Norway stopped all use of the vaccine on March 11 after reports of cases of blood clots in people who have received the vaccine. A total of four deaths have been reported.
The AstraZeneca vaccine is given in two doses, every few weeks, and for more than 100,000 Norwegians, the offer of dose two is currently unknown.
– There are quite a few people who are in that situation now. Who has received the first dose of AstraZeneca and now wonders if they should take a second dose of it, or if they should get something else, Nakstad tells Dagbladet TV.
FHI chose last week to postpone the decision, and the AstraZeneca break was extended until 15 April.
– At the moment we do not know how it will be and it depends on effect studies abroad. Most people will probably be offered a second dose. Whether it will be Pfizer, Moderna or another vaccine, we do not know yet.
– Good immunity
Nakstad says that studies have been made of individual vaccines and their effects, and also studies of the effect of only one dose.
– Then you can make calculations. Since this gives different types of immunity, and has different mechanisms of action, it may be that one dose of one vaccine, and one dose of another, give the same effect. But we do not yet have that knowledge. FHI is now looking at this, and they will give good advice to those concerned, he says and adds:
– I think those involved will get at least as good immunity as those who have received two doses of the same vaccine.
Steinar Madsen, medical director, says that the Norwegian Medicines Agency also has great faith that dose two of another vaccine will be a good solution.
– Yes, it is definitely a possibility. It is now being researched whether a combination of vaccines can actually provide better immunity, he says.
The reason is that the vaccines lead to the formation of slightly different antibodies, and that the sum results in better protection against covid-19, says Madsen.
– It has also become more relevant to combine vaccines with the mutations in mind, because some vaccines work better against some mutations than other vaccines.
Investigating Sputnik solution
According to Madsen, a research project has been decided that looks at the possibility of combining AstraZeneca and the Russian Sputnik vaccine. The Sputnik vaccine is not currently approved in the EU.
– One must be aware that no major studies have been done on combining vaccines, but we believe there is little risk that this will lead to unexpected side effects or problems. These are now things that are being considered by FHI, before they make a decision about AstraZeneca at the end of next week.
Although it is now several weeks since the people with AstraZeneca received the first dose, Madsen emphasizes that it is not urgent to be given a dose of two – of either AstraZeneca or any other vaccine.
– The stay between the two AstraZeneca doses is approved to be up to 12 weeks, and it also turns out that the effect of one dose is quite good and seems to get better with time, so there is no rush.
– Special side effect
In addition to studies in Norway and many other countries, the AstraZeneca vaccine is also under scrutiny by the European Medicines Agency EMA. On Wednesday, EMA chief Emer Cooke said they have investigated 62 serious cases, including 14 deaths, of the rare blood clot type that has occurred in people who have recently received the AstraZeneca vaccine.
– The fact that you get a strong immune response that can go beyond the platelet function, so they both clump together into blood clots, but are also removed from the circulation so that you become easily bleeding in addition, it is a very special side effect in that case, if it can be linked to this vaccine, Nakstad believes.
He says that they are now trying to find out why these people have had this reaction.
– Most women
Earlier this week, it became known that the German Hans Ehrlich Institute has registered 31 cases of blood clots in people who have received the AstraZeneca vaccine. 29 of these were women aged 23 to 60 years, and nine of the patients died.
– In the numbers, we see that it is most women who are affected, and it is the case that among younger people, it is mostly women – at least a large majority – who have received this vaccine. This is because among nurses, and those who prioritize personnel, there are more women than men. That is why it can be so simple, that there are simply more women who have received the vaccine, and thus there are more incidents among that group.
– Whether it is age, gender or other things that can make someone extra vulnerable to this, is something you now really go into to find out the most, Nakstad adds.
A causal link between the vaccine and blood clots has not yet been proven, but can not be ruled out, the EMA believes.
The Norwegian Medicines Agency believes that there is a probable connection between the serious cases of the disease and the vaccine.
On Wednesday, the EMA also published a report, dated March 24, which states that a total of 258 serious cases of blood clots and 45 deaths have been registered among people who have received the AstraZeneca vaccine.
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