The German government has decided that the Oxford/AstraZeneca vaccine should be used only on people over the age of 60, amid concerns over possible side-effects.
The decision was taken on Tuesday evening by federal and regional health ministers. The text of the decision said those younger than 60 can still receive the jab but only “at their doctor’s discretion” and at their own risk.
The ministers were following a recommendation of Stiko, the standing commission that advises the German government on vaccines. It said it was based on data regarding “rare but severe” blood clots that had formed in some people who received the jab. Symptoms had emerged 4-16 days after the vaccination chiefly in people under the age of 60, it said.
Angela Merkel, the German chancellor, said it was “great good fortune” that there were so many vaccines available. But “the whole vaccination campaign rests on the principle of trust. We have to be able to trust the vaccines,” she said after a video conference with the leaders of Germany’s 16 federal states.
Asked if the latest move by the government would destroy faith in the AstraZeneca jab, Merkel said the authorities couldn’t just “sweep everything under the carpet” and “not take the cases [of blood clots] seriously”.
“Openness and transparency are the best way of dealing with this situation,” she said.
Jens Spahn, the German health minister acknowledged it was a “setback that one of the vaccines available to us in this pandemic apparently presents a heightened risk for a certain age group”.
But he insisted the AstraZeneca vaccine was “very effective” and said it would now be given to people over the age of 60, even if it wasn’t technically their turn to be vaccinated.
Some states, such as Berlin and Brandenburg, the region that surrounds the capital, had already decided unilaterally on Tuesday to stop giving the AstraZeneca vaccine to people under the age of 60.
Dilek Kalayci, Berlin’s top health official, said: “This vaccine does prevent severe symptoms, and is very valuable, but we have to be careful with it nonetheless.” She described the decision to suspend use of the jab in Berlin as a “precaution”.
Germany’s move is a fresh blow to Europe’s mass inoculation campaign, just as it was beginning to pick up speed after a sluggish start over the winter.
Germany was one of a number of countries in Europe that suspended use of the AstraZeneca jab earlier this month over concerns it may cause blood clots. But many of them reinstated the vaccine after the European Medicines Agency insisted it was safe to use.
France has limited use of the AstraZeneca vaccine to the over-55s and Sweden has limited it to the over-65s. Norway and Denmark extended their complete suspension of the vaccine for another three weeks on 26 March.
In Canada this week health officials also suspended plans to give the vaccine to younger people over the same concerns about blood clots.
Germany’s main vaccine agency, the Paul Ehrlich Institute, had reported 31 cases of a rare brain blood clot occurring in people who had received the AstraZeneca vaccine. Nine of them died.
All but two of the 31 cases were reported in women aged between 20 and 63. The two men were 36 and 57.
“Although many more women were affected, Stiko is restricting its recommendation as a precaution for both sexes,” the commission said.
Earlier on Tuesday, Berlin’s Charité and Vivantes hospitals suspended inoculations of its younger female staff with the AstraZeneca jab, citing the risk of blood clots in the brain.
“This step is necessary in Charité’s view because we have become aware in the meantime of more cerebral venous thromboses in women in Germany,” said Charité.
According to the text of the health ministers’ decision from Tuesday evening, Germany’s 16 regions can now start giving the AstraZeneca jabs to the 60-69 age group. “This means that we will be able to vaccinate this especially endangered and large age group quicker, in view of the growing third wave of the pandemic,” they said. Vaccinations in Germany are currently being carried out on people aged 70 and over, under a strict system of “priority groups” largely defined by age.
AstraZeneca said: “Regulatory authorities in the UK, European Union [and] the World Health Organization have concluded that the benefits of using our vaccine to protect people from this deadly virus significantly outweigh the risks across all adult age groups.”
The company said it was continuing to analyse its database “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.”