Some in Europe go with 1-dose shot; others hold up

Worshipers gather for a Ramadan service Wednesday at a mosque in east London after the holy month had to be observed last year without the usual community prayer gatherings.
(AP/Aaron Chown)
Worshipers gather for a Ramadan service Wednesday at a mosque in east London after the holy month had to be observed last year without the usual community prayer gatherings. (AP/Aaron Chown)

BARCELONA, Spain -- European countries diverged Wednesday on whether they would push ahead with giving their residents Johnson & Johnson's covid-19 vaccine after reports of very rare blood clots in a handful of recipients in the United States.

While some European Union members put the vaccine on hold as recommended by the American company, Poland, France and Hungary said they would go ahead and administer the doses that had arrived as the EU's 27 nations face continuing pressure to speed up their immunization drives.

The Johnson & Johnson vaccine, distributed in Europe by its subsidiary Janssen, is a key part of Europe's vaccination campaign, which has been criticized as sluggish. Of the four vaccines currently approved for use in the EU, Johnson & Johnson's is the only one that requires a single dose to be fully effective. That makes it ideal for hard-to-reach, vulnerable groups, such as those who are homeless or migrant workers.

But the drugmaker decided Tuesday to delay deliveries to Europe after the Food and Drug Administration recommended a pause in the vaccine's use in the U.S. while the rare clot cases are examined. The decision was the latest blow to the vaccine rollout in Europe, which already experienced a similar clot scare with the vaccine developed by British-Swedish company AstraZeneca.

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The European Medicines Agency, the EU's regulatory agency for pharmaceutical products, has not advised EU members to put the Johnson & Johnson vaccine on hold. It said Wednesday: "The company [Johnson & Johnson] is in contact with national authorities, recommending to store the doses already received until the [European Medicines Agency's safety committee] issues an expedited recommendation."

It's not clear if the reports in the U.S. -- so far, six cases out of about 7 million inoculations -- are linked to the Johnson & Johnson vaccine. But European regulators already have declared that the unusual type of clots are possibly linked to the AstraZeneca vaccine, which is made with technology similar to Johnson & Johnson's product.

The AstraZeneca vaccine is in wide use around the globe, though not yet in the U.S. Several countries have imposed age restrictions on its use because of the clot concerns. Denmark, which put the vaccine on hold last month, decided Wednesday not to resume using the shots it had on hand, saying that citizens who had received a first dose would be offered a second dose of a different vaccine.

Still, experts agree covid-19 poses a much larger risk of death and hospitalization than the potential threat of atypical clots. But the concerns could still undermine public confidence in these vaccines and in the entire vaccination effort.

The European Medicines Agency, which approved the vaccine last month, said Wednesday that it will make a recommendation likely next week on how to proceed with the vaccine.

Until then, the regulator said that it "remains of the view that the benefits of the vaccine in preventing covid-19 outweigh the risks of side effects."

For Poland, that meant there was no reason to wait.

"In line with these recommendations, we will want to use it in inoculations," Polish Health Minister Adam Niedzielski said.

France, which received 200,000 doses, said it is also sticking to its plan to start administering the vaccine in the middle of next week to people age 55 and over. Hungary also said it would move ahead with the doses it received. It plans to distribute them using buses that deliver vaccines to rural areas.

Other countries, however, decided to hold up.

Italian Health Minister Roberto Speranza said his government was waiting for further information from the FDA and the European Medicines Agency to decide how to proceed with the initial 180,000 doses that arrived in Italy on Tuesday.

"But I think this vaccine must be used because it's an important vaccine, and the U.S. decision was a precautionary one, and the choice of Johnson & Johnson to not immediately put it on the market in Europe was also a precautionary choice," Speranza said.

"Our hope is that these knots can be resolved as soon as possible so we can use this vaccine, which would be the fourth one and is particularly useful for us," he said.

The Netherlands also put the 80,000 Johnson & Johnson doses it received into storage, as did Denmark, Croatia and Romania with their batches. South Africa suspended the shot as a "precautionary measure."

A man passes the entrance of the Janssen Pharmaceuticals company, which is owned by Johnson & Johnson, in Leiden, Netherlands, Wednesday, April 14, 2021. European nations from across the continent are scrambling to react to Johnson & Johnson's delay of the rollout for its COVID-19 vaccine amid reports of rare blood clots. (AP Photo/Peter Dejong)
A man passes the entrance of the Janssen Pharmaceuticals company, which is owned by Johnson & Johnson, in Leiden, Netherlands, Wednesday, April 14, 2021. European nations from across the continent are scrambling to react to Johnson & Johnson's delay of the rollout for its COVID-19 vaccine amid reports of rare blood clots. (AP Photo/Peter Dejong)
FILE - In this April 13, 2021, file photo, a box of Johnson & Johnson vaccines are shown by pharmacist Zsolt Szenasi at a warehouse of Hungaropharma, a Hungarian pharmaceutical wholesale company, in Budapest, Hungary. European nations are scrambling Wednesday, April 14, in the wake of Johnson & Johnson’s decision to delay the rollout of its COVID-19 vaccine amid reports of rare blood clots. (Szilard Koszticsak/MTI via AP, File)
FILE - In this April 13, 2021, file photo, a box of Johnson & Johnson vaccines are shown by pharmacist Zsolt Szenasi at a warehouse of Hungaropharma, a Hungarian pharmaceutical wholesale company, in Budapest, Hungary. European nations are scrambling Wednesday, April 14, in the wake of Johnson & Johnson’s decision to delay the rollout of its COVID-19 vaccine amid reports of rare blood clots. (Szilard Koszticsak/MTI via AP, File)
FILE - In this March 6, 2021, file photo, boxes stand next vials of Johnson & Johnson COVID-19 vaccine in the pharmacy of National Jewish Hospital for distribution in east Denver. The drug maker decided Tuesday, April 13, to delay deliveries to Europe after the American regulator recommended a pause in the vaccine's use in the United States while very rare blood clot cases are examined. (AP Photo/David Zalubowski, File)
FILE - In this March 6, 2021, file photo, boxes stand next vials of Johnson & Johnson COVID-19 vaccine in the pharmacy of National Jewish Hospital for distribution in east Denver. The drug maker decided Tuesday, April 13, to delay deliveries to Europe after the American regulator recommended a pause in the vaccine's use in the United States while very rare blood clot cases are examined. (AP Photo/David Zalubowski, File)

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