Australia said Friday it had ordered more alternatives to the AstraZeneca vaccine, postponing the launch of the vaccination, and Hong Kong delayed delivery of the shot amid concerns about the possible very low risk of rare blood clots.
With the Australian decision, plans to vaccinate the entire population by the end of October are effectively paying off, highlighting the delicate public health balancing act that the problem has created.
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Millions of doses of the AstraZeneca shot have been safely administered around the world and millions more have been ordered, but some countries have, as a precaution, restricted its use to older age groups while coagulation cases are being investigated.
Australia said it doubled its order for the Pfizer shot after health officials recommended under-50s to take it in place of AstraZeneca, which had been the mainstay of its vaccination program.
“It’s not a ban on the AstraZeneca vaccine,” Prime Minister Scott Morrison told reporters in Canberra. “There is strong encouragement for those over the age of 50 to take this AstraZeneca vaccine.”
The Anglo-Swedish company respected the Australian recommendation and worked with regulators around the world “to understand the individual cases, epidemiology and possible mechanisms that could explain these extremely rare occurrences”.
European and UK drug regulators said this week that they had found possible links to extremely rare cases of brain blood clots and reiterated the vaccine’s importance in mass vaccination against Covid-19.
The European Medicines Agency received reports of 169 cases of the rare cerebral blood clot in early April after 34 million doses were administered, Sabine Straus, chair of the EMA’s safety committee, said this week.
Most of the reported cases occurred in women under the age of 60.
On Friday, the EMA announced that regulatory action is needed to minimize risk if a causal link is confirmed or deemed likely. It was also said that Johnson & Johnson’s shot was investigated over reports of blood clots.
The AstraZeneca shot is by far the cheapest, highest volume vaccine launched to date. As such, it is likely to be central to many of the global immunization programs that are critical to containing the global pandemic and averting harmful lockdowns.
Germany, one of several European countries that have recommended alternatives to AstraZeneca for those under the age of 60, said on Friday a surge in infections means a new lockdown is needed.
“Every day we do not act, we lose lives,” said Lothar Wieler, President of the Robert Koch Institute.
Hong Kong Health Minister Sophia Chan said the city will delay deliveries of the AstraZeneca vaccine she ordered earlier this year to prevent other countries from falling short.
“We believe that if the vaccine is still in short supply worldwide, AstraZeneca vaccines don’t need to be shipped to Hong Kong this year to avoid wastage,” she said.
The government is considering buying a new type of vaccine that could offer better protection, she added.
The Chinese-ruled city had ordered 7.5 million AstraZeneca cans, which should arrive in the second half of 2021. However, Chan said the global financial center had sufficient alternatives.
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Costa Rica said Thursday it would use the AstraZeneca shot after evaluating EMA guidelines.
More than 40,000 doses of the vaccine arrived in the country on Wednesday. This was the first shipment under a one million vaccine agreement with the World Health Organization’s COVAX mechanism and the GAVI alliance to ensure vaccines reach poorer nations.
All countries that recommend age limits have emphasized that the vaccine is effective and that its benefits far outweigh the risk of getting Covid-19 for the elderly.
The top health authority in France, where the vaccine delay is high, recommended on Friday that those over 55 who received a first dose of the AstraZeneca shot should be given an alternative for the second.
The Haute Autorite de la Sante proposed obtaining a new messenger RNA vaccine, confirming a previous exclusivity from Reuters. Two such vaccines, one from Pfizer and BioNTech and one from Moderna, have been approved for use in France.
Messenger RNA vaccines cause the human body to make a protein that mimics part of the virus and triggers an immune response. AstraZeneca’s shot creates an immune response using a harmless, weakened version of a chimpanzee cold virus.
The French health authority also said that there should be a 12-week interval between the two shots in such cases, and recommended a study to assess the immune responses produced by these mixed vaccine prescriptions.