies. For example, researchers in Spain found that vaccinating people with both the Oxford–AstraZeneca and Pfizer–BioNTech COVID-19 vaccines produced a potent immune response against the SARS-CoV-2 virus.
In three recent studies, researchers found that following one dose of the AstraZeneca vaccine with a dose of the Pfizer-BioNTech vaccine produced strong immune responses, as measured by blood tests. Two of the studies even suggest that the mixed vaccine response will be at least as protective as two doses of the Pfizer-BioNTech product, one of the most effective COVID-19 vaccines.
Matthew Snape, a vaccine expert at the University of Oxford, agrees that the combination vaccine results so far are promising but cautions that they don't resolve whether any improvement in T cell response results from a longer dose interval.
Dan Barouch of Beth Israel Deaconess Medical Center, who helped develop the one-dose COVID-19 vaccine made by Johnson & Johnson, says that "two different vaccines may be more potent than either vaccine alone." Mixing the two types of vaccines may give the immune system multiple ways to recognize a pathogen. The mRNA vaccines are excellent at inducing antibody responses, while the vector-based vaccines are better at triggering T cell responses.
However, it is important to note that the recognition of mixed vaccines varies across different countries and organizations. For example, some countries in Europe and certain U.S. venues do not consider individuals with mixed vaccines as fully vaccinated. As a result, individuals with mixed vaccines may face obstacles when traveling or attending events that require proof of vaccination.
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Mixed doses may not be recognised by certain cruise lines
As of May 2023, some cruise lines are still not accepting passengers with mixed COVID-19 vaccine doses. This comes after the CDC's announcement in November 2022 that people who have received doses of two different COVID-19 vaccines will now qualify as fully vaccinated. However, the CDC's position is that only mRNA vaccines (Pfizer and Moderna) can be mixed. No other vaccine combination will meet the criteria to be considered fully vaccinated.
Carnival, Holland America Line, Norwegian Cruise Line, and Princess have all updated their health and safety protocols to deny passengers who've mixed and matched certain vaccine doses. For instance, a combination of AstraZeneca and Pfizer is considered unvaccinated by the CDC.
On the other hand, some cruise lines do accept mixed doses. These include Uniworld, AmaWaterways, Avalon Waterways, and Azamara. However, Azamara only accepts mixed doses of Pfizer and Moderna mRNA vaccines, with AstraZeneca accepted only if it is administered first, followed by either Pfizer or Moderna within 8-12 weeks.
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Mixed doses may not be recognised by certain U.S. venues
The CDC's position on mixed vaccine doses is creating problems for some Canadians who have booked trips to the U.S. Certain U.S. venues, such as large-scale indoor concerts in New York City, require proof of full vaccination. The New York State Department of Health has stated that it follows CDC guidelines and does not consider people with a mix of AstraZeneca and an mRNA vaccine (such as Pfizer or Moderna) as fully vaccinated. As a result, some individuals with mixed doses may be barred from entering these venues.
Cruise lines, such as Norwegian Cruise Line (NCL) and Royal Caribbean, are also not recognizing people with mixed vaccine doses as fully vaccinated. This has caused issues for individuals who have booked cruises that dock in the U.S., such as Bryan Holgate, who may have to cancel his $20,000 transatlantic cruise due to his mix of Pfizer and Moderna vaccine doses not being accepted by the cruise line.
The CDC's guidelines on mixed vaccine doses may change in the future as additional data becomes available. A spokesperson for the New York State Department of Health, Samantha Fuld, emphasized this point in an email. However, as of now, individuals with mixed vaccine doses may encounter challenges when travelling to the U.S. or attempting to enter certain venues that require proof of full vaccination.
It is important to note that the effectiveness of COVID-19 vaccines decreases over time, and new variants can further lessen their effectiveness. This is why it is recommended to stay up to date with vaccinations, including receiving updated vaccines that offer better protection against newer variants. Being fully vaccinated with mixed doses in one's home country does not guarantee that other countries or specific venues within those countries will recognize that status. Therefore, individuals with mixed vaccine doses should be aware of the potential obstacles they may face when travelling, especially to the U.S.
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Frequently asked questions
It depends on where you are. Some countries and cruise lines do not consider people with mixed vaccines to be fully vaccinated. For example, the New York State Department of Health follows CDC guidelines and does not consider people who have a mix of AstraZeneca and an mRNA vaccine as fully vaccinated. However, mixing vaccines has been proven to provoke potent immune responses, and is a good way to get protection when faced with safety concerns and unpredictable supplies.
Some examples of mixed vaccines include a combination of the Oxford-AstraZeneca jab and the Pfizer-BioNTech vaccine, or a mix of Pfizer and Moderna vaccine doses.
Mixing vaccines has been shown to trigger an immune response similar to or even stronger than two doses of either vaccine.
Some countries and cruise lines do not recognize mixed vaccines, which could create problems for travellers.
