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Norwegian health authorities say no to shortcut proposals to vaccinate more people in less time. Internationally, for example, it is considering combining vaccines, changing doses and extending the period from the first to the second dose.
– All this is interesting to follow. But the EMA, the FDA and the scientific committees that advise the authorities are negative to such solutions and believe that all should stick to the plan, says director Camilla Stoltenberg of the National Institute of Public Health to Dagbladet.
– The reason for this is that there is no documentation of what protection you get over time, and especially not in the elderly, if you deviate from it.
– Could it have been relevant to consider such solutions if the infection situation was significantly worse in Norway?
– Yes. And we see that some of the countries that have chosen to move away from that plan have a worse contagion situation. Some of them probably also have poorer access to vaccines and will not be able to vaccinate such large proportions of the population.
SIER NEI: Health Minister Høie and FHI Director Stoltenberg say no to shortcuts related to vaccination in Norway. Photo: Torstein Bøe / NTB
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UK grip
Health Minister Bent Høie says there is no question among professional experts that it is best to carry out vaccination according to instructions, as planned in Norway.
– Since the infection situation is now in Norway, I also think it is correct to do it this way. But there are other countries around us that have a completely different and much more difficult infection situation, which can make other considerations. I get it, Høie tells Dagbladet.
Pfizer has tested a regimen of two doses of vaccines set at three-week intervals. Moderna has also tried a two-dose regimen, but these doses should be set at four-week intervals.
The UK has record rates of infection and death, and on this basis has been open to deviating from the recommended vaccination interval. It has been decided that you can wait up to twelve weeks before administering the second dose of the corona vaccines. In this way, the first dose of vaccine can be established in many more in a much shorter time.
risk
We know a lot about the effect of vaccines up to three to four weeks after the first dose, says chief physician Sara Watle of the National Institute of Public Health. But we don’t know anything about the effect from week 4 to 12.
– The risk is that more people will get sick with COVID-19 between the first and second doses if you extend this interval, says Watle.
He states that it can also make sense in certain situations.
– In England, they have recommended postponing the second dose until twelve weeks after the first. And the reason is that they have a very different situation than Norway. They have a high infection pressure, a great burden on the health care system, and are limited in vaccine doses. Their strategy means that they will receive unsatisfactory protection until the second dose is established. But like I said, it can make sense in certain situations.
Half doses
Both Pfizer and Moderna vaccines have been approved for use against COVID-19 in Norway. Watle claims that they can target 95 and 94 percent efficacy against symptomatic COVID-19, respectively. They can also show a good effect among people over 65 years old.
– We do not recommend using half doses. In studies that have been done, the elderly in particular have a poorer immune response at half the dose, Watle says.
Combination
Many countries will vaccinate their populations with various covid-19 vaccines. In addition to Pfizer and Moderna, the AstraZeneca / Oxford vaccine and the Janssen vaccine are also expected to be approved during the first quarter of 2021. However, FHI does not recommend vaccinating a person with different vaccines.
– We also do not recommend that you change, that is, use one product for dose one and another for dose two, because there is no documentation on this yet. But this is, of course, something we need to reconsider if the situation and knowledge change, says Watle.
Norway will have access to covid-19 vaccines through EU agreements, through Sweden. Vaccine coordinator Richard Bergstrøm has previously stated that the agreements guarantee Norway 2.5 million doses of the Pfizer vaccine, 1.9 million doses of the Moderna vaccine and 3.3 million doses of the AstraZeneca / Oxford vaccine. Thus, Norway has agreements for 7.7 million doses of vaccines, which is enough to vaccinate 3.85 million Norwegians.
