By Bojan Pancevski
BERLIN -- Germany's government said Tuesday it will restrict the
use of the AstraZeneca PLC's Covid-19 vaccine for people younger
than 60 following fresh blood-clotting incidents among recipients,
potentially presenting the country's sputtering vaccine rollout
with fresh delays.
As of Wednesday, people under 60 will only be able to receive
the vaccine if they specifically demand it, and if their request is
granted by a physician, the government said Tuesday.
The decision comes 12 days after the European Medicines Agency
or EMA, the EU drug regulator, said the vaccine was "safe and
effective" and didn't increase the risk of blood clots.
Chancellor Angela Merkel told reporters on Tuesday night that
the change was prompted by the occurrence of what she called very
rare but very serious cases of thrombosis among younger and
predominantly female recipients of the vaccine.
"We cannot ignore those cases," Ms. Merkel said. She added that
the EMA and the World Health Organization were notified of the
incidents.
Like other European Union countries, Germany has struggled to
ramp up vaccinations amid a shortage of doses and bureaucratic and
logistical bottlenecks. Limiting the availability of the shot for
people under 60 could make it hard for the government to reach its
revised target of offering all residents a vaccine by the end of
September.
"It is without a question a setback that one of our vaccines in
this pandemic apparently poses a higher risk for a specific age
group," Jens Spahn, the healthcare minister, said at the Tuesday
press conference with Ms. Merkel.
However, he said that the country's vaccination plans wouldn't
be derailed by the change in rules as long as all vaccine makers
stuck to their supply schedules. He added the new rules might even
mean the over-60 could be vaccinated faster.
The latest restrictions on the shot's use could exacerbate
already widespread misgivings about the vaccine. Germany originally
authorized the shot only for those under 65 due to a lack of data
about efficacy in older age groups before briefly banning it
altogether for several days earlier in March following initial
blood-clotting incidents.
Since the product's approval earlier this year, local
authorities have reported reluctance to take the shot among those
eligible for it. Ms. Merkel acknowledged that the decision could
shake confidence in the vaccine but said that the damage would have
been greater had the authorities tried to "sweep the issue under
the carpet."
The change in Germany comes after authorities there recorded 31
cases of rare blood clotting in the brain among the nearly 2.7
million people who had received the shot by Monday. Nine people
died, and all but two of the incidents affected women aged 20 to
63, according to Germany's medicines regulator, the Paul Ehrlich
Institute.
"AstraZeneca continues to analyze its database on tens of
millions of records for COVID-19 Vaccine AstraZeneca to understand
whether these very rare cases of blood clots associated with
thrombocytopenia occur any more commonly than would be expected
naturally in a population of millions of people," a spokeswoman for
AstraZeneca said. "We will continue to work with German authorities
to address any questions they may have."
Berlin's decision was based on a new recommendation by the
standing vaccination committee of the Robert Koch Institute,
Germany's center for disease control, which will be published by
the end of the week. The government has so far followed the
recommendations of the committee.
The news comes as Germany is facing a sharp increase in Covid-19
infections despite imposing a succession of lockdowns since early
November. Chancellor Merkel called an emergency conference with the
premiers of Germany's 16 states on Tuesday to discuss the pandemic
response, including the future use of the AstraZeneca vaccine.
The European Union, of which Germany is a member, purchased 400
million doses from AstraZeneca and relies on the shot for about 30%
of its vaccination program.
Germany briefly suspended the AstraZeneca rollout earlier this
month after detecting seven cases of cerebral venous sinus
thrombosis or CVST, a very rare and potentially deadly condition
that causes blood clotting in the brain. France, Italy and other
countries also temporarily halted the use of the shot.
Vaccination in most European countries resumed, however, after
the European Medicines Agency ruled that the vaccine was safe for
general use.
Now, after the number of CVST incidents exceeded three dozen,
all of them people of working age, the German vaccine committee
decided to recommend against its use in younger people. Officials
of the German ministry of healthcare said that the expected
incidence of CVST would be about one case in 1.6 million.
Some nations, such as Norway, haven't resumed use of the vaccine
despite the EMA ruling and decided to wait for more research into
the origin of a condition that appears to affect primarily younger
women, a senior Norwegian healthcare official said.
Two medical teams in Germany and Norway separately concluded
that the CVST incidents, which are often followed by a condition
called thrombocytopenia, were caused by an autoimmune reaction
prompted by the vaccine. The German team of Andreas Greinacher,
professor of transfusion medicine at the Greifswald University
Clinic, published their findings in a study that is yet to be
peer-reviewed.
Prof. Greinacher's team examined nine cases from Germany and
Austria, and suggested that the incidents linked to the vaccine
resemble a rare disorder known as heparin-induced thrombocytopenia
or HIT, which they said is easily treatable with immunoglobulin and
blood-thinning medicine if identified promptly.
The vaccine, the study argues, generates so-called
anti-PF4/heparin antibodies, which then activate thrombocytes that
cause blood clotting. The condition can be diagnosed and treated in
any midsize or larger clinic, Dr. Greinacher said last week.
Write to Bojan Pancevski at bojan.pancevski@wsj.com
(END) Dow Jones Newswires
March 30, 2021 17:21 ET (21:21 GMT)
Copyright (c) 2021 Dow Jones & Company, Inc.
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