All vaxxed up with somewhere to go: Dealing with travel questions about AZ and mixed vaccines

With more than 65% of the country now fully vaccinated against COVID-19 and more than 70% protected with at least one dose, many Canadians are dusting off their passports and pulling their suitcases out of storage. Their trip may not go as planned if their COVID vaccine records show a single or double dose of AstraZeneca, or a combination of any of the three vaccines currently available in Canada. As a result, many Canadians are asking their pharmacists what they can and should do to minimize disruptions to their travel plans. Some are downright angry about following public health guidance to take the first available COVID-19 vaccine. “We definitely hear about these concerns a lot in pharmacy,” said Pam Kennedy, a pharmacist and owner of Bridgewater Guardian Pharmacy in Bridgewater, N.S. “ I haven’t heard of patients directing any negativity about this towards their pharmacist, but for people who travel a lot there’s definitely some pressure.” While there isn’t anything that pharmacists can do about other countries’ COVID vaccine requirements for visitors, there are some steps they can take to address patients’ concerns about taking a trip with their AstraZeneca or mixed mRNA vaccines. Read: Mixed messages for travellers cause confusion Validate their vaccine decisions Whether they chose AstraZeneca and an MRNA vaccine, or a combination of Moderna and Pfizer, reassure your patients that their decision to get vaccinated against COVID-19 was the right one. “Mixing vaccines is valid and objectively protects against COVID, some studies showing as much as two of the same mRNA doses,” said Kyro Maseh, a pharmacist and owner of Lawlor Pharmasave in Toronto. Point them to the right resources Urge your patients to research the COVID vaccine requirements in the countries they’re planning to visit. The most reliable and up-to-date sources for this information are the main government websites for each country but in some cases your patients may need to get in touch with a local consulate or embassy. Remind them about pre-departure and post-arrival COVID testing Make sure your patients also pay attention to requirements for COVID-19 testing before they leave and after they arrive. Each country has specific rules for when the tests should be done—some set the testing window based on departure date while others base it on arrival—as well as the type of test required. Alert them to the possibility of local or site-specific rules Is your patient planning to go to a concert while on vacation, or looking to catch a play on Broadway? Encourage them to check the rules for each of the venues and sites on their itinerary. That will help them avoid missing a show or event (and they might even thank you on Instagram). Tell them to check now, then check again COVID vaccine rules are changing constantly so patients should be advised to monitor the policies in their destination country, said Maseh. In addition to vaccine-specific requirements, the rules for incoming travel are also updated based on each travellers’ country of origin. The United Kingdom, for example, recently moved Canada from its amber list to its green list—an upgrade that reduces the testing requirements and eliminates the need for quarantine regardless of vaccination status. What if they want a booster shot for travel? Quebec is offering a third shot for travellers whose vaccine status isn’t recognized in their destination countries. But the rest of the country is, for now, following the guidance from the National Advisory Committee on Immunization, which says there’s currently no evidence to support the need for booster COVID vaccine doses. If you think your patient may try to get around your province’s rules for boosters, talk to them about the risk of taking this route and suggest they wait until there’s enough evidence—and supportive policy—to justify a third shot. “Policy always takes time to catch up, and some policy makers are just not there yet,” said Maseh. “I'm personally not concerned because I don't see this lasting much longer—policy makers will catch up eventually.” Read: Someone's already tried to bribe a Quebec healthcare worker into giving them fake proof of vaccination

All vaxxed up with somewhere to go: Dealing with travel questions about AZ and mixed vaccines

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