Alison Toni considered herself fortunate to receive Sinovac’s COVID-19 vaccine earlier this year in Chile. A month later, she was back in Minnesota for another round of vaccinations.
Toni, an American living in Chile, was in Minneapolis in April visiting her parents when she received her first Pfizer shot at a CVS pharmacy. In June, she returned for the second dose. She didn’t mention previous vaccinations.
“They didn’t ask, and I didn’t tell,” Toni, 55, explained, 55. She took that step after learning that China’s Sinovac vaccine was less effective than Pfizer Inc’s shot, developed in collaboration with German partner BioNTech, and Moderna Inc’s shot, both of which are widely available in the United States. Additionally, she consulted with her physician beforehand.
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Toni is one of a growing number of international visitors who have received a second vaccination in the United States or intend to do so.
Their reasons range from concerns that the vaccines immediately available were ineffective to fears that they require additional protection against the rapidly spreading Delta variant or a requirement to meet specific work or travel requirements. Some seek medical advice, while others conduct their own research.
Several countries are also beginning to offer a third booster dose to their citizens, based on evidence that vaccine protection diminishes over time or that an additional shot may help prevent infection with Delta, particularly in older adults and those with weakened immune systems.
Public health officials have not determined whether booster doses are necessary for the general population, and little data on the relative risks and benefits of complete revaccination are available.
“It is probably more than is needed,” said Jason Gallagher, an infectious diseases expert at Temple University’s School of Pharmacy. “A fourth dose is probably a waste; a third dose is probably unnecessary for a lot of people.”
The World Health Organization (WHO) has urged countries to delay booster vaccinations while many people worldwide await their initial doses.
Ricardo Dayne, 36, a Chilean engineer who received his first Sinovac vaccine at home in April, received his first Pfizer shot in June in New York.
“Everyone was also talking about the need to have a booster, so I decided to have it.”
‘PROCESS NEEDS TO BE FIXED’
The US Food and Drug Administration (FDA) approved a third vaccine dose for immunocompromised individuals last week. Government health officials estimate that would apply to less than 3% of the adult population in the United States, but have stated that boosters may eventually be required more broadly.
Meanwhile, the United States’ vaccine surplus, combined with a decentralised healthcare system, has made it easier for people to visit pharmacies and vaccination centers for additional doses. Over 1.2 million Americans, according to the US Centers for Disease Control and Prevention, have already received at least one additional dose following their initial vaccination.
When journalists inquired about travellers doubling up on vaccines, Moderna informed Reuters that its vaccine was not approved for this purpose, and J&J referred Reuters to the FDA and CDC. Pfizer did not respond to a request for comment immediately.
According to a CVS Health Corp spokesperson, the company’s policy is to deny service to patients who have been fully vaccinated at one of its pharmacies or who disclose having been fully vaccinated elsewhere. According to a Walgreens spokesperson, its pharmacies ask patients about vaccination status during the appointment process and have alerts in place to verify.
Jing Wu, 22, a graduate student, stated that he had no choice. Wu received the Sinovac vaccine in December before moving to the United States to attend Princeton University.
He was informed that Princeton intended to require proof of an FDA-approved vaccine. The university’s health service advised him to repeat the vaccination and assured him that it would be safe.
He was not reassured.
“I was nervous and stressed about it, but in April I got vaccinated (again),” he said, this time with the Johnson & Johnson shot.
Princeton announced the policy on April 20 but later decided to accept any WHO-approved vaccine, including Sinovac. The university’s health website still states that “there is no known harm from taking additional” vaccines.
The university did not respond to requests for comment.
“If I knew back then the Chinese vaccine would be enough, I wouldn’t have done it,” Wu said.
The United States is developing a plan to require nearly all foreign visitors be fully vaccinated, potentially creating similar issues for many people inoculated with vaccines not approved by the FDA.
Britain and the European Union’s lists of approved vaccines do not include shots made in Russia or China, which have been used in many countries.
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Governments should standardize their definition of fully vaccinated to include shots that may not be approved in their countries, but which are still effective, said Dr Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security.
“This whole process needs to be fixed, otherwise, as we get more vaccines and more people traveling, this will only happen more,” Adalja said. (Reporting by Ahmed Aboulenein; Additional reporting by Aislinn Laing in Santiago, Carl O’Donnell and Michael Erman in New York; Editing by Michele Gershberg and Aurora Ellis).
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