Answer by Dr Rajiva De Silva (mainly) & Dr Kanthi Nanayakkara
- What is the time gap should be maintained between COVID-19 vaccine and other vaccines importantly ARV, ARS Toxoid and Hepatitis B?
Gap should be 2 weeks. Reason being if side effects occur, cannot determine the culprit vaccine. However, if delay is unacceptable, such as with rabies, it is ok to give ARV at any time.
- If the 2nd vaccine dose (AZ Covishield) is delayed more than 6 months, is it okay to get the second and consider as completed, or do we have to restart again
No need to restart schedule
- Vaccines for immunosuppressed:
- If on immunosuppressive treatment - ?Vaccine/which one better
No head to head comparison. Suggest giving AZ/Pfizer if available. Sputnik no data
- Pts on steroids- Do they need to stop taking steroids/ if so how long before & after
No data with sputnik.
Sinopharm, WHO has not labelled as contraindication. AZ - Can give
However, immune response will be reduced
Do not compromise treatment of primary disease. If can stop/reduce (2 weeks), response better
- People planning pregnancy: To take vaccine/To postpone pregnancy - if so how long
WHO has said Sinopharm can be taken in pregnancy. However, in SL, suggest giving after 1st T
UK - Pfizer/Moderna preferred.
If AZ given as 1st dose, and becomes pregnant, can give AZ as 2nd dose
- Breast feeding mothers - at any time after birth?
- What if Covishield 2nd dose not available
AZ 1 dose may be protective against Wuhan strain for up to 6 months.
May have responses against B 1 1 7 as well. Data in SL shows reduced response after 1 dose.
B 1 617 2, one dose effectiveness 33% (AZ, Pfizer). If delayed and Indian strain spreads in SL may then cause problems.
- What if Sputnik 2nd dose not available?
Gamaleya says 2nd dose can be delayed up to 90 days. BUT NO DATA
Sputnik light one dose effective, but no data. S Light = Sputnik V 1st dose
- Better vaccine for younger generation 18 to 30?
- Better vaccine for over 60 years?
Sputnik not given
Sinopharm no data but given
Others can be given
No head to head comparison
- Should there be concerns regarding the vector used in the 2nd dose of sputnik?(rAD5)
- Assuming Pfizer is available, can we after 4 months have passed (Post 1st dose of Covishield) re start with Pfizer?