No mixed Covid-19 booster shots for China until scientists are sure, top disease expert says

A mix-and-match strategy may even be better than a third jab using the same vaccine, but regulators must wait for confirmed data, Shao Yiming told CCTV
A virologist at the University of Hong Kong described China’s insistence on using the same vaccine as a booster as ‘conservative’

Coronavirus pandemic

Linda Lew

Published: 6:00pm, 23 Oct 2021

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A mix-and-match strategy for Covid-19 booster shots could help raise immunity in the vaccinated population, but state regulators would need more scientific data before they could approve such an approach, one of China’s top epidemiologists has said.

In an interview with national broadcaster CCTV on Thursday, Shao Yiming, an epidemiologist with the Chinese Centre for Disease Control and Prevention and part of the country’s Covid-19 vaccine response team, explained that a mix-and-match strategy – receiving a different coronavirus vaccine as a booster – could be effective in sparking a stronger immune response.

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“From a scientific perspective, we understand that the mixing and matching of vaccines – including [what we have observed] in the use of vaccines for other diseases – can yield practical results that are as good as taking a third shot using the same vaccine,” Shao said.

“In some cases, mixing and matching may even give better results.”

But regulators can only give the green light when there is sufficient data to confirm safety and effectiveness, he added.

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“In that sense, we need to speed up our research to collect more data. Right now, the regulators’ decision is still that the booster should use the same vaccine [instead of mixing and matching],” he said.

“But once we receive more data from different types of vaccines, we will then make new recommendations,” he added.

China, which has vaccinated just over 80 per cent of the population, has begun to roll out booster shots especially for high-risk and vulnerable groups in recent months but maintained that the extra jab should be of the same vaccine as in the original regimen.

Shao reiterated that China would give the third jab in an orderly way, similar to how vaccines were first trialled – starting with high-risk and vulnerable groups, then gradually rolling them out to the general population.

“Medical workers, border staff, and workers processing import shipments at ports are at the highest risk. So the third shot will start with them,” he said.

06:05

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Shao’s comments came as the US CDC on Thursday approved the mixing and matching of mRNA vaccines, such as Moderna, with Johnson & Johnson, which uses a more traditional method involving a disabled adenovirus, for the booster shot.

Jin Dong-Yan, a virologist from the University of Hong Kong, has described China’s insistence on using the same vaccine as a booster as “conservative”.

A guide published by People’s Daily, the Communist Party mouthpiece, on the social media platform Weibo on Thursday said that many places across China were offering booster shots to those aged 18 and over, and fully vaccinated for at least six months.

Meanwhile, CCTV also reported that medical workers and those working at locations with high exposure to imported Covid-19 cases such as airports, as well as vulnerable groups, who had been fully vaccinated for at least six months should receive a booster shot.

Beijing, which is preparing for the 2022 Winter Olympics in February, kicked off its booster shot programme on Wednesday. Organisations with high-risk exposure to Covid-19 were asked to arrange for their staff to be immunised en masse, while individuals meeting the criteria for the shot could book appointments, according to the Beijing CDC.

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The booster drive comes as China battles a resurgence of cases that has spread to several provinces and aims to strengthen defences against Covid-19 ahead of winter.

Users on Weibo, China’s answer to Twitter, voiced fears that the booster shot could become increasingly mandatory, as grass-roots party cadres have sometimes defied recommendations from national authorities in order to complete quotas.

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The National Health Commission has repeatedly said Covid-19 vaccination is voluntary, but many authorities have made it impossible to enter public spaces without a health QR code that showed the person was vaccinated.

“Tasks are going to be delegated to the local authorities again,” one user wrote under the CCTV report about the booster shot.

According to the NHC, more than 2.24 billion doses of Covid-19 vaccines had been administered as of Friday, with more than 1.05 billion people fully vaccinated as of the end of September. Most of the vaccines administered in China require two doses.

00:55

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A Weibo user said officials in their village announced via loudhailers that people who had been fully vaccinated for at least two months could get the booster shot, before correcting themselves the next day to say that the gap should be at least six months.

Social media users also asked questions such as should pregnant women or those planning to conceive get the shot, and whether it was safe for someone who had been recently inoculated for another virus, such as the human papillomavirus.

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Chinese pharmaceutical companies have developed five different kinds of vaccine technologies, with Sinovac and Sinopharm’s inactivated vaccines – which use dead virus particles to train the immune system – administered to most people in the county.

An mRNA shot that uses messenger RNA (ribonucleic acid) to teach cells in the human body to make a protein to trigger an immune response, developed by the Academy of Military Medical Sciences and two other companies, is due to launch in the Chinese market.

This article appeared in the South China Morning Post print edition as: ‘More data needed to permit mixed boosters’