World Insights: Rare clot incidents impact Europe's COVID-19 vaccine rollout

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by Xinhua writer Chen Wenxian

VALLETTA, April 18 (Xinhua) -- On the heels of recent reports of rare cases of blood clots linked to the COVID-19 vaccine developed by Oxford University and AstraZeneca, the jab produced by U.S.-based pharmaceutical company Johnson & Johnson has hit a similar snag.

Both vaccines, along with two others -- Pfizer/BioNTech's and Moderna's -- have been authorized for use across the European Union (EU) by the bloc's watchdog, the European Medicines Agency (EMA).

The ensuing controversy has dealt a fresh blow to Europe's sputtering vaccine rollout even as COVID-19 continues to rage across the region.

ONE AFTER ANOTHER

On April 13, the U.S. federal health authorities called for a pause in the use of Johnson & Johnson's single-dose vaccine following six reported blood clot cases in the country. A few days later, Johnson & Johnson decided to delay its vaccine deliveries to Europe. To date, the EMA has not advised EU member states to put the use of this vaccine on hold but has initiated a review of the jab.

Meanwhile, some EU countries have already received batches of Johnson & Johnson's easy-to-store vaccine.

A few of them, such as Italy, Denmark or Romania, said they would halt their Johnson & Johnson vaccine rollout pending the EMA's findings and recommendations.

Others, such as France or Poland, continued to administer the Johnson & Johnson jab. France, which received the first shipment of 200,000 doses on April 12, said that it will continue to administer this vaccine to people aged over 55. France's COVID-19 death toll exceeded 100,000 on April 15, government figures showed.

Johnson & Johnson's vaccine was authorized in the EU on March 11, but its widespread use has not yet started.

On April 7, the EMA confirmed a possible link between the AstraZeneca vaccine and the occurrence of blood clots and said that these should be listed as very rare side effects. But EMA experts said that the reported combination of blood clots and low blood platelets is very rare, and the overall benefits of the vaccine in preventing COVID-19 outweigh the risk of side effects.

Despite the EMA's green light, Denmark on April 14 decided to entirely stop administering the AstraZeneca vaccine. To date, Denmark remains the first and only European country to do so.

"Based on the scientific findings, our overall assessment is that there is a real risk of severe side effects associated with using the COVID-19 vaccine from AstraZeneca. We have therefore decided to remove the vaccine from our vaccination program," said Soren Brostrom, director general of the Danish Health Authority.

BLOW TO VACCINATION CAMPAIGN

Troubled by vaccine shortages and slow rollouts, Europe is under heavy pressure to accelerate its vaccination campaign.

Over 100 million jabs have already been administered, more than a quarter of them as second dose. In total, around 27 million Europeans have already been fully vaccinated, European Commission President Ursula von der Leyen said on April 14.

The EU is struggling to achieve its goal of inoculating 70 percent of its adult population by the end of summer.

As of April 16, only 16.93 percent of Europe's total population had received at least one COVID-19 vaccine dose. The world's "front-runners" are Israel (61.72 percent) and the United States (38.20 percent), according to Our World in Data, a project of the United Kingdom-based Global Change Data Lab.

Some European countries have decided to adjust their vaccination age limits or provide alternative vaccines, in response to the public's concerns over the AstraZeneca and Johnson & Johnson jabs' reported side effects, while others chose to extend the interval between the two doses in order to vaccinate as many people as possible.

Britain's Medicines and Healthcare products Regulatory Agency (MHRA) said on April 7 that Britons in the 18-29 age group will be offered an alternative to the AstraZeneca vaccine. Currently, three vaccines -- Pfizer/BioNTech, AstraZeneca and Moderna -- are used in Britain.

Ireland's National Immunisation Advisory Committee said on April 12 that the AstraZeneca vaccine should only be administered to those above 60 and people under 60 who were due to get this vaccine in the coming weeks will instead get another type of jab. Germany's health authorities made a similar decision by recommending that people below 60 who had already received one shot of the AstraZeneca vaccine should receive a different vaccine as their second dose.

In Finland, people under the age of 65 who had received their first dose of AstraZeneca may receive another vaccine as the second dose.

In Bulgaria, people who want to receive their second AstraZeneca shot can have it, but all others will be offered an alternative vaccine. In some of the country's local clinics, the AstraZeneca shot's rejection rate was reportedly high. However, a 77-year-old resident who only identified herself as Mariana said she still wanted to be vaccinated. She went to Sofiamed clinic in a wheelchair and told Xinhua that she did not want to wait any longer.

"It would be very bad if people started questioning whether or not they should have their second dose of this safe and effective vaccine (AstraZeneca), which is essential for ensuring that their immunity to COVID-19 is as effective and long-lasting as possible," said Simon Clarke, associate professor in cellular microbiology at the University of Reading in Britain.

To quickly inoculate as many people as possible, as of April 14 France has extended the interval between the two doses of the mRNA (messenger ribonucleic acid) coronavirus vaccine by two weeks.

EXPECTATION

Although Europe currently lags behind in the vaccination race, there is widespread confidence that the countries' vaccination campaigns will pick up speed and herd immunity will eventually be achieved.

"We are in a race against time," von der Leyen said. "The faster we reach our target of having 70 percent of adults in the European Union vaccinated, the better chances we have of containing the virus."

French President Emmanuel Macron reiterated on March 31 that it was vital "to vaccinate as quickly as possible," and especially those who are "the most fragile." He said that starting on May 15 people aged between 50 and 60 will also be vaccinated. From mid-June, the age limit will be lifted and "all the French people older than 18 who want a shot will be vaccinated by the end of this summer."

The French government aims to administer 20 million jabs by mid-May and to inoculate 30 million people, or two-thirds of the adult population, by mid-June.

"Sweden and the European Commission chose to hedge our bets by signing numerous agreements (with medical companies). This means we will most likely achieve the vaccination goal," Sweden's national vaccination coordinator Richard Bergstrom told local media on April 14.

The vaccination process in Latvia has not been as smooth as expected, which has called the country's chances of achieving herd immunity by August or September into question, but Prime Minister Kirsjanis Karins said he was confident that the country's health ministry was capable of coping with the task of immunizing the population against the virus.

People's willingness to receive the shots in Europe is also increasing. According to a survey conducted by Sweden's Public Health Agency between March 11 and March 22, only five percent of the respondents said that they do not intend to get vaccinated, while 69.5 percent said they definitely want to receive the shots.

Janita Eskelinen, 43, an airline ground crew member from Finland, told Xinhua that she was willing to be vaccinated. "As long as it is a vaccine approved by the EMA, I can accept it. I hope that the extensive vaccination campaign can restore society to normal as soon as possible."

People across the world want to defeat the COVID-19 pandemic and bring the economy and life back to normal. Confidence and cooperation are needed to turn this expectation into reality. Enditem

(Liu Fang in Paris, Chen Jing in Helsinki, Sun Yifei in Sofia, Zhang Jiawei and Jin Jing in London, Zhang Qi in Dublin, Li Deping and Guo Qun in Riga, Yuan Liang in Budapest, Chen Xu in Warsaw, Fu Yiming and Patrick Ekstrand in Stockholm, Lin Jing in Copenhagen contributed to the story.)

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