Norway and Denmark have decided to extend the AstraZeneca break for three weeks, while countries such as Iceland, Finland and Sweden have decided to resume use of the vaccine in the elderly. Chief Physician Are Stuwitz Berg at National Institute of Public Health explains the reason why the countries are divided.
– We have a close and good dialogue with our neighboring countries. We have had several meetings in the past few weeks, and knew about their decisions. I think we have ended up in slightly different places because you may have been affected by the cases you have seen in your own countries, and the different infection situations, such as in Sweden, Berg tells Dagbladet.
He emphasizes that the countries have also made similar assessments related to not resuming the use of the vaccine in younger age groups.
– Finland and Sweden have probably placed more emphasis on the risk of serious covid-19 disease in people over 65 years being higher than for younger people, says Berg.
Sweden and Finland have decided to resume use of the vaccine in people over 65, Iceland has decided to resume use in people over 70, while France has resumed use in people over 55. Other countries choose to offer the vaccine to all adults.
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Vaccine breaks
The vaccine break was implemented after a serious and very rare course of the disease was discovered in a few patients who had received the AstraZeneca vaccine. Patients developed blood clots, low platelet counts and bleeding. A connection between vaccination and the rare course of the disease has not been established, but it cannot be ruled out either.
– This disease picture is something that the experts have not really seen before. It is a very unusual picture of the disease, says medical director Steinar Madsen at the Norwegian Medicines Agency to Dagbladet.
National Institute of Public Health states in a statement that they are considering three possible alternatives for further use of the vaccine: 1) Continue as before the break. 2) Offer the vaccine only to people over 65 years of age. 3) Continue the break.
– In Norway, we have seen cases of this rare disease course in people over 50 years. At the same time, we have almost not vaccinated people over the age of 65 with the AstraZeneca vaccine, and feel that we still have a little too little knowledge about it, says FHI chief physician Berg.
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Meeting activities
Medical director Madsen says that there is intense meeting activity among European experts.
The European Medicines Agency (EMA) has convened an independent expert group to hold a meeting on Monday, while the regulator’s committee for drug safety (PRAC) will also hold a meeting next week.
Madsen says that Norwegians will probably participate in Monday’s meeting with EMA’s expert group, and that they will discuss everything they now know about the vaccine and the occurrence of the rare course of the disease. The expert group will initially give advice to PRAC, which Madsen hopes can reach an agreement that allows better advice related to the AstraZeneca vaccine in all countries in Europe.
– All medicines and vaccines have a risk, and the pharmacovigilance aims to reduce that risk as much as possible, says Madsen.
– I think there is relatively little doubt that the risk among the elderly is much less, but we would very much like more data on it, and therefore it is wise to take a break so that you can gain experience from the countries that have continued or resumed vaccination of the elderly.
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Great Britain
Norway has registered five cases of the rare course of the disease, which are relatively many compared to other European countries. Furthermore, the health authorities will closely monitor experiences from the United Kingdom. This is because they have vaccinated over 11 million people with the AstraZeneca vaccine, but reported only a few cases of the rare course of the disease.
– Why has Norway registered so many cases of the rare disease course compared to other countries?
– This is one of the questions we are curious about. The course of the disease is still rare, and there are few cases in Norway, and perhaps it is coincidences that have led to us coming out so unfortunate, says Berg at FHI and continues:
– It may also be that there are conditions in other countries that have led to them not being able to find all the cases, such as other reporting systems or that the health service is larger and more burdened.
– Why has the United Kingdom registered relatively few cases?
– We are first and foremost curious about what surveys the UK has done. We have contacted our British colleagues to find out more about this. This is something other countries in Europe are also curious about.
