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Issue 25,  19 July 2021

The newsletter on COVID-19 vaccination is an RIVMNational Institute for Public Health and the Environment publication with up-to-date information for professionals involved in COVID-19 vaccination.

Progress report on the COVID-19 vaccination campaign

The 18 millionth COVID-19 vaccination was administered this week. 77% of all people over 18 have now received at least one vaccination, and 46% of adults are fully vaccinated at this point.

Shorter interval between first and second vaccination

The Minister announced in a letter to Parliament on 9 July 2021 that the interval between the first and second vaccination will be shortened. The implementation guideline states that an interval of at least 21 days is used for Comirnaty® (Pfizer/BioNTech) and 28 days for Spikevax® (Moderna). This is in accordance with the package leaflet, because there are currently sufficient vaccines in stock and capacity available at the Municipal Public Health Services (GGDs). A communication from GGD GHOR Netherlands will provide more information on how this will be organised in the GGD appointment system in actual practice from Monday 19 July 2021 on.

Options are being reviewed to see if people who already have an appointment for their second vaccination can schedule an earlier appointment. The Minister has asked everyone to wait for further updates on this topic and not to call the GGD yet, since it is not yet possible to make an earlier appointment for the second vaccination.
 

Heterologous vaccination

As of 16 July 2021, people (including pregnant women) who have had their first vaccination with the AstraZeneca vaccine, and would prefer to have a second vaccination with the Pfizer/BioNTech vaccine (Comirnaty®), can make an appointment for vaccination by the GGD. Additional information has been provided to GP practices via an alert. People have been distributed across various days to limit the pressure on the GGD call centre:

  • Friday 16 July, from 10:00 on – people born in 1956 or before
  • Saturday 17 July, from 10:00 on – people born in 1957
  • Monday 19 July, from 10:00 on – people born in 1958
  • Tuesday 20 July, from 10:00 on – people born in 1959
  • Wednesday 21 July, from 10:00 on – people born in 1960
  • Thursday 22 July, from 10:00 on – anyone over 18 years old.

If an absolute medical contraindication has been established for the AstraZeneca vaccine (Vaxzevria®), due to a severe allergic or anaphylactic reaction, thrombosis with thrombocytopenia syndrome (TTS) or systemic capillary leak syndrome (SCLS) after the first vaccination, then this contraindication also applies to the other brands of COVID-19 vaccines. In such cases, the series cannot be completed with the Pfizer/BioNTech vaccine.

People who already have an appointment for a second vaccination with the AstraZeneca vaccine in the next few weeks are still advised to keep the appointment as scheduled, since it will give them optimal protection as quickly as possible. People who have a second vaccination scheduled with their GP and would like to cancel that appointment are requested to inform their GP by email.

European Medicines Agency (EMA)

EMA’s Pharmacovigilance Risk Assessment Committee (PRAC) has concluded that anyone who has previously had systematic capillary leak syndrome (SCLS) must not be vaccinated with the Janssen vaccine (absolute contraindication). SCLS will be added to the package leaflet for the Janssen vaccine as a new side-effect, along with a warning for healthcare providers and consumers. PRAC previously drew the same conclusion for the AstraZeneca (Vaxzevria®) vaccine based on a similar review.

PRAC is now also reviewing reports of Guillain-Barré syndrome (GBS) following vaccination with Vaxzevria® and the Janssen vaccine. GBS is a disorder that causes nerve inflammation outside the central nervous system and can result in muscle weakness or paralysis, often accompanied by tactile dysfunction such as numbness or tingling. There is insufficient evidence to confirm or exclude a causal link to vaccination at this time. PRAC has recommended that a GBS warning be included in the package leaflet for Vaxzevria® .

The update on COVID-19 issued by the EMA and the European Centre for Disease Prevention and Control (ECDC) urges EU citizens to get vaccinated and to adher4e to the recommended number of doses. This is particularly important taking into account the spread of the Delta variant of SARS-CoV-2 (the virus that causes COVID-19), the need to protect citizens, especially those at risk of severe COVID-19, and the desire to open up our societies and relax restrictions.

How to use the HKVI portal

Does someone need a COVID-19 certificate, but does not have access to the CoronaCheck app and/or DigiD? In that case, the only party that can determine whether someone has been vaccinated is the vaccinating organisation, which has administration rights for the source registration. Care providers can do so via the HKVI portal, the system used to update vaccination data manually based on a check performed by the vaccinating organisation. Instructions and technical manuals for the HKVI portal are provided here (in Dutch).

Updated implementation guidelines for COVID-19 vaccination

The implementation guidelines for COVID-19 vaccination 2021 have been updated. The latest version of the implementation guidelines is always available online (in Dutch). Section 1.3 outlines all major changes compared to the previous version; more minor interim changes are listed under Version Management (at the end of the document).

Public communication

On Monday 12 July 2021, the Junior class on COVID-19: questions about vaccines was broadcast for pupils in the first years of secondary school and their parents. The class was presented by Ton de Boer, chairman of the Dutch Medicines Evaluation Board (CBG-MEB), and ethicist/philosopher Naomi van Steenbergen. The livestream is still available on YouTube (in Dutch only).

editors

Editors: Vaccination implementation, National Coordination Centre for Communicable Diseases Control (LCI).

For questions and/or comments about this newsletter, healthcare professionals can send a message to vaccin-covid@rivm.nl.

Private citizens can call the public information number 0800 - 1351 with their questions.