Coronavirus The director of the Vaccine Research Center defends the Astra Zeneca policy, which has been reprimanded by THL: “I would not have thrown the first stone”

The chairman of the National Vaccination Expert Group also describes the line as justified, although he criticizes THL’s communication. “It was a very important thing in the spring to get vaccinations ahead,” he says.

Health and Welfare (THL) was medically justified, says Director of the Vaccine Research Center Mika Rämet.

Deputy Parliamentary Ombudsman criticized last week THL strictly from its vaccine guidelines for 65-69 year olds. Rämet estimates that THL made its decision on the basis of the best information at the time and that its benefits outweighed the disadvantages.

“Even if THL had acted in a legal way worth noting in its guidelines, I do not think that does not necessarily mean that THL had acted incorrectly in the situation at the time,” Rämet writes in a statement published on Monday. in their blog post.

“I wouldn’t have thrown the first stone.”

Along the same lines is the chairman of the National Vaccination Expert Group (Krar) Ville Peltola.

“I do understand that the situation may have proved awkward for this age group when other age groups have been given a different vaccine. Certainly better communication would have been needed, ”he adds, however.

“The need for hospital care is the most important and clear measure.”

THL At the end of March, it instructed municipalities to offer the Astra Zeneca vaccine to people aged 65 to 69, even though its effectiveness against the coronavirus was estimated to be weaker than other vaccines.

The vaccine was no longer recommended for younger people because it had been linked to rare blood clotting problems in new studies. A large proportion of people over the age of 70 had already been vaccinated with other products.

The THL guideline was not a binding provision, but in many municipalities it was interpreted as such. For example, in Finland’s four largest cities, people aged 65–69 were no longer offered anything but Astra Zeneca vaccine.

Deputy Ombudsman Maija Sakslinin according to the ruling, THL violated the Constitution, the prohibition of discrimination, and the Patients Act by not legally evaluating its guidelines. THL announced on Mondaythat it intends, inter alia, to review the wording of its guidelines.

Read more: THL and STM break the law in vaccinations for 65-69 year olds, Ombudsman remarks – Three jurists assess whether more drastic action should have been taken

When when making medical decisions, the pros and cons must always be evaluated. In the spring, the THL considered that people aged 65 to 69 were not at increased risk of serious harm from the Astra Zeneca vaccine, but that the benefit of vaccine protection was great for them.

“In this age group [65–69-vuotiailla] The benefits of the vaccine were indisputable, ”says Mika Rämet.

“The information at the time was that the side effects mainly affect women under the age of 60.”

Adenovirus vaccines, which include Astra Zeneca, provide less protection against coronavirus disease than Pfizer-Biontech and Moderna mRNA vaccines.

According to Rämet and Peltola, however, the most important thing is how well the vaccines prevent the disease from developing into a serious and hospital-requiring one. The goals of Finland’s coronary vaccine strategy also include preventing deaths and the burden on healthcare.

“After all, it’s boring if there are symptoms of an infection. But the need for hospital care is the most important and clear indicator, ”Rämet says.

He refers to a Scot researchthat the first dose of Astra Zeneca was as effective against severe coronavirus disease as the Pfizer-Biontech vaccine. The study was already known in March and was later published in The Lancet.

Mika Rämet, Director of the Vaccine Research Center, in November 2020.

Also the benefits of calming the epidemic are a strong justification. The harder the epidemic rages, the greater the benefits of rapid vaccination.

In Finland, infection rates peaked at the end of March. Discontinuation of Astra Zeneca would have meant a delay in the vaccination schedule.

“It would have caused serious illnesses. In the spring, it was very important to get vaccinations ahead,” Ville Peltola commented.

In its decision, THL referred to the assessment of the group led by Peltola. It was based on comprehensive research data and reports from health authorities around the world. For example, the European Medicines Agency (EMA) had decided that Astra Zeneca’s benefits are greater than its risks.

But why weren’t people aged 65-69 choose which vaccine to take?

One background factor was the limited supply of vaccines. If alternative vaccines had been given to people aged 65 to 69, vaccinations could have been delayed in those age groups for which Astra Zeneca was not recommended.

“At that point, vaccinations for medical risk groups were still underway,” Peltola points out.

According to him, THL could still have emphasized the right to self-determination under the Patients Act in its communications.

“Could it have been announced that Astra Zeneca will be available for the age group first, but the mRNA vaccine will also be available later,” Peltola ponders.

Admittedly, he estimates that if a large number of people had not taken the Astra Zeneca vaccine in the spring and waited for a different type of vaccine, there would have been more serious illnesses.

“Yes, that time would have had a significant impact.”

Ville Peltola is a professor of infectious diseases, while Mika Rämet is a professor of pediatrics and experimental immunology. Both point out that they make their comments from a medical rather than a legal perspective.

“I understand that there are laws and they are respected,” Rämet says.

“But the approach of medicine is to help people. Personally, I think that is the highest guiding value. ”

Read more: THL goes through the “verbal wording” of its guidelines due to the allegations made by Deputy Ombudsman Astra Zeneca

Read more: THL’s Mika Salminen on the decision of the Parliamentary Ombudsman: “We accept criticism very humbly”

Read more: Parliamentary Ombudsman: THL and STM operate illegally in Astra Zeneca vaccinations for people aged 65-69 in the spring

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