The EU’s largest countries joined a stream of states halting their rollouts of AstraZeneca jabs on Monday (15 March) over blood clot fears, as the World Health Organization and Europe’s medicines watchdog insisted it was safe to use.
Both organisations will hold special meetings this week after a host of countries said they would stop using the vaccine pending further review.
The fresh suspensions were a major blow to a global immunisation campaign that experts hope will help end a pandemic that has already killed over 2.6 million people and decimated the global economy.
The three largest EU countries — Germany, Italy and France — all paused rollouts on Monday and were later joined by Spain, Portugal, Slovenia and Latvia.
Denmark and Norway stopped giving the shot last week after reporting isolated cases of bleeding, blood clots and a low platelet count. Iceland and Bulgaria followed suit and Ireland and the Netherlands announced suspensions on Sunday.
The suspensions were not limited to Europe, with Indonesia also announcing a delay to its rollout of the jab, which is cheaper than its competitors and was billed as the vaccination of choice for poorer nations.
But the WHO insisted countries should keep using the vaccine, adding that it had scheduled a meeting of its experts on Tuesday to discuss the vaccine’s safety.
“We do not want people to panic and we would, for the time being, recommend that countries continue vaccinating with AstraZeneca,” WHO chief scientist Soumya Swaminathan said.
“So far, we do not find an association between these events and the vaccine,” she said, referring to reports of blood clots from several countries.
WHO chief Tedros Adhanom Ghebreyesus said an advisory committee meeting on AstraZeneca would be held on Tuesday.
The European Medicines Agency (EMA), which is holding a special meeting on Thursday, echoed the WHO’s calls for calm and said it was better to get the vaccine than not.
“The benefits of the AstraZeneca vaccine in preventing Covid-19, with its associated risk of hospitalisation and death, outweigh the risks of side effects,” the agency said in a statement Monday.
The EMA has said that as of 10 March, a total of 30 cases of blood clotting had been reported among close to 5 million people vaccinated with the AstraZeneca shot in the European Economic Area, which links 30 European countries.
Michael Head, a senior research fellow in global health at the University of Southampton, said the decisions by France, Germany and others looked baffling.
“The data we have suggests that numbers of adverse events related to blood clots are the same (and possibly, in fact lower) in vaccinated groups compared to unvaccinated populations,” he said, adding that halting a vaccination programme had consequences.
“This results in delays in protecting people, and the potential for increased vaccine hesitancy, as a result of people who have seen the headlines and understandably become concerned. There are no signs yet of any data that really justify these decisions.”
A senior German infectious diseases physician, however, said the background incidence of 2-5 thromboses per million per year was significantly lower than the number of 7 out of 1.6 million vaccinated people cited by Germany’s health ministry.
“This should be the reason to suspend the vaccination in Germany until all cases, including suspected cases in Germany and Europe, have been completely cleared up,” said Clemens Wendtner, head of the special unit for highly contagious life threatening infections at t
The UK has doled out more than 11 million doses of the AstraZeneca jab — more than the entire EU — apparently without major problems.
The United Kingdom said it had no concerns, while Poland said it thought the benefits outweighed any risks. Belgium’s federal government expressed a similar position.
Officials in Brussels attribute the mess with AstraZeneca to the domino-effect describing it as “political overreaction” following Denmark’s decision. “EU health ministers can take the political responsibility of vaccine deliveries’ delays but when people die, the political risk is enormous”, an official said.
Bad news for the vaccination campaigns
The moves by some of Europe’s largest and most populous countries will deepen concerns about the slow rollout of vaccines in the region, which has been plagued by shortages due to problems producing vaccines, including AstraZeneca’s.
Germany warned last week it was facing a third wave of infections, Italy is intensifying lockdowns and hospitals in the Paris region are close to being overloaded.
German Health Minister Jens Spahn said that although the risk of blood clots was low, it could not be ruled out.
“This is a professional decision, not a political one,” Spahn said, adding he was following a recommendation of the Paul Ehrlich Institute, Germany’s vaccine regulator.
France said it was suspending the vaccine’s use pending an assessment by EMA.
“The decision taken, in conformity also with our European policy, is to suspend, out of precaution, vaccination with the AstraZeneca shot, hoping that we can resume quickly if the EMA’s guidance allows,” French President Emmanuel Macron said.
Italy said its halt was a “precautionary and temporary measure” pending EMA’s ruling.
“The EMA will meet soon to clarify any doubts so that the AstraZeneca vaccine can be resumed safely in the vaccination campaign as soon as possible,” said Gianni Rezza, Director General of Prevention at Italy’s Ministry of Health.
Austria and Spain have stopped using particular batches and prosecutors in the northern Italian region of Piedmont earlier seized 393,600 doses following the death of a man hours after he was vaccinated. It was the second region to do so after Sicily, where two people had died shortly after having their shots.
Italy provided another reminder that the pandemic was far from over — most of the country re-entered lockdown on Monday with schools, restaurants, shops and museums closed.
The streets of central Rome were quiet on Monday morning and businesses already battered by a year of anti-virus measures braced for another hit.
Meanwhile, intensive care doctors in Germany issued an urgent appeal for new restrictions to avoid a third wave as the British variant takes hold there.
As policymakers struggled to manage vaccine rollouts, Estonia’s Prime Minister Kaja Kallas announced she had tested positive — underlining the continuing threat of the contagion.
She tweeted that she would continue to work virtually and the government added that she had “a low fever but no other symptoms and is generally feeling well”.