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Information about the COVID-19 vaccination in the family doctor's practice
According to the EU's announcement, it appears that there will be no more deliveries of the VAXZEVRIA vaccine from AstraZeneca after June. Until more precise details are known, also with regard to the necessary second vaccinations, we will probably not carry out any more vaccinations with this vaccine!
Due to a chaotic communication strategy, recommendations that changed at short notice and sometimes hysterical reporting, many citizens became very uncertain about the Covid-19 vaccine from AstraZeneca. In the following we would like to answer the most frequently asked questions about this vaccine in our consultation hours.
Should I get the AstraZeneca vaccine?
If one weighs the potential risk with the benefit of the vaccination, the decision from a scientific point of view is clearly in favor of vaccination with AstraZeneca vaccine. Ultimately, of course, the decision is yours alone. On this page we would like to enable you to make a conscious and self-determined decision by providing as objective information as possible.
I have a vaccination appointment with AstraZeneca, but would prefer a different vaccine. Is that possible?
If you get a vaccination appointment, be it at the vaccination center or in our practice, for vaccination with AstraZeneca, you have the option of canceling this appointment. Switching to another preparation as desired is not possible in the current situation. You will then have the option to remain on the waiting list until one can be offered in the appointment with a different vaccine. This of course results in a delay in the vaccination, you remain exposed to the risk of Covid-19 disease longer. You must take this into account when making your decision. According to the current data, the risk of a cerebral vein thrombosis is e.g. 0.0013%. On the other hand, there is a massively increased risk of thrombosis in patients who contract Covid-19. Depending on the study, this risk for seriously ill Covid-19 patients in hospital is sometimes over 40%. Possibly as a result of the vaccination, there were nine deaths among young women, on the other hand, well over 200 people, including young people, die of Covid-19 every day in Germany.
What were the serious side effects of this vaccine?
Most likely as a result of the vaccination with AstraZeneca vaccine, 31 cases of thrombosis of a cerebral vein had been described in Germany by the end of March 2021, of which 9 patients died. It was almost exclusively young women. Neither men nor older people were affected by this problem to a statistically significant extent.
How is the relevance of these side effects to be classified?
It is important to be aware of the statistical risk of such a side effect. By the end of March almost 2.4 million vaccinations had been carried out with this vaccine in Germany. The risk of developing cerebral vein thrombosis in relation to all age groups is therefore 0.0013%, and the risk of dying as a result of this complication is 0.00038%. The risk can therefore be assessed as very low. In view of the fact that this complication almost exclusively affected young women, it can be assumed that the target group of over 60 years of age intended for vaccination in Germany does not increase the risk compared to the non-vaccinated population of the same age.
When assessing the risk, you must also take into account that if you have not been vaccinated, there is a risk of infection with the coronavirus. A study by the University of Oxford recently found that the risk of cerebral vein thrombosis after Covid-19 disease is 10 times higher than the risk of the vaccine with AstraZeneca. (https://osf.io/a9jdq/)
Why was this vaccine not initially approved for the elderly and now only recommended for people over 60?
In the registration study of the vaccine by AstraZeneca, too few people over the age of 60 were initially included, so that it was initially not possible to make a reliable statement about its effectiveness in this age group. The approval was also extended to this age group due to data collected later, which also showed good effectiveness in people over 60 years of age.
How effective is the AstraZeneca vaccine in people over 60?
A large study that scientifically accompanied the vaccination campaign in Scotland showed that the AstraZeneca vaccine was 94% effective against serious illnesses that led to hospitalization, intensive care or death after the first vaccination. Interestingly, the effectiveness of the Comirnaty vaccine from Biontech was "only" 85%. In relation to the group over 80 who is most at risk from corona infection, the risk of hospital admission was reduced by 81% (both vaccines). (https://publichealthscotland.scot/news/2021/february/vaccine-linked-to-reduction-in-risk-of-covid-19-admissions-to-hospitals/)
Why is the second vaccination only after 12 weeks? Does this mean that I am protected more slowly than with other vaccines that are re-vaccinated after 6 weeks?
The initial shortage of vaccine has led to the UK increasing the interval for the second vaccination to 12 weeks. The scientific support of the British vaccination campaign then showed that a better effectiveness can be achieved by extending the interval to the second vaccination. A very good vaccination protection builds up after the first vaccination. It has not yet been observed that the longer vaccination interval in comparison to mRNA vaccines causes disadvantages for the patient.
I have ever had a thrombosis / heart attack / pulmonary embolism and / or take "blood thinners". Can I still get the AstraZeneca vaccine?
According to the current state of knowledge, vaccination with AstraZeneca is possible without restrictions. The complication of a "cerebral vein thrombosis", which is currently under discussion, seems to have a different cause than "normal" thromboses. It is believed that there is an autoimmune mediated disease of the blood platelets and that these thromboses then occur as a result. There is currently insufficient evidence for an accumulation of "normal" thromboses as a result of the vaccination. Please note that the risk of thrombosis is greatly increased in the event of an infection with the coronavirus. In this respect, it would be important for previously ill patients to vaccinate as quickly as possible Taking an anticoagulant drug does not constitute a reason to forego vaccination with AstraZeneca.
I have been vaccinated once with AstraZeneca and I am under 60 years old. With which vaccine should the second vaccination be carried out?
The STIKO recommendation is to have the second vaccination with an mRNA vaccine (Biontech / Pfizer or Moderna). There are currently insufficient data for this procedure, but based on theoretical considerations, one can assume that the vaccination will be effective. The second vaccination with an mRNA vaccine is scientifically monitored and evaluated. If, in retrospect, there is inadequate protection, it can be assumed that there will be appropriate recommendations for re-vaccination.
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