recentlyWorld Health Organization (WHO) Published Interim recommendations for heterologous COVID-19 vaccine schedules in Interim guidance, revealing preliminary recommendations forvaccination for covid-19 different types, orcross vaccination Either using different vaccines in the second dose, orimmune boosting vaccineIn the third dose, with reference to educational documents from around the world.
including data from research studies in Thailand in the use of inactivated vaccines followed by viral vectors or mRNA
One such information comes from Results of a research study in the COVID-19 Vaccination Safety and Response Study Program. 3rd needle stimulation : Booster Study by Clinical Research Center Faculty of Medicine Siriraj Hospital led by Assoc. Prof. Nasikan Angkasekwinai, Asst. Prof. Dr. Jaturong Sawetanon, Asst. Prof. Dr. Sansanee Senavong, Asst. Prof. Dr. Suwimon Niyannaitham, MD. Kulkanya Chokpaiboonkit
and researchers from the Department of Medical Sciences Ministry of Public Health Dr. Sompong Sapsuthiphas, Dr. Saphorn Phoom-Amon, Department of Medical Sciences Ministry of Health
Siriraj Cross Formula Vaccine Research
Prof.Dr. Kunkanya Chokpaiboonkit Director of the Clinical Research Center Faculty of Medicine Siriraj Hospital said that the research on the COVID-19 vaccine which is a crossword formula studied in Thailand showing examples of the use of various vaccines Set an example for many countries that don’t have mRNA vaccines like Europe or America.
For research studies related to the first covid vaccine from the Siriraj Clinical Research Center This was a study in volunteer medical personnel. that has been injectedsinovac vaccine 2 needles andAstraZeneca vaccine 2 needles
It was found that after 2 injections of Sinovac vaccine, the immune system was increased. But less than the two doses of the AstraZeneca vaccine, especially when compared to the Delta antiviral test, which is consistent with the high number of reports of delta strains in people who previously had two doses of synovac.
and even in those who had two doses of astraZeneca vaccine. also had a severe drop in immunity after the last dose 3 months
This reflected the need for the third dose of vaccination, which was the source of the study on the use of different types of vaccines. came to inject a stimulus as the 3rd needle, which was found that if using different types of vaccines will stimulate immunity better
We also studied to increase the potential of the first two doses of vaccination. with alternating cross-needle injections in the first and second doses with locally available vaccines
between inactivated vaccines Vector virus (Sinovac + AstraZeneca), inactivated vaccine followed by mRNA (Sinovac + Pfizer), vector virus followed by mRNA (AstraZeneca + Fire. Sir)
and vector viruses, followed by inactivated vaccines. (AstraZeneca + Sinovac), which our studyIt was found that using different vaccines was able to induce immunity levels better than using both inactivated vaccines alone.
while the effect of vector virus vaccination followed by mRNA vaccines to induce immunity levels better than two doses of vector viral vaccines, but inactivated vaccines after vector vaccination The immune system is not high.
“After 12 weeks of follow-up, it was found that regardless of the type of vaccination, I have a significantly reduced immunity. Therefore, a third dose of booster vaccination is necessary.
What type of vaccine will be given to receive the 3rd dose of vaccine? And when the booster should be given varies depending on the type of vaccine given in the first and second doses.
For those who have two injections of Sinovac It was found that if AstraZeneca or Pfizer was injected as a 3 dose injection, the immune response was higher than that of the inactivated vaccine as well. (In which we used the Sinofarm vaccine)
Recommendations for cross-needle vaccine 3
Assoc.Prof.D.Nasikan Angkasekwinai Department of Infectious Diseases and Tropical Medicine Department of Internal Medicine Faculty of Medicine Siriraj Hospital
As research team leader for the COVID-19 vaccination safety and response study program Third dose booster: The Booster Study says third dose cross-formula vaccination recommendations at the World Health Organization According to the Siriraj study, it was a project that started in July. Until December 2021
which is during the epidemic of Delta mutant in Thailand This makes it necessary to give a third dose of vaccination to healthcare workers who have had two doses of Sinovac vaccine with a variety of vaccines.
because at that time there was already information that A different vaccine type than the previous vaccine given may be more effective or a better level of immunity.
Therefore, the research was conducted in collaboration with the Siriraj Clinical Research Center. The study was divided into 4 groups: AstraZeneca, Sinofarm, Pfizer full dose. and half dose of Pfizer
“We performed an immunization test two weeks after the subjects received the third dose of booster vaccination, in two forms, one that measures antibody levels. and cellular immunity It was found that the results of both tests were in the same direction.
If boosted with Pfizer vaccine both a full-dose and half-dose needle have the highest level of immunity
For boosters with AstraZeneca following two doses of Sinovac vaccination, the level of immunity was higher than with Sinofarm inactivated vaccine as booster.
Immune Cross-Formula Vaccine
Assoc.Prof.Dr. Nasikan For example, subjects who had received two doses of Sinovac vaccine for 2 weeks had an average immune response of 230 BAU/mL, at 12 weeks their immunity was reduced to 33 BAU/mL.
and after 2 weeks after the 3rd injection with 4 groups of vaccines, the results showed that Immunized with Pfizer full-dose vaccine at 5,152 BAU/mL, half-dose Pfizer. Immunity was at 3,981 BAU/mL, AstraZeneca was at 1,358 BAU/mL, while Sino Farm was at 155 BAU/mL.
In those who had received two doses of Astra before, a third dose of AstraZeneca had an immune level of 246 BAU/mL and was boosted with sinofarm. was at 129 BAU/mL
But if using the Pfizer full-dose vaccine It reached 2,377 BAU/mL, and half-dose Pfizer hit 1,962 BAU/mL, which is much higher.
“The research team therefore proposes a recommendation to the Ministry of Public Health of Thailand regarding the triple needle stimulation injection in various formulations. Ready to be published in a pre-print journal, which the World Health Organization has seen this work. Therefore, we refer to the third dose of heterogeneous vaccine, and it was found that the increased immunity also protects against both delta and beta mutants well,” said the lead researcher for the Booster Study.
It also followed up on people who received the third dose of vaccination. and check the immune level after a long period of time, approximately 4-5 months after the third dose.
It was found that the immune level dropped 5-10 times as compared to 2 weeks after the injection, which made us know that When there is an epidemic of mutation It may be necessary to initiate a 4th needle stimulation injection in frontline personnel and high-risk groups. especially those who received sinovac- sinovac-astra after the last dose for more than 3 months”
Asst. Prof. Dr. Suwimon Niyomnaitham, MD. Deputy Director of Siriraj Clinical Research Center added that Switching to different types of vaccines will make the body’s immune cells stronger.
However, the properties of the vaccine are important.
because the research team found If the third dose was stimulated with an inactivated vaccine In this study, the Sinofarm vaccine was used. The results showed that the immune system did not increase. or the person who injected the second syringe with the vector virus and then stimulate the third needle with lethal germs. The immunity did not increase as well.
including three injections of vector virus The immune level was only slightly increased. In addition, our study found that Pfizer booster, which is the third cross-dose formulation. Even with only half a dose it is very effective.
“Therefore, the selection of the COVID-19 booster syringe is recommended for those who vaccinate the first two doses of Sinovac or Sinofarm. Immunity can be stimulated with either a virus vector or mRNA (Pfizer or Modena).
But for those who have taken two doses of AstraZeneca, the recommendation for the third dose must be mRNA only to boost immunity high enough to protect against mutations.”
Immediate vaccination
Prof.Dr. Kunkanya suggest that Get vaccinated as soon as possible, especially for those who haven’t received the first or second dose to reduce the risk of infection and severe symptoms. especially the people at risk groups, known as the “608” group.
which consists of 3 main population groups, namely elderly people aged 60 years and over, patients with 7 congenital diseases, namely chronic respiratory disease, cardiovascular disease, chronic renal failure, stroke, obesity, cancer and diabetes And finally, the group of pregnant women aged 12 weeks or more.
“If we have completed two vaccinations across the country People will have enough immunity. We now have about 30% of the population who have not been vaccinated. or injected with just one needle which is very worrying
Therefore, the mobilization of one and two injections must be accelerated as much as possible. In which the cross-injection formula in the second needle results in a high degree of immunity. For those who have received the second vaccination for more than 3 months, it is recommended to get the booster as well.”
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