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COVID-19 VACCINES

Denmark to maintain exclusion of AstraZeneca and Johnson & Johnson vaccines

Health officials in Denmark said on Friday they will continue to exclude the AstraZeneca and Johnson & Johnson Covid vaccines from the country's inoculation drive after the government had asked for a review of the data.

Denmark to maintain exclusion of AstraZeneca and Johnson & Johnson vaccines
(Photo by Tiziana FABI / AFP)

The balance between possible benefit and possible harmful effects is still not favourable, even when we include assumptions in our analyses that benefit the vaccine,” the Danish health authority said a statement, according to Reuters.

The review of the data on the vaccines came after Denmark’s government had asked the
health authority to reconsider rulings against using the Johnson & Johnson and AstraZeneca vaccines, after struggling to keep its vaccination drive on schedule.

The use of both vaccines was abandoned earlier in spring over concerns about rare, but severe cases of blood clots in some recipients.

But the Danish authorities have had difficulty getting deliveries of the Moderna vaccine from the United States, forcing a revision of plans to have everyone vaccinated by September.

At the moment, the estimated delay amounts to two weeks.

Health Minister Magnus Heunicke told state broadcaster DR it was in this context that the government had asked the health authority to reconsider.

The authority withdrew AstraZeneca from the country’s vaccination programme in mid-April, and Johnson & Johnson in early May.

It cited not just the health concerns but the fact that the epidemic appeared to be under control and there seemed to be sufficient supplies of the approved vaccines, Pfizer/BioNtech and Moderna.

Denmark was the first European country to drop the two vaccines from its official campaign, but in May 20 it loosened the restrictions for anyone who was willing to take them.

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COVID-19 VACCINES

Who is eligible for a fourth Covid vaccine dose in Denmark and when?

Public health officials in Denmark say a low turnout for the second round of Covid booster shots — for most people, their fourth jab — has made them concerned that many don’t realise they’re eligible.

Who is eligible for a fourth Covid vaccine dose in Denmark and when?

 Danish authorities have hardly clear on whether to offer fourth Covid jabs and to whom, since the beginning of 2022.

In January, the government announced that fourth shots would be given to the very elderly and other high risk populations— but that decision was reversed just four weeks later and the fourth Covid dose program was ended.

At a June 22nd press conference, Prime Minister Mette Frederiksen announced plans for a more general booster program in the autumn and added that the ‘particularly vulnerable’ would be eligible for new doses the following week. 

When the Covid vaccination program began in early 2021, Denmark estimated the number of ‘selected patients with particularly increased risk’ that should be prioritised for vaccination at 240,000. But in the month since Frederiksen’s announcement, only about 3,500 people have come in for a fourth jab. Experts say that’s in no small part over confusion as to who is ‘particularly vulnerable.’

Indeed, the Danish Health Authority website doesn’t appear to currently provide a list of conditions that qualify for a second booster and instead refers readers to their primary care provider. That’s unfortunate since even general practitioners are finding it hard to determine who the rules say can get a fourth shot, Danish broadcaster DR reports.

The failure to resolve the issue is putting many patients at risk, some public health experts worry. “With the spread we are seeing with Covid at the moment, I think the Health Authority needs to be very clear about who should get the fourth prick now and who should wait,” Torben Mogensen, chairman of the Lung Association, told DR. 

READ ALSO: Danish health minister says further Covid-19 vaccinations could ward off restriction

What we know for sure 

  • Pregnant and breastfeeding women are already eligible for fourth doses
  • People with suppressed immune systems are already eligible 
  • Approximately September 15: fourth doses begin for people in care homes and among ‘particularly vulnerable’ elderly people 
  • October 1st: fourth doses begin for everyone 50 years of age and and over 

Your primary care provider (the one on your yellow card) can refer you for a vaccination appointment, as can doctors at hospitals. 

What factors will your doctor consider? 

Guidelines provided to doctors by the Danish Health Authority ask them to weigh the patient’s age, risk of serious course of illness if infected, their presumed immunity status based on recent infection, and their overall risk of infection based on their living conditions (strangely, crowded living conditions and living in a sparsely populated area both suggest you may need a booster shot). 

…and now for the riddles

In lieu of a list of conditions that might qualify a patient for an early fourth shot, doctors have been offered a series of ‘example patients’ that are eligible for a booster  under the new rules. 

  • 45-year-old woman with reduced immune system due to haematological cancer
  • 74-year-old man with severe obesity and heart failure, who has had recurring lower respiratory tract infections for the past six months and declining functional level
  • 65-year-old woman with severe obesity and diabetes with serious co-morbidities, e.g foot ulcers or chronic kidney failure
  • 82-year-old woman with rapid onset of functional loss (e.g. failing memory, reduced mobility and need for help with personal care) and beginning signs of malnutrition (eats too little, does not gain weight)
  • 23-year-old with cystic fibrosis with frequent pneumonia and hospitalisations
  • 50-year-old male with bowel cancer who has recently completed chemotherapy
  • 85-year-old man who lives with his children and grandchildren in a small home
  • 65-year-old woman who has been operated on for breast cancer and has diabetes, and who needs to travel to an area with high infection
  • 39-year-old resident of a social psychiatric residence, with heavy tobacco consumption, occasional alcohol overconsumption, overweight and in treatment with many different drugs

READ ALSO: Danish hospitals see rise in number of Covid patients 

It’s worth a call or message 

With a particularly nasty flu season on the horizon, public health experts say it’s worth a call, email, or message to your primary care provider if you have any reason to suspect you might be eligible for vaccination. 

“We know that infection rates have been rising both in Denmark and in Europe in recent weeks, and a new variant is on its way in,” Aarhus University professor emeritus of infectious diseases told DR.  “Then comes autumn, when we know that a respiratory virus spreads more than it does in summer. So there’s every reason to get that fourth jab if you’re in the vulnerable groups and it’s been more than six months since you had your third.” 

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