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Philippines suspends AstraZeneca vaccination of people under 60 amid blood-clots reports

By Tanya Lara Published Apr 08, 2021 1:51 pm Updated Apr 14, 2021 12:32 pm

On the recommendation of the Philippine Food and Drug Administration, the country has suspended AstraZeneca vaccination of people under 60 years old. 

In a joint statement with the Department of Health (DOH), FDA director general Eric Domingo said April 8, “We are aware of the recommendation of the European Medicines Agency (EMA) to list blood clots as very rare side effects of the AstraZeneca vaccine. While we have not seen such incidents in the country, the FDA has recommended to temporarily suspend the use of the vaccine for persons below 60 years old as we await results of the review being done by our local experts, as well as the official guidance of the WHO.”

“I want to emphasize that this temporary suspension DOES NOT MEAN that the vaccine is unsafe or ineffective—it just means that we are taking precautionary measures to ensure the safety of every Filipino. We continue to underscore that the benefits of vaccination continue to outweigh the risks and we urge everyone to get vaccinated when it's their turn,” Domingo added.

The National Adverse Events Following Immunization Committee (NAEFIC) has not received any local reports of such side effects. The DOH and FDA are carefully monitoring the rollout of vaccines to identify and appropriately manage any possible adverse events.

Based on current global data, a person is 90 times more likely to be struck by lightning than die from brain blood clots after getting vaccinated with AstraZeneca, according to an AFP report.

Domingo said in a Viber message to DOH reporters that they will review the data and prepare before the next batch of AstraZeneca vaccine arrives. "The review will be completed before the schedule of the second dose.”

The FDA also admitted that the Philippines has run out of AstraZeneca vaccine. New supplies are due to arrive in May, according to the agency.

What happens if you miss your second dose?

Time magazine reported, “While a three- or four-week gap between shots is ideal, the US Centers for Disease Control and Prevention (CDC) says you can get your second shot within 42 days of the first one and still mount a full immune response.”

“Beyond that, we start to operate in an area where there’s simply less data,” Dr. Adam Ratner, a pediatric infectious disease doctor at NYU Langone Health and a vaccine researcher, said.

Another expert, Dr. Ashley Drews, medical director of infection prevention and control at Houston Methodist, said, “What we don't know is how effective either vaccine is when delayed beyond six weeks, but getting your second dose is still recommended and likely to be beneficial," Dr. Drews says. "Even if your second dose is significantly delayed, you do not need to start the vaccine series all over. You should just get the second dose to complete the series as soon as possible.”

With the Philippines’ order and delivery of vaccines being delayed, can you mix vaccines? Let’s say, AstraZeneca for the first jab and Moderna for the second?

No, according to experts. At least not yet.

The UK’s NHS is conducting a study on the efficacy of combining two different vaccines. Called Com-COV study, the trial’s purpose is to see how well people’s immune systems respond when they are “primed with one type of vaccine, then boosted with another and to see how good the response is when the second dose is separated from the first dose by different periods of time.”

Blood clots

According to the Philippine FDA, blood clots were not reported as an adverse effect from those jabbed with AstraZeneca.

Across Europe, there have been 222 cases of a rare thrombosis affecting the brain or abdomen among 34 million people inoculated with AstraZeneca. On April 7 the European Medicines Agency (EMA) recommended that a dangerous type of blood clot should be listed as a “very rare side effect” of the AstraZeneca vaccine.

“This thrombosis of large veins is unusually located in the brain, and even more rarely in the digestive tract,” the French Medicines Agency (ANSM) said.

Skynews reported that “there have been 79 reports of blood clots accompanied by low blood platelet count in the UK, all in people who had their first dose.” Of these, 19 people have died but the cause of death has not been established.

The NHS recommends that people under 30 without other health conditions get a different vaccine, while Italy and Spain are recommending the vaccine to be used on people over 60.

While EMA said last week that the link between the vaccine and blood clots “has not been proven but is possible,” other specialists said there is a link as they have not found any other triggering factor.

AFP reported that “someone getting the AstraZeneca vaccine stands a 1-in-153,000 chance of cerebral venous sinus thrombosis (CVST), the blood clot in the brain, or its equivalent for the digestive tract. The risk of death, based on data as of March 22, is one in 1.4 million.

“To put that in a different perspective: the odds of getting hit by lightening in an average lifetime—about 1 in 15,000, according to the US National Weather Service—are more than 90 times higher than dying from a brain blood clots after receiving an AstraZeneca jab.”