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At the first Astra-Zeneca vaccination stop in mid-March, SPD health expert Karl Lauterbach spoke out in favor of not suspending vaccinations completely - but continuing to vaccinate while the vaccine is being checked. In view of the new data, he now sees a higher risk than originally assumed. Nevertheless, he is in favor of continuing to vaccinate older people with Astra Zeneca - and younger people with Biontech.
SZ: Mr. Lauterbach, what's wrong with Astra Zeneca?
Karl Lauterbach: It has been confirmed that sinus vein thrombosis is a side effect of the vaccine, and it is a little more common than we thought, especially in younger women. It was originally thought to occur in 1 in 250,000 cases. Now it could be that the risk is slightly higher and affects more than 1 in 100,000 women vaccinated. We do not know for sure whether the risk is also increased in younger men. But the cost-benefit balance of the vaccine has changed in younger people.
In view of the numbers, does one have to speak of a common side effect?
No, this is still a rare side effect. We're not in the area where the vaccine could be pulled off the market, for example. But it's a side effect that is dangerous. We understand it more and more clearly, it was discovered relatively quickly by Professor Andreas Greinacher from the University of Greifswald and Professor Rolf Marschalek from the University of Frankfurt. It is a reaction that is seldom seen when heparin is administered. Heparin is given to prevent thrombosis - but in rare cases it does the opposite and causes thrombosis. The vector vaccine apparently also triggers a cross-reaction, just like in the paradoxical heparin thrombosis. They are also more likely to affect younger women.
The fact that younger women are mainly affected is not due to the fact that Astra Zeneca was injected mainly into younger women in Germany - such as carers and educators?
This is what the data indicate. It was originally thought that limiting the side effect to younger people was an artifact of the fact that this vaccine was used predominantly on younger people. But that doesn't seem to be the case, because we are now using the vaccine in older people, but we continue to see this complication mainly in younger women. Heparin-induced thrombosis is also more common in younger women. Both the epidemiology and the pathophysiology of the complication mechanism indicate that it would actually make sense not to use the vaccine in younger people - because we have alternatives and the risk is concentrated in this age group.
When you first stopped at Astra-Zeneca, you advocated that vaccinations should not be suspended, but that vaccination should continue while the vaccine was being checked. Do you see it differently now?
We now clearly have different data, but I am not in favor of a vaccination freeze either. I am not in favor of not using the vaccine at all. But that we quickly come to a decision not to use it with the younger ones, but to continue the vaccinations with Astra Zeneca with the older ones and not to stop them. To put it simply, we have no new information on the elderly that the vaccine is more dangerous. Then why should one expose him to the elderly?
But isn't the risk of getting seriously ill with Covid-19 higher than the risk of the side effect in younger people too?
We have other vaccines. I would use more Biontech vaccine on the younger ones and more Astra-Zeneca on the older ones. It's just a matter of who gets which vaccine? If it were now the case that the younger ones who take the risk every day, such as kindergarten teachers, could not be vaccinated - if that were the alternative, then the vaccination ban for the younger ones would not be justifiable either. But if I have the opportunity to use the Astra Zeneca vaccine with the elderly, so that the younger ones can get more Biontech, then I am simply optimizing the use of the vaccine. I stick to it: suspending the vaccine is by no means justifiable.
The fact that Astra Zeneca was initially only approved in Germany for the group that is now affected by the side effect - while older people were not allowed to get the vaccine - looks pretty bizarre in retrospect.
I said that from the very first minute, and this decision was received, for example, by American vaccination experts with, let me say, surprise. After all, it has never happened before, that a vaccine is not used in the group that has a 600-fold increased risk of death.
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