Regional leaders of two German states badly hit by a third wave of the pandemic have urged the rest of the country to re-impose a tough lockdown to flatten infection rates, as a leading virologist said Germany was in a “serious and complicated” stage of the pandemic.
In a joint letter reported on by Süddeutsche Zeitung newspaper, Bavaria’s conservative premier, Markus Söder, and the Green head of Baden-Württemberg, Winfried Kretschmann, said the situation was “more serious than many believe”.
“That is why we must live up to our responsibility now and not discuss it any longer,” the two politicians said, in an apparent swipe at other state leaders seen as reluctant to enforce an emergency break on easing restrictions.
Despite the political impasse over another lockdown and an already stuttering vaccine rollout, Germany on Tuesday heeded growing concerns over a rare blood-clotting condition and, alongside Canada and several other European countries, chosen to restrict use of the AstraZeneca jab to those aged 60 and over.
Angela Merkel said on Tuesday night that her government “cannot ignore” the latest findings of her country’s vaccine regulator, which has reported 31 German cases where people who had received the Oxford-developed jab developed cerebral venous sinus thrombosis, in most cases accompanied by lowered platelets (thrombocytopenia).
Among women under the age of 70, Germany has recorded one case of blood clotting in every 61,400 vaccinations, making the disorder extremely rare.
A previous decision to resume using the AstraZeneca jab had rested on findings showing the risk of blood clots to be less than one in a million cases, which remains the case among men under 70.
Because Germany had initially cleared the vaccine for only the under-65s, a majority of recipients in the country so far have been high-priority care workers, about two-thirds of them women under 70.
In Britain, where AstraZeneca is also a central pillar of the vaccine rollout, much fewer cases of blood clotting have been reported, with the UK’s MHRA only recording four cases of cerebral venous sinuous thrombosis between the start of the year and 14 March in people who have received an Oxford/AstraZeneca shot, compared with two cases among those who have had the Pfizer/BioNTech jab.
“Vaccination relies on a principle of trust,” Merkel said at a press conference on Tuesday night. “Trust springs from the knowledge that every suspicion and every isolated case is being investigated.”
Sandra Ciesek, an influential virologist at Frankfurt am Main’s university clinic, supported the government’s decision: “If only this one vaccine was available, you would have to think harder and weigh up benefits against risks,” she told Die Zeit. “But we do have a choice.”
The director of the World Health Organization, Tedros Adhanom Ghebreyesus, said on Wednesday that his body stuck to its benefit-risk assessment for the AstraZeneca vaccine and still weighed heavily in favour of its use.
And the European Medicines Agency reiterated that “according to the current scientific knowledge, there is no evidence that would support restricting the use of this vaccine in any population”.
Merkel on Tuesday emphasised that recent studies from Scotland had proven the vaccine’s effectiveness especially among seniors, and said she would in principle be happy to receive the AstraZeneca jab herself when it was her turn.
The health minister, Jens Spahn, added that the restricted use of the Anglo-Swedish jab would not impede the plan to offer everyone in Germany a vaccination appointment before the end of the summer.
But confidence in the vaccine, already damaged by shaky data from early trials and misleading reports in the German press, has been significantly dented and may lead to a reluctant take-up of the further 16.9m doses of the Oxford shot that Germany is expecting to receive in the second quarter of 2021.
The daily newspaper Die Welt argued that faith in the vaccine had been eroded so badly that Germany should stop using it altogether. Prioritising AstraZeneca for the over-60s after the country’s vaccine regulator had initially only authorised the same jab for the under-65s, the newspaper said, “did not build trust but uncertainty”.
The latest challenge for Germany’s vaccine rollout – and for AstraZeneca – comes as the country finds itself in what virologist Christian Drosten called a “serious and complicated” situation, with infection rates of the virus rising steeply but political actors in a deadlock over how to respond.
Drosten said in his podcast that a third wave could not be flattened without the “hammer” of another strict lockdown, a measure also believed to be favoured by Merkel. But the chancellor has struggled to keep the heads of Germany’s 16 federal states in line and is restricted in her decision-making by the country’s constitution.
Germany is hoping to make use of remaining and expected doses of the Oxford jab by freeing state authorities from strict age prioritisation rules around its use, allowing them to use AstraZeneca’s vaccine on those aged 60 to 69 from this week.
Young people who expressly wish to receive the AstraZeneca shot will still be able to do so after being informed of the potential side-effects by a doctor.
The vaccine regulator is going to decide by the end of April whether the 2.2 million people under 60 who have already a first dose of the AstraZeneca shot in Germany will receive their second dose from the same manufacturer.