European countries justified in pausing vaccination to investigate clotting incidents, says public health expert

Netherlands has joined 10 other countries in pressing pause on giving the AstraZeneca-Oxford University vaccine to its people, following reports of blood clots in those vaccinated – a development that brings up the question on how India should proceed with its vaccination programme that includes the AZ vaccine.

“Safety is paramount in any immunisation programme, and governments in Europe are justified in pausing to evaluate the cluster of cases that have been reported from different countries,” says public health veteran, Dr Srinath Reddy.

India’s health administrators should keep track of the international development, but in the absence of similar reports of clotting in India, there is no need to pause the vaccination programme, Dr Reddy, President with Public Health Foundation of India, told BusinessLine.

Vaccines are safe, and the recent events should not be reason to pass a judgement on the vaccine, he said. But an investigation was necessary to understand the reason for the clotting and to reassure people that safety was not being compromised, he pointed out.

Some of the angles that would be looked into include possible manufacturing glitches or changes in producing the vaccinethat could have caused the clotting. And, whether people stopped taking their blood-thinners when they went for their vaccination, he said.

India is within striking distance of vaccinating three crore people, but there is criticism in certain quarters on the limited visibility on the number and nature of adverse events being reported. Dr Reddy, however, observed that a major clotting incident would have been public knowledge if it had occurred.

Explaining the situation confronting health administrators, he saidunlike a medicine that is given to treat an illness, a vaccine is given to healthy people to prevent them from getting the illness, and if they do, to ensure it was not severe. It is approved only when the benefits outweigh the risk. But the “broader good” aside, people are justified in being concerned about their individual safety as well.

As clotting reports emerge from Austria to Norway, Iceland and others, he said, governments are in a position to suspend vaccination and investigate the incidents as public health measures are still in place and more vaccine candidates are available.

No causal link

Meanwhile, AstraZeneca clarified that a review of safety data of more than 17 million people vaccinated in the European Union (EU) and UK with their vaccine showed “no evidence of an increased risk of pulmonary embolism, deep vein thrombosis (DVT) or thrombocytopenia , in any defined age group, gender, batch or in any particular country”.

After Ireland suspended its vaccination programme, the United Kingdom’s regulatory authority observed that the clotting did not appear to be linked to the vaccine, and urged people to continue to take it. Similarly, the European Medicines Agency (EMA) said the number of thromboembolic events in vaccinated people was no higher than the number seen in the general population. “As of March 10, 30 cases of thromboembolic events had been reported among close to 5 million people vaccinated with Covid-19 vaccine AstraZeneca in the European Economic Area,” the EMA said, as it continued to investigate the incidents. The World Health Organisation, too, pointed to the EMA findings and said its safety committee would also review the occurrences.