Regulators' Update on AZ Vaccine, Vaccination and Variants, NZ Travel Bubble: COVID-19 Global Weekly Highlights

Medscape, Univadis, & MediQuality Staff

April 09, 2021

These are the global coronavirus stories you need to know about this week.

The European Medicines Agency (EMA) said the risk of rare cases of thrombosis with thrombocytopenia with the AstraZeneca vaccine should be included in product information. However, its ongoing safety review again concluded that the vaccine is safe and effective with the benefits outweighing any possible risks.

The UK regulator MHRA said that people under 30 should be offered an alternative vaccine to the Oxford/AstraZeneca product after its ongoing rare blood clots safety review. It stressed the benefits still outweigh the risks. On Tuesday, the University of Oxford paused a trial of the vaccine in children due to wider concerns rather than a trial-related event. Meanwhile, the Moderna vaccine started to be rolled out on Wednesday, the UK's third approved vaccine. As of Tuesday, 31.7 million first vaccine doses, and 5.7 million second doses had been administered. Nearly 1 in 10 adults have now received both doses. New cases, hospital admissions, and deaths continue to fall. However, data are being closely monitored after more lockdown measures were relaxed in England on Monday. Twice-weekly rapid testing is being offered to everyone in England from this week. 

In Germany GPs joined vaccination centres in vaccinating people nationwide. By the end of April, more than 3 million additional vaccine doses will be provided to practices. COVID-19 case numbers are still high. After the Easter holidays, Germany’s health departments reported 9677 new infections within one day. That number is probably an underestimate as over the holiday period fewer laboratory tests were performed. 

Last Tuesday Spain updated its vaccination calendar and it’s expected that by the end of August, 33 million people will have received a COVID-19 vaccine. The Spanish Government decided to temporarily stop giving the AstraZeneca vaccine to under-60s after the EMA review and will assess its use for older people over the following days. The regional government of Madrid has started discussions over the production and distribution of the Russian vaccine Sputnik V, which hasn’t yet been approved by the EMA. The central government insisted that the centralised procurement of vaccines should go through the European Commission. As of Wednesday, COVID-19 incidence increased to 167 cases per 100,000 inhabitants in the last 14 days. In total 3,326,736 people have been infected and 76,037 have died since the start of the pandemic. 

Portugal started the second phase of lifting its lockdown on Monday, with students  returning to classrooms, and restaurants reopening outdoor spaces to groups of up to four people. Travel restrictions were lifted and the border between Portugal and Spain was reopened. On Wednesday, there were 663 confirmed cases and the number of hospitalised patients fell below 500 for the first time in more than 6 months. There have been a total of 825,031 confirmed cases of SARS-CoV-2 infection and 16,890 COVID-19 deaths since the beginning of the pandemic. As of Wednesday, 1,346,317 first vaccine doses were administered, and 560,871 second doses.

In France, the epidemic is worsening with 433 new deaths in 24 hours and 2189 new intensive care admissions in the last 7 days. Intensive care units in many areas are full despite help from private clinics. The vaccination campaign is progressing with 18.7% of adults having received a first vaccine dose, and 6.4% both doses. Bottling of the Pfizer/BioNTech vaccine and production of the Moderna vaccine is beginning in France.

Italy has reported a slight decrease in the incidence of COVID-19 but cases remain high. Half the country is in a red zone, and half in orange zones. The number of hospitalised patients has decreased but ICU admissions have risen slightly. As of April 4, more than 11 million vaccine doses had been administered, with around 3,450,000 people fully vaccinated. Prevalence of the B.1.1.7 (UK) variant was 54% in February and now accounts for 86.7% of cases. Another 4% of samples were positive for the P.1 (Brazilian) variant.  

The United States is in a race between vaccination and variants, and it’s unclear which is winning. The more contagious B.1.1.7 variant now dominates transmission of COVID-19.  That’s mostly in line with early predictions by the CDC that the strain would take over by the end of March.  At the same time, the US is vaccinating at a furious pace. President Joe Biden said he wants most adults to be eligible to receive a vaccine by April 19, about 2 weeks ahead of a previous May 1 deadline. Currently, people over the age of 16 are eligible to be vaccinated in 36 states. The US is currently third in the world in terms of pace of vaccination, averaging about 3 million doses a day behind China (4.5 million daily doses) and India (3.4 million doses a day). New data released by the CDC show that COVID-19 was the third leading cause of death in the US in 2020, behind heart disease and cancer.

Last Tuesday, 6, Brazil had its 24 deadliest hours since the beginning of the pandemic, with a record 4211 deaths. It’s the equivalent of more than 170 deaths per hour. An analysis published on the same day indicated that 19 states and the Federal District had an occupancy rate for ICU COVID-19 beds for adults above 90% between March 29 and April 5. In the same period, 21 capitals had ICU occupancy rates above 90%. São Paulo is looking at building new cemeteries. Measures to restrict the movement of people are being adopted by state and municipal governments in different ways. According to the Fiocruz foundation, if the restrictions are not followed consistently, the situation will worsen and the collapse of the public health system will be prolonged. As of Wednesday, 13,100,580 diagnoses of COVID-19 and 336,947 deaths have been recorded. So far, 9.84% of the population has received a first vaccine dose, 2.78% were fully vaccinated. However, vaccination has been paused in some areas because of supply problems.

The second wave of COVID-19 infections continues to ravage India, with 1,26,789 daily cases reported on Thursday. Several states in the country have implemented partial lockdowns and restrictions to curb rising infections. Some states reported a shortage of vaccine supplies, which the Health Minister dismissed. India has so far administered more than 86 million vaccine doses.

The tiny Himalayan nation of Bhutan has achieved the feat of vaccinating 62% of its eligible population against COVID-19 in just a week. By April 6, 85% of the adult population had received a single dose of vaccine. 

Iran reported a record number of 20,954 daily COVID-19 infections on Wednesday. The country is currently witnessing a surge of infections following a 2-week public holiday for Persian New Year. 

South Korea has granted approval to Johnson & Johnson’s COVID-19 vaccine, making it the third vaccine to be authorised in the country, after AstraZeneca and Pfizer/BioNTech.

The Kyoto University Hospital in Japan carried out the world's first lung transplant from living donors to a COVID-19 patient. A woman who developed severe pneumonia after being infected with COVID-19 received lung tissue from her husband and son.

New Zealand and Australia  announced a quarantine and COVID-19-testing free 'travel bubble' from April 19. “The Trans-Tasman travel bubble represents a start of a new chapter in our COVID response and recovery, one that people have worked so hard at,” NZ Prime Minister Jacinda Ardern said.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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