‘Mixed dose’ Covid vaccines – what are the rules in France?

'Mixed dose' Covid vaccines - what are the rules in France?
Photo: Pascal Pochard Casablanca/AFP
It's not uncommon for people to have received a different brand for their second dose of the Covid vaccine, but does this make a difference to whether you are counted as 'fully vaccinated' in travel terms?

The practice of giving people two different Covid vaccines for their first and second dose is relatively widespread, but different rules in different countries mean that people vaccinated in this way can run into trouble when travelling.

This is a problem if you wish to go to England, since the UK government refuses to recognise as ‘fully vaccinated’ travellers who did not have two vaccines of the same brand – despite the NHS using this practice in some cases.

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See also on The Local:

Travellers who are not considered fully vaccinated have to quarantine on arrival and pay for two expensive Covid tests.

But while the UK government appears to be an outlier in its travel policy regarding mixed doses, few countries are as enthusiastic about mixing doses as Germany.

The advice from Germany’s STIKO vaccine commission from the beginning of July said studies show the immune response after two doses of different types of vaccine – first vector, then mRNA vaccine – is “clearly superior” to the immune response after two doses of AstraZeneca.

Many thousands of Germans have been vaccinated in this way, including Chancellor Angela Merkel, and there’s even a word for it – kreuzgeimpft or cross-vaccinated. It’s also referred to as the ‘Merkel cocktail’. 

French authorities seem less enthusiastic about mixed doses, which are regarded more as a matter of necessity rather than something done to get a better immune response.

Nonetheless, many thousands of people in France have been vaccinated in this way.

France changed its policy on AstraZeneca vaccinations in March in response to concerns over rare blood clotting risks, saying that the vaccine should only be used for people over the age of 55.

By then thousands of people, mainly health-workers, had already received a first dose of AstraZeneca, so the country’s medical regulator recommended that they receive Pfizer or Moderna for their second dose – health minister Olivier Véran, 40, was one of many who had this combination while over 55s received AstraZeneca for both doses.

For people who got their first dose after March, there has been less mixing, although it is allowed.

Mixing two mRNA vaccines like Pfizer and Moderna is not widespread in France, although it is quite commonly practiced in Canada.

In response to a question from a Canadian reader, the Local asked the French ministry about its attitude to mixed doses of Pfizer and Moderna.

They said: “France does indeed recognise vaccine regimens comprising one dose of AstraZeneca and one dose of an mRNA vaccine [such as Pfizer and Moderna] 

“Concerning the regimens comprising one dose of Pfizer and one of Moderna, the Haut Autorité de Santé has allowed this as a possibility in case of serious pressure on supplies, while expressing reservations as to their perfect interchangeability given the little data we have to date on this subject. Clinical trials were launched in June by the Paris hospitals group AP-HP.

“Nevertheless, this vaccine scheme is recognised as a ‘complete vaccination’ at the border.”

The most common vaccination dose in France is two shots of Pfizer, since this vaccine can be used on any age group and makes up the great bulk of all vaccination administered in France, which is mainly down to supply.

So in short, mixed dose vaccines are fine to enter France with, but bear in mind the other criteria to fulfil before you can be accepted as ‘fully vaccinated’.

To qualify as fully vaccinated, travellers must:

  • Have received a vaccine that is approved by the European Medicines Agency – Pfizer, Moderna, AstraZeneca or Johnson & Johnson (also known as Janssen). The Indian-produced Covishield vaccine is now accepted by France 
  • Be at least two weeks after the second injection for double-dose vaccines or for two weeks after a single dose for those people who had previously had Covid-19
  • Be at least four weeks after the injection for people who had the single dose Johnson & Johnson vaccine
  • If you have a mixed dose, both your doses must be of EMA-approved vaccinations 

Member comments

  1. The statement regarding fully vaccinated is incorrect. It is 7 days after the 2nd dose to enter France according to the interior ministry website. Or has this changed?

  2. As far as anyone knows the UK has just made this up out of thin air without any clinical backup whatever. Moreover it has provided no justification at all. Shameful nonsense, but not of course unexpected ! It’ll take a while for them to admit they’re wrong too, so lots of people will be fucked over till they do.

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