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COVID-19

No European deaths directly tied to Covid-19 vaccine, say scientists

Scientists in Europe say evidence available so far does not incriminate the new anti-Covid vaccines in the numerous deaths of elderly and frail people shortly after they had received the coronavirus vaccine.

No European deaths directly tied to Covid-19 vaccine, say scientists
A Pfizer/BioNtech Covid-19 vaccine being prepared. Andy Buchanan / AFP

Health agencies stress however that the vast majority of post-vaccination fatalities were elderly, already vulnerable and often sick.

Here's a review of the situation:

Elderly, vulnerable

Norway sparked alarm last week when it reported the deaths of 33 of some 20,000 retirement home residents who had received a first shot of the Pfizer/BioNTech vaccine.

At least 13 of the fatalities were not only very elderly but also considered frail with serious ailments, the Norwegian Institute of Public Health said.

While it noted that no analysis had yet been carried out on the causes of the deaths, it suggested that with the aged and vulnerable the normal side effects of vaccination such as fever or nausea could have contributed.

Outside Norway the news raised widespread concern and fed anti-vaccine scepticism, prompting the authorities to stress that no link had been established between the vaccine and post-jab deaths.

READ MORE: How has Norway reacted to elderly Covid vaccine deaths?

In France, of 800,000 people vaccinated, nine deaths of chronically ill residents of care and retirement homes were recorded by Friday.

The national medicines agency ANSM said that based on available evidence, “Nothing leads to the conclusion that the reported deaths were linked to vaccination.”

Other examples include 13 deaths of elderly people recorded in Sweden and seven in Iceland, all with no link established.

In Portugal, a care worker died two days after being inoculated but the justice ministry said a post-mortem found no direct link.

France's interior ministry on January 18 listed 71 “observations of death” in Europe of people who had the inoculation, but offered no further details.

Continued monitoring

The European Medicines Agency said that despite the deaths, “to date no specific concerns have been identified with Comirnaty”, the commercial name for the Pfizer shot.

The EMA noted that the authorities investigate fatalities to determine whether the vaccine was responsible.

National and European agencies check any problems with vaccinations reported by health professionals, pharmaceutical firms and patients themselves.

For the moment, the number and type of deaths among those vaccinated are not considered abnormal, with no cause-and-effect relationship identified.

In many countries — such as France, Norway, Britain and Spain — the frail and elderly are first in line for vaccinations.

“It is not unexpected that some of these people may naturally fall ill due to their age or underlying conditions shortly after being vaccinated, without the vaccine playing any role in that,” the UK medicines regulator MHRA said.

Transparency, reassurance 

The deaths are a highly sensitive issue, and approaches to informing the public vary.

France and some Nordic countries have reported post-vaccination deaths and detailed the potential side effects of the jabs even if no link has been established.

But Britain's MHRA said it would make a statement at a later date, possibly seeking to avoid spreading alarm.

“We will publish details of all suspected reactions reported in association with approved Covid-19 vaccines, along with our assessment of the data on a regular basis in the future,” it said.

In any event, European health officials say the deaths do not call into question the safety of the vaccines.

Norway has not changed its vaccination rollout, even if it has recommended doctors consider the overall health of the most frail before giving them the jab, the policy of numerous other countries.

Globally, more than 60 million doses have been received in at least 64 countries or territories, according to an AFP tally on Saturday.

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HEALTH

What are the rules on IVF in Spain?

Spain has some of the best fertility clinics in Europe and people travel from all over for assisted reproduction techniques here, both because of the high success rates and standard of care, but what are the invitro fertilisation rules in Spain?

What are the rules on IVF in Spain?

Spain has the second lowest fertility rate in the EU, with an average of 1.23 children per woman, according to the latest data provided by the European Statistical Office, Eurostat, corresponding to 2019 and updated at the end of June 2021.

A report by the Spanish Fertility Society (SEF), says that more and more couples are having problems conceiving and many are choosing to undergo assisted reproductive techniques in order to become parents.  

They consider infertility as: “the inability to achieve pregnancy after one year of sexual intercourse with normal frequency and without the use of any method of conception”.

Although male infertility factors are responsible for between 25 percent to 35 percent of cases, the number of older women who want to have children in Spain is the number one issue, the society explains.

But, it’s not just Spaniards who use fertility clinics in Spain, people come from all over Europe and even further afield. A recent study by the American Society for Reproductive Medicine found that five percent of European fertility care involves patients cross border travel and that the most popular European destinations are Spain, the Czech Republic, Denmark and Belgium.

In 2019, Spanish fertility clinics carried out 18,457 treatment cycles for foreigners, the majority from France and Italy. According to Barcelona IVF, the French, English and Italian are the ones who travel the most to Spain to undergo fertility treatments.

So what are the rules on IVF and other assisted reproductive techniques in Spain? 

The In Vitro Fertilisation Law in Spain states that any woman over 18 years old can undergo reproductive techniques in Spain regardless of marital status and sexual orientation. Egg freezing for future use is also allowed.

This legal framework establishes that assisted reproductive techniques can only be used when there are possibilities of success and when they do not pose a serious risk to the health of the patient.

The IVF law in Spain does not allow for uterus transplants or the use of surrogates or gestational carriers.  

While the law has not yet incorporated any mention of ROPA techniques, this is also offered in Spain. The ROPA method is used when women in a same-sex relationship want to share parenthood, whereby one provides the egg and the other one carries the baby.

What is the law on PGD and PGS testing?

Preimplantation Genetic Diagnosis or PGD is when the embryos are tested for specific inherited genetic issues such as cystic fibrosis. PGS also referred to as PGT-A is Preimplantation Genetic Screening or Testing and tests to see whether the embryo is genetically normal. The second one is typically used for women over the age of 35 or for those who have had multiple implantation failures or miscarriages.

Both types of tests are legal in Spain, however, the IVF law prohibits these tests to allow for selecting the sex of the baby or for physical characteristics. In some countries, such as the US for example, it’s very common to find out the sex of the embryo when these tests are carried out.

What are the rules for IVF in public health care?

Assisted reproduction techniques such as IVF and artificial semination are available through the public health care system in Spain, however, out of the more than 400 fertility centres in Spain only between 10 and 20 percent are public centres.

READ ALSO: Spain restores free IVF to singles, lesbians and now trans people

This means that there are also long waitlists for reproductive techniques through the public system, as well as stricter rules. According to the latest data available, wait lists for IVF are just over one year, however, in many regions, this can go up to two years or longer. In fact, waiting much longer than this is not uncommon.

The government laws establish that the maximum age to undergo these treatments in the public health system is 40 years in the case of women and 55 years for men. This age limit drops to 38 in the case of insemination with a partner’s semen.

The state guarantees a maximum of three rounds of IVF, six if it is by artificial insemination with donor sperm and four if it is with a partner’s sperm. 

Some regions in Spain, have their own rules however such as Madrid which raised the age to 45 and increased the number of rounds from two to four. 

READ ALSO: Madrid raises age limit for women to have free IVF up to 45

What are the laws on egg and sperm donations?

The In Vitro Fertilisation Law in Spain also regulates egg and sperm donation. Egg and sperm donation in Spain is anonymous, voluntary and altruistic.  

The choice of the donor will only be made by a medical team and cannot be selected by the patients, however, doctors will try to match certain physical characteristics. 

Is embryo donation/ embryo adoption legal in Spain?

Yes, according to Article 11 of the law 14/2006 embryo donation or embryo adoption as it is commonly referred to is legal in Spain. Donations must be anonymous and altruistic. 

A couple may wish to donate their embryos if they have a surplus and have already completed their family, while a couple or single woman may want to adopt an embryo if there have issues with their eggs or sperm.

What are the costs of IVF in Spain? 

IVF is a costly process when you go privately, but prices in Spain can be almost half of those you would pay in the US for example. According to the IVF Abroad Patient’s Guide 2022 for IVF using your own eggs, the costs range from €3,600 to €6,700. 

If using an egg donor, it can range from €5,900 to €8,500. For IVF using embryo donation, the costs range from €3,000 to €5,000 and for IVF involving egg freezing, the costs range from €3,500 to €4,700.

Medications for the injections are typically not included in these prices and can cost an extra €1,000 on top. 

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