Düsseldorf In NRW, Astrazeneca should not be continued to be used for vaccinating under 60-year-olds. Therefore, as a second dose for teachers, educators and rescue workers, there is now mostly Biontech. The dates that have been set remain in place. Whether a mixed vaccination is as effective as Astrazeneca twice is to be clarified by mid-May.
In North Rhine-Westphalia, 1.1 million citizens have received Astrazeneca vaccination so far. Among them are many educators, teachers, nursing and rescue workers. But only 4700 have already received their second dose. For most, the second appointment is coming up soon - and that raises many questions. Because while the vaccine was initially recommended only for younger people, the assessment changed after cases of thrombosis occurred. In the meantime, the Standing Commission on Vaccination (Stiko) recommends the Astrazeneca vaccine only for those over 60 years of age.
■ What vaccine do teachers, educators, nurses get as a second vaccination if they are under 60 and got Astrazeneca first?
Most importantly, they now get the drug from Biontech, which so far has not had any known cases of thrombosis following vaccinations. "In the vaccination centers, the rule for people under 60 years of age who have received a first vaccination with Astrazeneca is that, based on the Stiko recommendation, vaccine from the company Biontech is to be used for the second vaccination," explained a spokesman for NRW Health Minister Karl-Josef Laumann (CDU).
■ Can younger people still take Astrazeneca?
Basically no, but exceptions are possible in individual cases. "A choice between using Astrazeneca and Biontech for the second vaccination cannot be granted in principle for people under 60 years of age in the vaccination centers," Laumann's spokesman explained. "In individual cases and after careful individual medical information and individual risk acceptance, this can be deviated from and vaccine from the company Astrazeneca can be used."
■ What will become of the appointment at the vaccination center, will it remain - even if there is another agent?
"Yes, the appointments will remain," the ministry explained. "Those affected do not have to do anything else and can simply show up for the second appointment." Changes arise at most because the time span between the first and second administration has been extended. The Düsseldorf vaccination center, for example, has contacted those affected, according to its own statement: "The people who are due for a second vaccination and are in the nine-week interval have been contacted by mail to move the second appointment to twelve weeks," a spokesperson for the city explained. The background is that with a longer interval between the first and second dose, the effectiveness is supposed to be higher and Germany can increase the vaccination rate at the same time.
■ What applies to medical staff?
Doctors, nurses, psychologists and other hospital staff can get Moderna instead of Biontech, because hospitals often give the U.S. manufacturer's vaccine anyway. Moderna, like Biontech, is an mRNA vaccine. "For second vaccinations in hospitals or additional facilities, Moderna vaccine can be used for second vaccinations outside of vaccination centers as a deviation if this is necessary to ensure greater flexibility," Laumann's spokesman explained.
■ Is protection as good with "first Astrazeneca, then Biontech" as with "twice Astrazeneca"? Or do people need a third vaccination later?
Whether protection is as high after a mixed first and second vaccination as after two Astrazeneca vaccinations is still being studied. "The extent to which a third vaccination may be necessary cannot be foreseen at the moment," Laumann's spokesman explained. However, he said, this also applies in principle to vaccinations that are given with the same vaccine in each case. The Paul Ehrlich Institute (PEI) explained that since both vaccines trigger an immune response against the same antigen - the spike protein of the coronavirus - "heterologous vaccination" of persons under 60 is a precautionary measure that is well-founded from a scientific point of view, even though the vaccine combinations have not yet been clinically tested and approved. According to the PEI, three trials investigating mixed vaccination are currently underway, including one at Oxford University, where Astrazeneca's Vaxzevria was developed. "Initial results are expected by mid-May," PEI said.
■ What about those over 60?
If they received the first vaccination with Astrazeneca, they must also take the second dose of this. "For people 60 years and older who have received a first vaccination with Astrazeneca, there is no choice, as the recommendation of the Standing Commission on Vaccination currently provides exclusively for homologous vaccination," Laumann's spokesman explained. Homologous vaccination means that the same vaccine is used. Affected elderly people therefore receive the Astrazeneca product for both the second and first vaccination.
Original text: Antje Höning
Translation: Mareike Graepel