Spain to restart AstraZeneca vaccine with new side-effect warnings and procedures

SPAIN will restart administration of the AstraZeneca or 'Oxford' vaccine from this coming Wednesday (March 24) based upon a European Medicines Agency (EMA) verdict that it is 'safe and effective' and that the 'benefits outweigh the risks'.

Meanwhile, scientists have been studying the thrombosis issue and working out the warning signs and immediate and effective treatments, and who is most likely to experience these side-effects, in a bid to prevent any future issues arising.

A few dozen cases of clotting disorders have been reported across Europe, including several deaths, in a target group which is typically young and with no pre-existing physical health conditions.

The three deaths in Spain include Pilar G., a 43-year-old high-school teacher from Marbella.

Researcher Andreas Greinacher of the Paul Ehlrich Institute in Germany attributes the thrombosis cases to a 'very rare immune response' where the medicine formula produces antibodies in the blood which activate the platelets, causing these to clot.

This explains, he says, why the cases of venous thrombosis – 13 in Germany out of 1.6 million people vaccinated – come accompanied with a low platelet count.

It mirrors a disorder known as 'thrombocytocaemia through heparin', where levels of platelets fall drastically within five to 14 days after being treated with heparin, an injectable anti-clotting agent.

This reaction is almost identical to that seen in a very small number of people – in Spain, all aged under 55 – who have had the AstraZeneca vaccine, and which is treated by injecting high doses of immunoglobulin intravenously.

Even though these findings do not rule out that the thrombosis cases may have had other causes, they give a clear indication as to the signs to look out for, what to test for, and how to treat people whose platelet count hints they may have become affected.

'Normal' side-effects of the vaccine, such as 'influenza-like symptoms' – muscle and joint pain – appearing one or two days after being immunised 'should not cause undue concern', the research report states.

Those for which recipients of the vaccine should seek immediate medical attention include dizziness or feeling faint, headaches, blurred or otherwise altered vision, trouble breathing, or pain in arms or legs that last three or more days.

German health authorities have now updated their set procedures so as to respond effectively to any possible cases. 

Also, in the UK, where the vaccine was created – and where it is, in fact, being administered to the over-65s – people who have received it are urged to seek medical attention straight away if they notice unexplained bruising or suffer headaches.

In Spain, the AstraZeneca jab has only been given to the under-55s and, at the time of its cessation, was being administered to teachers in State and private schools and colleges, health and care workers not on the front line – such as physiotherapists – home carers including family who do so as non-professionals, and 'essential' workers such as police, Armed Forces and firefighters.

Health minister Carolina Darias says the government will 'make a decision as to which communities' will be given the jab from Wednesday onwards, but has not provided details as yet.

It is likely the 'Oxford vaccine' will be limited to certain age groups or avoided for those with a greater risk of suffering 'thrombosis-like events'.

At the moment, the majority of those who have reported these – although not exclusively – have been women.

A final meeting will decide upon the target groups and sign these off on Monday, in order for instructions to be given to regional governments on Tuesday.

The Spanish Medications and Healthcare Products Agency (AEMPS) stresses that the thrombosis cases, where they occur, happen within 14 days of the vaccine, and that 'special attention' should be paid to symptoms appearing within the first two to three days.

This initial period is when 'normal' side-effects will occur, and few drugs are exempt from these.

Persistent headaches, especially those which worsen when lying down or changing position, blurred vision, inflammation – particularly where this is sudden – chest pains, reddening, breathing problems, fever, abdominal pain which may be sudden or persistent or both, are all signs a vaccinated person should look out for.

The best course of action is to either attend one's nearest walk-in clinic or, if waiting times in these run into several hours, simply call the 112 emergency service hotline, where several languages are spoken.

Unusual symptoms may not be caused by blood clots or haemorrhaging, but may be other, extremely rare – albeit not impossible – conditions, such as an allergic or anaphylactic response, or an infection resulting from the needle site.

Fast attention by qualified medical professionals can ensure that even if a dangerous reaction is experienced, this can be swiftly resolved with no permanent damage.