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22 March 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

Vaccination with AstraZeneca vaccine will start again

Starting next week, vaccination with the AstraZeneca vaccine will be resumed in the Netherlands, as well as in a number of other European countries. This was decided by the Minister of Health, Welfare and Sport (VWS). The EMA and CBG-MEB have not found any link between normal thrombosis and the vaccine. A link between the vaccine and blood clot formation in combination with a low platelet count cannot yet be ruled out. This requires further research. A warning regarding these symptoms will be added to the summary of product characteristics (SmPC) for care providers and the package leaflet for patients. The EMA and CBG-MEB are of the opinion that the advantages of vaccination outweigh the disadvantages, and that the symptoms are so rare that the vaccine can still be considered safe and effective.

 

Effect of vaccination

The effects of vaccination are becoming increasingly visible. The downward trend in infections among nursing home residents is continuing. The number of infections in nursing homes has dropped below the national average infection rate per 100,000 inhabitants. There has been no visible increase in infections among elderly people living at home; the first people in that group were vaccinated at the end of January. It is too early to say whether this is an effect of the vaccinations. The number of hospital admissions is also decreasing among people aged 80 years and over, probably due to the start of vaccination in this group.

impact vaccinatie op besmettingen (17 maart 2021)

Figure: Number of reported SARS-CoV-2 infections per 100,000 inhabitants per age group and week, in elderly people living at home and nursing home residents, weeks 1 through 10, 2021. Source: Osiris

Advisory report of the Health Council of the Netherlands

The Health Council of the Netherlands advises first using the Janssen vaccine for the most vulnerable groups. This primarily involves people aged 60 years and older (to be vaccinated in order from old to young). This also includes groups with specific medical conditions: people with Down’s syndrome, people with morbid obesity (severe overweight with a Body Mass Index >40) and patients with neurological disorders that can lead to respiratory problems. This advisory opinion also applies to the CAS countries (Curaçao, Aruba and St. Maarten). The Minister of Health, Welfare and Sport (VWS) has not yet decided on the vaccination strategy in response to this advice.

Public communication

Cécile van Els, Professor of Vaccinology, discusses facts and fiction about COVID-19 vaccination in this video. 

 

Facts and fiction about COVID-19 vaccination

(On-screen title: Facts and fiction about the COVID-19 vaccine. Voice-over:)

TRANQUIL MUSIC

VOICE-OVER: Does the vaccine have coronavirus in it?

(Cécile van Els:)

CÉCILE VAN ELS: There is no live coronavirus in the vaccines.
What vaccines do is teach your body what the coronavirus looks like.
Most vaccines do that by revealing a small fragment of the coronavirus SARS-CoV-2
a characteristic piece of the exterior: the spike protein.
Your immune system can learn to recognise it
and develop an immune response to defend against it,
so you will be protected if you later come into contact with the actual virus.
There are also vaccines that do use viruses.
They show your body more of the coronavirus,
but only contain inactivated, or dead, virus.
That means you cannot be infected by the vaccine,
and you also cannot infect other people as a result of the vaccine.

(On-screen text: You CANNOT infect other people as a result of the vaccine. Voice-over:)

THE TRANQUIL MUSIC CONTINUES

VOICE-OVER: Does the vaccine affect fertility?
CÉCILE VAN ELS: That idea was based on the theory
that there was supposedly a substance in the vaccines
which is produced naturally by the human body
and is important in pregnancy,
both to become pregnant and to help the baby grow.
A specific hormone.
But that hormone is not in the vaccines.
So, there is no reason to assume
that our bodies would produce an autoimmune response
and become infertile as a result.

(On-screen text: There is NO reason to assume that our bodies would become infertile as a result.)

THE TRANQUIL MUSIC CONTINUES

VOICE-OVER: Will I pass the vaccine on to my child during breastfeeding?
CÉCILE VAN ELS: If you get vaccinated
during the period when you are breastfeeding your child,
you will not vaccinate your child.
No vaccine ends up in your breast milk.

(On-screen text: NO vaccine ends up in your breast milk.)

THE TRANQUIL MUSIC CONTINUES

VOICE-OVER: Does the COVID-19 vaccine affect your own DNA?
CÉCILE VAN ELS: This question is mainly asked in respect of RNA and DNA vaccines,
since those words evoke that association to some extent.
But that's not what they do.
What they do is give your body a blueprint
for building fragments of the coronavirus SARS-CoV-2.
Once those fragments have been built, your immune system can look at them
and develop an immune response to defend against them.
And then that blueprint is cleared away again.
It's the same thing that happens when you catch a cold
and you use those blueprints to fight off a cold virus.
So, no. Your own DNA is not affected by the vaccines.

(On-screen text: No, your own DNA is NOT affected by the vaccines.)

THE TRANQUIL MUSIC CONTINUES

VOICE-OVER: Weren't the vaccines developed too quickly?
And does that make them unsafe?
CÉCILE VAN ELS: They were developed very quickly, within a single year.
That has never happened before.
So, you may be wondering: how is that possible?
Vaccines are developed by going through a predefined number of steps.
Vaccines must be researched, and scientific proof must be compiled
about whether the vaccines are safe and if they are effective.
There is no way around that.
But there are four things that made it possible
to complete those steps within a year.
And that is really incredible, the biggest surprise of 2020.
But it was a success. So, what were those four things?
Firstly, all of the knowledge and expertise we already had,
for example on previous outbreaks of SARS and MERS,
was used to devise and develop vaccines as quickly as possible.
Secondly, very clear agreements were made with the evaluating authorities
about exactly what those vaccines had to be capable of.
And those evaluating authorities used 'rolling reviews',
monitoring researchers' work, which saved time.
Thirdly, all phases of the research and clinical trials that had to be completed
were scheduled very quickly and efficiently, in sequence.
That rapid sequencing would not normally happen,
but it did now. That also saved a lot of time.
And fourthly, an absolutely massive amount of money was raised
by governments, international agencies and philanthropists
to make all of this possible and to start producing vaccines
even before we were sure if they would even work.
All in all, this ensured that we were able
to achieve the first COVID-19 vaccines within a year,
without compromising their safety or efficacy.

(On-screen text: Without compromising on safety or efficacy.)

THE TRANQUIL MUSIC CONTINUES

VOICE-OVER: Is it true that vaccines can give you autism?
CÉCILE VAN ELS: No. The fable that vaccines could cause autism
was launched about 20 years ago by the British physician Andrew Wakefield.
He published an article asserting that in a reputable medical journal.
When other doctors reviewed the article, they found that it was not based on facts,
and that the data used to support the article was simply incorrect.
So, the journal retracted the article,
and the British doctor was even barred from practising medicine in the UK.

(The Dutch coat of arms, next to: National Institute for Public Health and the Environment. Ministry of Health, Welfare and Sport. The screen turns ruby red and white. On-screen text: For more information, visit RIVM.nl/en/covid19.)

THE TRANQUIL MUSIC FADES AWAY

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.