Booster and mix-matching doses rolled out for all COVID-19 vaccines

Tujoromajo Kasuto

All vaccination centres have commenced with the voluntary administration of 3rd dose/booster of Sinopharm, AstraZeneca and Pfizer BioNTech vaccines to eligible individuals.

The same type of vaccine should be used in the primary/initial series. However, if the same product is not available, or in case of an allergic reaction to one vaccine, another COVID-19 vaccine can be administered.

Executive Director (ED) in the Ministry of Health and Social Services (MoHSS), Ben Nangombe, says research has been conducted on the safety and effectiveness of mix-and-matching of COVID-19 vaccines. Findings have shown that persons who receive two different COVID-19 vaccines generate potent immune responses. Where side effects are reported, they are not worse than those caused by standard regimens.

Namibia’s Vice President, Nangolo Mbumba, today kick started the administration of booster doses and mix-matching COVID-19 vaccines at the Windhoek Central Hospital, he received a Pfizer dose after he was fully vaccinated with Sinopharm earlier in the year.

Mbumba encourages all Namibians to take vaccination seriously and to show up in numbers. “We need to believe in our health system so we don’t inconvenience our families by being rushed to hospitals at wrong hours as no country can put up health facilities and qualified officials and then accuse them to endangering our health,” he says.

3rd/booster doses of the vaccine are advisable and may be administered voluntarily for moderately or severely immune compromised persons.

An additional dose for persons with malignancies, recipients of solid organ or stem-cell transplants, primary immunodeficiency, HIV/AIDS not controlled with antiretroviral therapy, and persons receiving immunosuppressive therapy should be given during a period of one to three months or at the earliest opportunity if more than three months have elapsed following the administration of the standard primary series (after being fully vaccinated).

An additional COVID-19 vaccine dose (3rd dose) is and may be administered voluntarily for those older than 60 years who have received two doses of the Sinopharm vaccine. An interval of three to six months is recommended between the second and third doses.

All Covid-19 vaccines available in Namibia have been associated with substantial reductions in the risk of severe/critical disease as well as preventing death due to COVID-19. However, scientific evidence suggests that COVID-19 vaccine-induced immunity wanes with time; thus, additional doses are advised to boost the required level of protection against COVID-19 disease severity.

Last month the MoHSS introduced a “third dose” of Sinopharm vaccine for persons fully vaccinated with Sinopharm. In addition, COVID-19 vaccination with Pfizer BioNTech vaccine was expanded to children aged 12-17 years.

WHO supports the administration of additional (booster) doses because the primary vaccination series may not induce an adequate immune response in some population groups. This may be the case with immunocompromised persons and in older adults.

In such instances an additional dose of a vaccine may be required as a part of an extended primary series to optimise or enhance the immune response to establish a sufficient level of protection and efficiency.

The United States of American (USA) Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) indicate that a booster dose of a different vaccine from the type used for the primary series (i.e., a heterologous booster) can be used. However, the interval and indications for the booster dose depend on the vaccine given for the primary series.

Currently, WHO recommends that the mix-and-matching of vaccines be considered in cases of severe adverse reaction to the first dose, or shortages of vaccines in jurisdictions.

If an individual is travelling to a country where a vaccine they have received is not recognised, that individual can be given a vaccine recognised in the country of destination if travelers present documents as evidence of the intention to travel.

MoHSS issues this guidance regarding booster shots and mix-and-matching options based on the above background.

In addition, all individuals 18 years and older who are fully vaccinated and visit Vaccination sites to receive booster doses (as tabulated in Table 1 above) should not be turned away.

Vaccinators must obtain informed consent before administration of any 3rd/booster doses.


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