AstraZeneca back in Brunei’s vaccination programme

James Kon

Following a review of available current data and taking into account the effectiveness of the AstraZeneca vaccine in preventing COVID-19 infection, Brunei Darussalam is resuming the administration of AstraZeneca in the National Vaccination Programme.

Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar made the announcement in a press conference on the latest developments of the COVID-19 situation in the country yesterday.

“Due to the increased risk observed in younger individuals, and the lower risk and higher benefit ratio of those above 60 years, the AstraZeneca vaccine will be offered to adults above the age of 60,” he said.

“Adults below the age of 60, who have not yet received their first dose of AstraZeneca, will not routinely be offered the AstraZeneca COVID-19 vaccine. Subject to availability, adults aged under 60 will be offered another vaccine, such as Sinopharm.

“However, the AstraZeneca COVID-19 vaccine can be used in adults aged under 60, where the benefits are likely to outweigh the risks for that individual who has made an informed consent based on the understanding of the risks and benefits, and who has personally requested the AstraZeneca COVID-19 vaccine.”

Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar. PHOTO: JAMES KON

“To date, there are no reports of rare clotting/low platelet events following receipt of the second dose of the AstraZeneca COVID-19 vaccine.

“Therefore, individuals who have received a first dose of the AstraZeneca COVID-19 vaccine should continue to receive a second dose of AstraZeneca COVID-19 vaccine, irrespective of age. The second dose is important for longer lasting protection against COVID-19.

“Since the temporary pause on the use of the AstraZeneca COVID-19 vaccine on April 6, the Ministry of Health (MoH) reviewed reports from other countries of very rare cases of blood clots with low platelets (a component of the blood that helps it to clot), following vaccination with the AstraZeneca COVID-19 vaccine.

“At the most recent meeting, the COVID-19 Vaccine Technical Committee reviewed updated information from the European Medicines Agency (EMA) and the Medicines and Healthcare products Regulatory Agency (MHRA), United Kingdom (UK), together with information from other countries on the COVID-19 Oxford-AstraZeneca vaccine.

“Meanwhile, a Scientific Exchange Meeting was held on April 12, among experts across the Asia-Pacific Region – including Brunei Darussalam – and representatives from AstraZeneca, where the information from this meeting assisted with the review.

“The COVID-19 Vaccine Technical Committee notes that in extensive vaccination campaigns, potential adverse events can occur following immunisation. However, this does not necessarily mean that the events are linked to the vaccination itself, but they must be investigated to ensure that any safety concerns are addressed immediately. Vaccines, like all medicines, can have side effects. The administration of vaccines is based on a risk versus benefit analysis.

“Based on the latest information on the occurrence of cases of blood clots with low platelet count, namely Thrombotic Thrombocytopenia following immunisation of the COVID-19 vaccine, the administration of the AstraZeneca COVID-19 vaccine may be related to the event.

“Nevertheless, such incidents are extremely rare, where the number of occurrences is low with a risk rate of about four cases for every one million doses given.

Alhamdulillah, in Brunei Darussalam, based on the 2,323 individuals who have received their first dose of the AstraZeneca vaccine, no events of this nature have been identified.”

He added, “Information from countries which have reported this event suggest that while the overall risk is extremely low, the risk appears to be higher in younger age groups. At present, based on an analysis of baseline rates among the population of the UK and Europe, there does not appear to be an increased risk in older age groups.

“In connection with the occurrence of blood clots, it is important to note that this is a treatable condition and clinical guidelines for the management of events of this nature have been developed for use in Brunei Darussalam.

“Early detection of these symptoms is important, and individuals who have received the AstraZeneca COVID-19 vaccine are advised to immediately report any symptoms of shortness of breath, chest pain, leg swelling, persistent abdominal pain, severe or persistent headaches or blurred vision after vaccination, or who experienced skin bruising (petechia) beyond the site of vaccination after a few days.

“Based on the available data and taking into account the effectiveness of this vaccine in preventing COVID-19 infection, especially to those at risk such as the elderly and given that the reported incidence of low blood clots/platelets is very rare, therefore the COVID-19 Vaccine Technical Committee is of the opinion that the administration of AstraZeneca COVID-19 vaccine can resume in the country.

“Vaccination remains a safe and effective way to protect ourselves, our families and our community from COVID-19. The MoH reassures the public that vaccine safety is the utmost priority, and that measures have been put in place to minimise the risk of serious adverse events.

“The administration of the AstraZeneca COVID-19 vaccine will be constantly monitored from time to time, by taking into account the local COVID-19 situation, as well as the latest developments on the vaccine.”