Canada's vaccine advisory committee on Monday recommended suspending the use of the AstraZeneca-Oxford COVID-19 vaccine in people under 55 because of safety concerns, the latest setback for a vaccine seen as crucial in tackling the coronavirus pandemic across the globe.
The National Advisory Committee on Immunization (NACI) updated its guidelines to provinces and territories following reports out of Europe of very rare instances of blood clots in some immunized patients — notably among younger women.
Clinical and real-world data have suggested the vaccine, which is easier and cheaper to transport than rival shots, is highly successful in reducing serious illness and death connected to COVID-19. But it has been dogged by poor communications and questions about possible side-effects.
Here's the latest on the vaccine's status in other countries:
German health officials agreed Tuesday to only give the AstraZeneca vaccine to people aged 60 or older, unless they belong to a high-risk category for serious illness from COVID-19 and have agreed with their doctor to take the vaccine despite the small risk of a serious side-effect.
The move follows the recommendations of Germany's independent vaccine expert panel and comes after the country's medical regulator released new data showing a rise in reported cases of an unusual form of blood clot in the head — known as sinus vein thrombosis — in recent recipients of the vaccine.
The Paul Ehrlich Institute said its tally of the rare blood clots reported by March 29 had increased to 31, out of some 2.7 million doses of AstraZeneca administered in Germany so far. Nine of the people died and all but two of the cases involved women, who were aged 20 to 63, the regulator said.
Spain has decided to remove an upper age limit of 65 years on the AstraZeneca vaccine, Cadena Ser radio reported on Tuesday.
A public health commission approved the change at a meeting on Tuesday, the broadcaster said, citing a document it had seen. That comes a week after Spain decided to reintroduce the AstraZeneca shot for people aged 18 to 65.
Like Germany and several other European countries, Spain had suspended administering the shot over blood clot concerns but resumed its use after the EU's drug regulator deemed the vaccine "safe and effective."
Italy resumed using the AstraZeneca vaccine on all age groups on March 19 after briefly pausing usage earlier this month.
On Tuesday, Prime Minister Mario Draghi and his wife Maria Serenella Cappello, who are both 73, received their first doses of the vaccine at a large vaccination centre set up at Rome's main railway station, the prime minister's office said.
The head of the health panel advising the government has said that Italians who decline to be inoculated with the AstraZeneca vaccine will be "reconsidered later for another type of vaccine."
France's medical regulator approved the resumed use of AstraZeneca's vaccine on March 19 but said it should only be given to people aged 55 and older, breaking with guidance from the European Medicines Agency (EMA).
France said the decision was based on evidence that the clotting affected younger people.
Denmark was among the first countries in Europe to suspend the use of the AstraZeneca vaccine this month over concerns about the rare cases of blood clots. On March 25, it extended its suspension for another three weeks, pending further investigation.
Authorities said they still could not rule out a connection between the vaccine and the very unusual illness in two local cases, which are still being analyzed, and cases elsewhere in Europe.
Approximately 150,000 people in Denmark had received AstraZeneca's shot before it was suspended.
WATCH | Why Canada's vaccine committee recommended pausing AstraZeneca:
Like neighbouring Denmark, Norway suspended the rollout of the AstraZeneca vaccine on March 11. On March 26, health officials said they would delay a decision on whether to resume its use until April 15.
Norway had reported five cases in which healthy recipients of the vaccine were admitted to hospital with a combination of blood clots, bleedings and low platelets, three of whom died.
The country's health agency said on March 25 it will resume use of the vaccine for people aged 65 and older, but keep the pause in place for younger Swedes.
Thailand began using the AstraZeneca vaccine on March 16, after it delayed rollout the week before over safety concerns.
Prime Minister Prayuth Chan-ocha was the first in the country to be inoculated with the vaccine.
"Today I'm boosting confidence for the general public," Prayuth, who was soon to turn 67, told reporters at Government House before he received the shot.
South Korea authorized the AstraZeneca vaccine for people 65 and older earlier this month after delaying its use for that age group, citing a lack of clinical data.
President Moon Jae-in received the vaccine at a community clinic on March 23, a day after authorities reaffirmed they had found no evidence of health risk.
Cameroon's Health Ministry suspended administration of the batch of AstraZeneca vaccines it was scheduled to receive on March 20 as part of the global vaccines-sharing initiative COVAX.
The ministry said in a statement March 18 that the suspension was due to precaution and prudence. It gave no further reasons for the decision or say if it will go ahead and take delivery of its share of the vaccine.
WATCH | Should people who've had the AstraZeneca vaccine be concerned?
The U.K. was the first country in the world to approve the AstraZeneca vaccine, on Dec. 30. On March 18, Britain's medicines regulator gave its continued backing to the vaccine, saying the benefits outweighed the risks after finding there had been five cases of a rare brain blood clot among 11 million administered shots.
Britain's Medicines and Healthcare Products Regulatory Agency (MHRA) said that use of the vaccine should continue while the five reports were investigated.
At a news conference that day, Prime Minister Boris Johnson said he was receiving a first dose of the AstraZeneca vaccine himself the following day.
"The Oxford jab is safe and the Pfizer jab is safe," he said. "The thing that isn't safe is catching COVID, which is why it's so important that we all get our jabs as soon as our turn comes."
While the AstraZeneca vaccine has been authorized for use in more than 50 countries, it has not yet been given the green light in the U.S.
U.S. health officials had publicly rebuked the drugmaker for not using the most up-to-date information when it published an interim analysis of its major U.S. trial on March 22 that said the vaccine had a 79 per cent efficacy rate at preventing symptomatic illness. An updated analysis showed a 76 per cent efficacy rate, AstraZeneca said a few days later.
AstraZeneca said it plans to seek U.S. emergency use authorization in the coming weeks and that the latest data has been presented to the independent trial oversight committee, the Data Safety Monitoring Board.