Germany has restricted the use of the AstraZeneca vaccine to people over 60 over fears that it can lead to deadly blood clots.
Health Minister Jens Spahn and state officials agreed unanimously on Tuesday to only give the vaccine to people aged 60 or older unless they belong to a high-risk category for serious illness from COVID-19 and have agreed with their doctor to take the vaccine despite the small risk of a serious side-effect.
Chancellor Angela Merkel later confirmed the restriction in a press conference alongside Spahn, saying that the vaccination programme was based on trust and the expectation that every possible risk was being addressed.
The decision came after the country’s medical regulator announced that it had received a total of 31 reports of rare blood clots in recent recipients of the AstraZeneca vaccine.
Nine of the people died and all but two of the cases involved women aged 20 to 63, the Paul Ehrlich Institute said.
Several European countries temporarily halted the use of the AstraZeneca vaccine earlier this month after reports that it could cause an unusual form of blood clot known as sinus vein thrombosis.
But the European Medicines Agency concluded the benefits of the vaccine outweighed the risks but recommended that warnings about rare side effects should be provided to patients and doctors.
Most European Union countries have since resumed AstraZeneca inoculations, but some of them, including France, Finland, Sweden and Iceland, have restricted their use in elderly populations.
Also on Tuesday, two state-owned hospitals in Berlin announced that they had stopped giving AstraZeneca's coronavirus vaccine to female staff members under 55.
The heads of five university hospitals in western Germany called for a temporary suspension of the vaccine for all younger women, citing the blood clot risk.
Around 2.7 million doses of the AstraZeneca vaccine have been given in Germany so far.
Canada pauses AstraZeneca COVID-19 vaccine for people under 55
Outside Europe, Canada on Monday suspended the use of the Oxford-AstraZeneca coronavirus vaccine for people under age 55 following concerns it might be linked to rare blood clots.
The National Advisory Committee on Immunisation had recommended the pause for safety reasons and the Canadian provinces, which administer health in the country, announced the suspension on Monday.
“There is substantial uncertainty about the benefit of providing AstraZeneca COVID-19 vaccines to adults under 55 given the potential risks,” said Shelley Deeks, vice-chair of the National Advisory Committee on Immunisation.
Deeks said the updated recommendations come amid new data from Europe that suggests the risk of blood clots is now potentially as high as one in 100,000, far higher than the one in one million chance that was previously believed.
She said most of the patients in Europe who developed a rare blood clot after vaccination with AstraZeneca were women under age 55, and that the fatality rate is as high as 40%.
Joss Reimer of Manitoba’s Vaccine Implementation Task Force said despite the finding that there was no increased risk of blood clots overall related to AstraZeneca in Europe, a rare but very serious side effect has been seen primarily in young women in Europe.
Reimer said the rare type of blood clot typically happens between four and 20 days after getting the shot and the symptoms can mirror a stroke or a heart attack.
“While we still believe the benefits for all ages outweigh the risks I’m not comfortable with probably. I want to see more data coming out of Europe so I know exactly what this risk-benefit analysis is,” Reimer said.
The AstraZeneca shot, which has been authorised in more than 70 countries, is a pillar of a U.N.-backed project known as COVAX that aims to get COVID-19 vaccines to poorer countries.
It has also become a key tool in European countries’ efforts to boost their sluggish vaccine rollouts.
“This vaccine has had all the ups and downs. It looks like a roller coaster,” said Caroline Quach-Thanh, the chair of the National Advisory Committee on Immunisation.
Health Canada said it has not received any reports of blood clots in Canada, and the department’s chief medical adviser, Supriya Sharma, said she still believes the vaccine’s benefits outweigh the risks.
Last week, the department changed its label on the vaccine to warn about the risk of blood clots.
Only those 60 and above have received AstraZeneca in Ontario, Canada's most populous province.
“We have no concerns with those who have received it so far,” said David Williams, Ontario's chief medical officer.
Mark Mendelson, a 63-year-old Toronto man who has had heart surgery, said that he has no regrets about getting his first AstraZeneca dose two weeks ago and that he will get the second.
“Get what you can,” Mendelson said. “I had no ill effects at all from the AstraZeneca. I am in a better position than those who don’t have any vaccine at all. If you are a betting person you would take those odds any day of the week. I’m quite prepared to roll the dice.”
Canada is expected to receive 1.5 million doses of AstraZeneca from the US on Wednesday.