Q & A on COVID-19 Vaccine

p1-QnA

Answer by Dr Rajiva De Silva (mainly) & Dr Kanthi Nanayakkara

p2-QnA
  1. 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.

  1. 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

  1. 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

  1. 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

  1. Breast feeding mothers - at any time after birth?

Any time

  1. 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.

  1. 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

  1. Better vaccine for younger generation 18 to 30?

Anything OK

  1. Better vaccine for over 60 years?

Sputnik not given
Sinopharm no data but given
Others can be given
No head to head comparison

  1. Should there be  concerns regarding the vector used in the 2nd dose of sputnik?(rAD5)

No

  1. Assuming Pfizer is available, can we after 4 months have passed (Post 1st dose of Covishield) re start with Pfizer?

No data

Author: Piume madushani