Stricter vigilance encouraged in AstraZeneca health policies by the EU
Article: New Recommendations for the Second Dose of the AstraZeneca Vaccine in Europe
In a recent development, the Standing Committee on Vaccination (STIKO) has advised that individuals under 60 who have already received a first dose of the AstraZeneca vaccine should be immunized with a different agent for the second dose. This recommendation comes in light of concerns about rare side effects, particularly vaccine-induced thrombotic thrombocytopenia (VITT).
The European Medicines Agency (EMA) had previously identified a link between the AstraZeneca vaccine and the occurrence of thromboses. However, on Wednesday afternoon, the EMA recommended the continued use of the vaccine without restriction. Yet, in several EU countries, including Germany, its use remains restricted to people aged 60 and over.
Peter Liese, health policy spokesman for the EPP group in the European Parliament, welcomes the EMA's continued use recommendation for the AstraZeneca vaccine. However, he also expresses support for increased caution in Germany regarding the vaccine.
For younger individuals (often under 60 years of age), many European countries recommend heterologous vaccination (mixing vaccines). After an initial AstraZeneca dose, the second dose may be an mRNA vaccine like Pfizer-BioNTech's Comirnaty or Moderna's Spikevax. Evidence supports that such heterologous schedules produce robust immune responses with an acceptable safety profile.
If someone contracts SARS-CoV-2 after the first dose, guidance varies: if infection occurs within 14 days of the first dose, a second dose is recommended within 6 months; if infection occurs after 14 days, that infection counts as an immune booster equivalent to the second dose. Booster doses after the primary series (two doses) are currently recommended mainly for older adults (60+), typically using mRNA vaccines.
This heterologous approach for younger people addresses safety concerns and maintains strong protection. The recommendations are based on evolving evidence and expert advice from European health agencies and are consistent with current immunization guidelines as of mid-2025.
| Age Group | Recommended 2nd Dose | Notes | |-----------------------|---------------------|------------------------------------------------------------| | Older adults (60+) | AstraZeneca or mRNA | Complete primary series, boosters if eligible with mRNA | | Younger adults (<60) | mRNA vaccine | Heterologous schedule preferred due to safety considerations | | Post-infection after 1st dose | May omit 2nd dose if infection after 14 days | Infection counted as second dose stimulus |
Peter Liese also predicts that a vaccination with adapted vaccines will be needed in the fall due to mutations. He suggests that given the rare but disproportionately frequent cases of cerebral venous thrombosis, the AstraZeneca vaccine should only be used where these cases have not occurred. Liese believes that those who have received the first vaccination with AstraZeneca and the second with BioNTech/Pfizer are similarly well protected.
In conclusion, the current recommendations for the second dose of the AstraZeneca vaccine aim to balance safety and efficacy, particularly in younger populations. As the pandemic continues to evolve, these guidelines will undoubtedly adapt to reflect the latest scientific understanding and expert advice.
[1] European Centre for Disease Prevention and Control. (2021). Vaccine-induced thrombotic thrombocytopenia after vaccination with COVID-19 Vaccine AstraZeneca. Retrieved from https://www.ecdc.europa.eu/en/publications-data/vaccine-induced-thrombotic-thrombocytopenia-after-vaccination-covid-19-vaccine-astrazeneca [2] European Medicines Agency. (2021). Vaccine-induced immune thrombotic thrombocytopenia (VITT) after COVID-19 Vaccine AstraZeneca. Retrieved from https://www.ema.europa.eu/en/medicines/human/EPAR/covid-19-vaccine-astrazeneca/product-information/safety/overview
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