Clot questions over AstraZeneca and J&J vaccine
Bottles of the single-dose Johnson & Johnson Janssen Covid-19 vaccine await transfer into syringes for administering at a vaccine rollout targetting immingrants and the undocumented in Los Angeles, California on March 25, 2021. The US is calling for a pause on April 13, 2021 on administering the Johnson & Johnson Covid-19 vaccine due to blood clotting concerns.
AFP/Frederic J. Brown

Clot questions over AstraZeneca and J&J vaccine

Paul Ricard (Agence France-Presse) - April 14, 2021 - 7:18am

PARIS, France — The AstraZeneca and Johnson & Johnson vaccines have come under suspicion of causing very rare but serious blood clots in a handful of cases among the millions vaccinated in the drive to bring the pandemic under control.    

Here is what we know about the two vaccines, which are based on the same technology. 

What happened?

The European Medicines Agency last week said unusual blood clots should be listed as a very rare side effect of the AstraZeneca vaccine, although stressing that overall benefits in preventing Covid-19 outweighed the risks. 

The clots occur in veins in the brain — called cerebral venous sinus thrombosis, CVST — as well as the abdomen and arteries. 

They are uncommon both for where they appear in the body and because they occur together with low levels of blood platelets, which help the blood to clot. 

Paradoxically, this can mean the patient has both haemorrhages as well as blood clots.

There were 222 cases of these atypical thromboses out of 34 million AstraZeneca injections carried out in the European Economic Area (EU, Iceland, Norway, Liechtenstein) and Britain, as of April 4, according to the EMA. And there were 18 deaths, as of March 22. 

Most of the cases reported were in women under 60 years of age within two weeks of vaccination.

In the US, where more than 6.8 million single-shot J&J vaccine shots have been administered, health authorities on Tuesday recommended that use of the jab be paused while they investigate six reported cases of CVST that also occurred with low levels of blood platelets.  

All those cases involved women between the ages of 18 and 48 and one case was fatal, officials said.

Suspected causes

Both of these vaccines — as well as the Russian Sputnik V jab — are based on a technique known as "viral vector". 

The vaccines use a common-cold causing adenovirus, modified so it can't replicate, as a "vector" to shuttle genetic instructions into human cells, telling them to create a protein of the coronavirus.

This trains the immune system to be ready for the live coronavirus

AstraZeneca opted for a chimpanzee adenovirus, J&J for a human adenovirus. 

"Whilst a causal link between certain Covid-19 vaccinations, platelet abnormalities and blood clots has not, so far, been confirmed, the index of suspicion is rising that these rare cases may be triggered by the adenovirus component of the AstraZeneca and J&J vaccines," said Eleanor Riley, an immunology professor at Edinburgh University. 

What mechanism?

Although nothing has been proven, Peter Marks of the US Food and Drug Administration said the "probable cause" of the clots could be an unusual reaction to the vaccines.

The FDA has also said that while in normal circumstances an anticoagulant drug called heparin is used to treat these blood clots, in this case administering heparin may be dangerous.

That might be because the disorder resembles a rare reaction to heparin itself, in which the body forms antibodies in response to the thinner, and in turn triggers platelets to form dangerous clots.

A team of German and Austrian scientists made the connection between this previously-known immune response to heparin and the AstraZeneca vaccine in March.

And the EMA said this was "one plausible explanation", calling for more research. 

Balancing risk

The European agency has said no specific risk factors for this type of reaction have been confirmed for the AstraZeneca vaccine, but different countries have opted to restrict access to the jab by age. 

The reasoning is that the older people get, the more they risk developing a serious form of Covid, and the more it is in their interest to be vaccinated, despite potential side effects. 

For example, Britain has said it will not administer AstraZeneca to the under 30s, while France is not using it on the under 55s.   

In the US, health authorities said the suspension of the J&J vaccine was "out of an abundance of caution". 

People who have had the shot within the past three weeks were asked to report to their doctors if they experience severe headaches, abdominal pain, leg pain, or shortness of breath.

Ian Douglas, Professor of Pharmacoepidemiology at London School of Hygiene & Tropical Medicine, said it was important to underscore how rare these events appear to be. 

"To put this into perspective, it's similar to the chance of being struck by lightning in any given year in the UK," he told the Science Media Centre in response to the US announcement.

"On the other hand, the risks from Covid-19 are substantial."  

As It Happens
LATEST UPDATE: May 11, 2021 - 9:57am

Pharma giants Sanofi and GSK said on July 29, 2020, that they have agreed to supply Britain with up to 60 million doses of a potential COVID-19 vaccine. The agreement covers a vaccine candidate developed by France's Sanofi in partnership with the UK's GSK and is subject to a "final contract."

This thread collects some of the major developments in the search for a vaccine to ease the new coronavirus pandemic. (Main photo by AFP/Joel Saget)

May 11, 2021 - 9:57am

The US Food and Drug Administration (FDA) on Monday authorized the use of the Pfizer-BioNTech Covid-19 vaccine for children aged 12 to 15 years old.

"This is a promising development in our fight against the virus," said President Joe Biden.

"If you are a parent who wants to protect your child, or a teenager who is interested in getting vaccinated, today's decision is a step closer to that goal."

The FDA previously granted an emergency use authorization for the Pfizer-BioNTech vaccine to individuals aged 16 and older. — AFP

May 10, 2021 - 8:01pm

German firm BioNTech says Monday that the Covid-19 vaccine it developed with Pfizer does not require any modifications at the moment to protect against variants of the virus.

"To date, there is no evidence that an adaptation of BioNTech's current Covid-19 vaccine against key identified emerging variants is necessary," the company says in a statement.

Nevertheless, in preparations for a need at some point to make tweaks to its current vaccine, the company says it began tests in March on a "modified, variant-specific version" of its jabs. —  AFP

May 8, 2021 - 6:23pm

The EU has concluded a deal with BioNTech/Pfizer for up to 1.8 billion extra doses of its COVID-19 vaccine, European Commission chief Ursula von der Leyen says on Saturday.

"Happy to announce that the EU Commission has just approved a contract for guaranteed 900 million doses (+900 million options) with BioNTech/Pfizer for 2021-2023," she tweets from an EU summit in Portugal.

"Other contracts and other vaccine technologies will follow," she promises. — AFP

May 8, 2021 - 5:32pm

Pope Francis offers his support Saturday for waiving coronavirus vaccine patents to boost supply to poorer countries, in a video message to the "Vax Live" concert.

The Argentine pontiff backs "universal access to the vaccine and the temporary suspension of intellectual property rights" in the recording made in his native Spanish.

Francis, who has repeatedly spoken of the need to share vaccines, condemns the "virus of individualism" that "makes us indifferent to the suffering of others." — AFP

May 6, 2021 - 9:00pm

Russian President Vladimir Putin on Thursday said he supported the idea of a waiver on patent protections for coronavirus vaccines and urged his government to consider lifting them for Russia's jabs.

A campaign to lift patent protections on Covid-19 vaccines picked up steam on Thursday, with French, German and EU leadership saying they were ready to discuss a proposal by US President Joe Biden before Putin added his voice in support.

"We are hearing from Europe an idea that, in my opinion, deserves attention -- namely, to remove patent protections from vaccines against COVID-19 altogether," Putin said during a televised meeting with Deputy Prime Minister Tatiana Golikova.

"Russia would of course support such an approach," Putin said, urging Golikova to work out the logistics.

"As I have said many times... We should not think about how to extract maximum profit, but about how to ensure people's safety."  — AFP

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