“Only 15% of adverse reactions in Portugal related to AstraZeneca” while second dose ‘can be substituted by another other vaccine’

Only 15% of the more than 3600 cases of adverse reactions reported in Portugal are related to the AstraZeneca vaccine while DGS health chiefs today have ‘admitted’ that the second dose ‘could be substituted by any other vaccine’.

And so began another ‘stranger than fiction’ week in Portugal where no-one can really tell where the pandemic is taking us.

Last night on his regular slot on SIC television, commentator Luís Marques Mendes dismissed the rising Rt (which he warned would be up to 1.04 by today), saying it has not translated into a flood of further serious illnesses and thus the country will indeed be moving forwards with deconfinement stage 3 next Monday.

Boroughs however “where the situation is most difficult” run the risk of returning to confinement.

It wasn’t clear from his explanations whether this refers to all 29 boroughs that have a rolling average rate of new cases above 120 per 100,000 inhabitants, or only the most critical situations will be targeted. The answers will come clear possibly as soon as Thursday.

Meantime, following ‘doubts’ last week over what was to be done with under-60s who had received their first dose of AstraZeneca (and are now too young to be given the second click here) the matter seems to have been settled: they can receive ‘any other vaccine that is available’.

This is ‘surprising’ in that the World Health Organisation said only days ago that there was no data available to sustain this approach. The Pfizer and Moderna vaccines use mRNA technology (messenger RNA), whereas AstraZeneca uses adenovirus-vectored technology. 

Nonetheless, from one week to the next, the ‘doubts’ have been dispelled and people mid-way through the inoculation process are being told ‘there is nothing to worry about’.

Worse than any risks from vaccines (whichever they are), says vaccine coordinator Henrique Gouveia e Melo, are the risks of not being vaccinated at all.

Said the vice-admiral who took over the country vaccination programme after a fairly shambolic start, it is very important that people “do not enter a curve of hysteria” over all the issues surrounding AstraZeneca (now renamed Vaxzevria) as this could prejudice not only the vaccination process but the protection of people…”

It was Gouveia e Melo who reported on the ‘adverse reactions’, saying that 81.1% related to Pfizer (which has seen 1.4 million doses administered in Portugal so far); 4% to Moderna and ‘around 15%’ to AstraZeneca. That 15% related to 535 reported cases, he said – only one of these having been a blood clot.

Portugal this far has suffered two clotting incidents. Health chiefs have not revealed the other vaccine involved.

On a percentage basis of doses administered, the number of adverse reactions reported for Pfizer have been 0.21%, AstraZeneca 0.14% and Moderna 0.12%.

One anomaly from the interview this morning of Luís Graça of the DGS Vaccination Technical Committee is that he “admitted that people who have received the first dose of AstraZeneca vaccine and are under 60 can receive a second dose of any other vaccine”. But he also “explained that the country is in a situation where it can wait and see what happens in other countries and studies that are being done”.  

Said TSF radio, Luís Graça described work being promoted by the University of Oxford to study the effect and safety of mixing vaccines – a second dose different to the first”.

Right now, all those requiring their second doses will come up for the new shot in May, by which time, says Graça “we will be much more secure of the safest and most effective strategy”.

He added that the (Portuguese) decision to wait for results “is a message of safety” to all those wondering what will happen with their second dose, as it shows “a decision is not being made on the basis of incomplete data”.

It was perhaps as bizarre a remark as could come to start another week of uncertainty.

As for the ‘results’, today’s bulletin shows that the Rt taking in the archipelagos is indeed up to 1.04. It is 1.03 on the mainland (and if we take Luís Marques Mendes inside information, it ‘doesn’t really matter’ as it is still suitably low).

The problem is that hospital admissions have increased slightly, though numbers in hospitals and ICUs are still low: 479 and 119 respectively.

In the last 24-hours, only two people have died with Covid-19; 445 have ‘recovered’ from positive PCR tests (which does not mean they ever actually had Covid-19) and weekend testing (always reduced) flagged 271 new cases across the board.

The number of active cases across Portuguese territory is still extremely ‘low’ in comparison to total population: 25,054 positive cases out of a population of 10.2 million people.

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