[VACCINEWatch]: Is this infographic including Sinovac vaccine ‘cocktails’ legitimate?

By November 24, 2021 COVID-19, Health, Vaccine

We came across this image being forwarded on WhatsApp:

Below is the image in full:

The image appears to be that of a screenshot taken of a TODAY news article which contains an infographic. Titled “Vaccine Mix-And-Match”, the infographic sets out to provide information on the efficacy of the various ‘cocktails’ of COVID-19 vaccine jabs.

As seen in the infographic, Pfizer, Moderna and Sinovac – the three vaccines approved under the national vaccination programme, are included. This infographic is particularly handy, given that individuals are currently being encouraged to take their booster jabs against COVID-19.

There is no context given as to when this infographic was published, but we see it being credited to the (we assume) graphic designer at TODAY who created it.

Evaluating COVID-19 vaccine ‘cocktails’

For context, Sinovac was only recently included in the national vaccination programme, following the Health Sciences Authority’s (HSA) decision to grant it interim authorisation under the Pandemic Special Access Route (PSAR).

In the announcement dated 23 October 2021, the Ministry of Health (MOH) noted that there are some individuals who choose not to take up mRNA vaccines (Pfizer and Moderna) due to “strong personal preferences”.

However, MOH had noted the lower vaccine efficacy of the Sinovac vaccine, and said that those who can take mRNA vaccines should continue to take two doses of them, following recommendations by the expert committee on COVID-19 vaccination.

Sinovac would also not be offered as a booster to those who received two doses of an mRNA vaccine and did not have adverse reactions or allergies. For this group, a third dose of mRNA vaccine will be offered.

From which article could the infographic have been taken from?

Given that the screenshot was forwarded with no context on when exactly it was published, we did a Google search using the keywords “vaccine mix and match today singapore” and were led to this article on TODAY published on 17 November 2021.

Titled “Explainer: What’s the best mix of Covid-19 vaccines and boosters? Early indications and studies may shed some light“, the article explores vaccine ‘cocktails’, their varying efficacies, and studies published about them.

Lower down in the article, we see a familiar sight – the “Vaccine Mix-And-Match” infographic, but without the inclusion of the Sinovac vaccine combinations.

Below is a side-by-side comparison of both infographics:

As seen, other than the inclusion of the Sinovac ‘cocktails’, the information on both about the Pfizer and Moderna ‘cocktails’ are identical.

The footnotes at the bottom of both infographics are also identical, save for the note about the source of information for the Sinovac vaccine, which indicates that it was taken from the “Chile Ministry of Health (Oct 25)”.

Going back at the TODAY article, we read that while “not much reliable information is available on whether the vaccine’s recipients should take a different dose (after taking Sinovac)”, a reference to a presentation to the World Health Organisation (WHO) by the Chilean government in October which “showed higher effectiveness against COVID-19 when taking a Pfizer shot as a third dose” was made.

The slides for the presentation in question was uploaded on WHO’s website.

The stats listed in the screenshot of the infographic (i.e. 74% effectiveness against COVID-19 for three doses Sinovac; 95% effectiveness against COVID-19 for two doses of Sinovac and one dose of Pfizer) can be seen in the presentation slide below:

What’s the advisory in Singapore?

In an article on The Straits Times, we read that Associate Professor Hsu Li Yang, an infectious diseases expert at the National University of Singapore Saw Swee Hock School of Public Health said that “there are no published studies on the effect of using Sinovac or Sinopharm as a booster after mRNA vaccination”.

While he believes that mixing mRNA and non-mRNA “will give the immune system a boost against COVID-19”, he suspects that “in general, the levels of antibodies post-booster may not be as high as if the individuals had received an mRNA vaccine as a booster”.

Prof Bertoletti of Duke-NUS Medical School told TODAY that it is still an “unproven hypothesis for inactivated virus vaccines such as Sinopharm and Sinovac to be administered as a booster after two doses of mRNA vaccines”, but says that “it may be a good idea” and “can potentially be more protective”.

On 15 November 2021, Health Minister Ong Ye Kung announced that a MOH study found that individuals who took two doses of Pfizer can reduce the risk of infection more effectively if they took a Moderna booster versus another dose of Pfizer.

Then, he said that there are “results for other combinations, such as all three shots of the Moderna vaccine and two shots of Moderna with a Pfizer-BioNTech booster”, but said that the sample sizes are not as large and the “statistics may not be as meaningful”.

Open to misinterpretation when taken out of context

Thus, while it looks like the jury is still out on the efficacies of various vaccine ‘cocktails’, the main question remains – was the infographic which included Sinovac jabs published on TODAY?

From what we understand, TODAY updated the infographic to avoid misinterpretation of the findings. And as evident from the tip-off we received, the original infographic was being forwarded indiscriminately without the accompanying article which provided context for the data presented.

It is also important to note that in the footnotes for both infographics, it was also explicitly mentioned that “the figures from one study should not be used to compare with that from another study”.

Therefore, while the information reflected on the infographics are factually accurate and it is true that the original infographic appeared on TODAY, it appears that it was updated so as to prevent more individuals from taking the information out of context.

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