Suspension of AstraZeneca COVID-19 vaccines for those under the age of 65 extended – THL evaluating how it affects the vaccination programme

Publication date 14 Apr 2021

The Finnish Institute for Health and Welfare (THL) takes the line that the AstraZeneca Vaxzevria coronavirus vaccine will still not be given to those under the age of 65. This is because of the extremely rare coagulation disorders observed among recipients of the vaccine in Europe, which the European Medicines Agency (EMA) says could be linked with the AstraZeneca vaccine.

“The vaccinations are continuing among those aged 65 years and older because they have not been shown to have a higher risk of getting the extremely rare coagulation disorders after being vaccinated. The risk of a serious case of coronavirus disease is many times greater among the elderly than among younger people. Coronavirus disease itself is also associated with a significant risk of coagulation disorders, which grows with age”, says THL:n Chief Physician Hanna Nohynek.

However, because of the precautionary principle, the AstraZeneca vaccine is not being given to those aged 65 and over who have previously had cerebral venous sinus thrombosis or heparin induced thrombocytopenia (HIT).

The THL policy is in line with the recommendation issued on Tuesday by the National Advisory Committee on Vaccines (KRAR).

European countries have reported a higher incidence of very rare coagulation disorders among those given the AstraZeneca coronavirus vaccine. The European Medicines Agency EMA concluded on 7 April 2021 that a link between coagulation disorders and the AstraZeneca COVID-19 vaccine is possible. The disorders are very rare. In Europe, the rate is about one for every 100,000 who have been vaccinated.
Three cases have been reported in Finland among the nearly 250,000 who have been given the AstraZeneca vaccine. All the patients have been under the age of 65 and the symptoms have emerged within two weeks of being vaccinated. No increases in other coagulation disorders or cases of thrombosis have been observed.

Using other vaccines to continue the series of vaccines for those under 65 is under consideration
Those aged 65 and over whose first dose was an AstraZeneca vaccine may continue their series of vaccines with AstraZeneca.

Researched information on using different vaccines for the first and second doses is expected to come later. It is already possible to administer other coronavirus vaccines for the second dose by those under 65 years of age whose second dose is scheduled in the coming weeks.

THL is currently considering how to continue the vaccine series.

Introduction of Janssen's vaccine delayed

The vaccine manufacturer Janssen announced on 13 April that deliveries of the company's coronavirus vaccines to EU countries had been suspended indefinitely. The vaccine was given a marketing authorisation by the European Commission on 11 March, but the vaccine has not yet been delivered for use in the EU countries.

According to information from the company the reason for the suspension of deliveries is that a total of six suspected coagulation disorders have been reported among US recipients of the vaccine. A total of 6.8 million people have been given the Janssen vaccine in the United States. Both the Janssen and AstraZeneca coronavirus vaccines are adenovirus vector vaccines.

Pharmaceutical authorities in both the United States and Europe are evaluating the situation.

THL assessing how restrictions on use affect the vaccine programme

Restrictions on the use of the AstraZeneca vaccine could lead to weeks of delays on the progression of coronavirus vaccinations. The delay of the Janssen vaccine could also affect how quickly vaccine coverage expands if the arrival of vaccines in Finland is delayed.

THL is currently evaluating how the slowdown of the vaccine programme will affect the burden imposed by the coronavirus epidemic on and the health and well-being of the population. The aim is to reduce the disease burden caused by the epidemic by continuing the vaccines, preventing deaths and loss of years of life, and securing the carrying capacity of health care. The results of the assessment will be announced as soon as it is completed.

“An adequate vaccination shield among the population forestalls the need for hospital treatment and prevents fatalities. Finland's epidemic situation has improved in recent weeks, but the risk of an acceleration of the epidemic remains significant”, observes Taneli Puumalainen, Chief Physician at THL.

In the past 14 days 5858 new coronavirus cases have been diagnosed in Finland. On 13 April, a total of 183 patients were in hospital care, 38 of whom were in intensive care. A total of 896 people in Finland have died of the disease. The epidemic also has other harmful effects on the health and well-being of the population, and more broadly on the activities of society as a whole.

Further information:

Taneli Puumalainen
Chief Physician
[email protected]

Hanna Nohynek
Finnish Institute for Health and Welfare
Chief Physician
[email protected]

Mia Kontio
Chief Specialist
[email protected]

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