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The Netherlands on Sunday joined five other European nations that have suspended AstraZeneca vaccinations over blood clot concerns despite advice from the European Union’s medicines regulator that the benefits of the shot outweigh any potential risks.

Dutch Health Minister Hugo de Jonge said on Monday that a “rare combination” of blood clots and lowered blood platelets in several AstraZeneca vaccine recipients in Norway and Denmark was “enough reason” to pause use of the vaccine in the Netherlands for two weeks.

While any causality remains an open question, reports about six cases in Norway and Denmark — which suspended AstraZeneca vaccinations on Thursday — had given the Netherlands’ medicine authority enough reason “to press the pause button,” de Jonge said.

“Thrombosis is of course a very common complaint. And so if you are vaccinating a large group of people, it’s not crazy that there will also be people with thrombosis after vaccination. But in this case it is a very rare combination of thrombosis in which bleeding can also occur due to a reduced number of platelets,” he added.

The Health Minister had said as recently as Thursday that blood clots were occurring “not because of vaccination,” and that there was “no cause for concern.”

In a letter to parliament sent on Sunday, de Jonge wrote that the pause would be in effect until March 29, “pending further advice from the EMA,” or European Medicines Agency.

The EMA on Thursday advised that the benefits of the AstraZeneca vaccine outweigh the risks, and did not recommend suspending its use while investigation into thromboembolic events are ongoing. 

The EMA said it was aware that Denmark was suspending AstraZeneca vaccinations due to reports of blood clots in people who had received it, but said: “There is currently no indication that vaccination has caused these conditions, which are not listed as side effects with this vaccine.” 

The Danish Medicines Agency on Monday said the woman who died of a blood clot after receiving AstraZeneca in Denmark had an “unusual picture of illness around the death,” with a low number of platelets, blood clots in small and large vessels and bleeding.

“The clinical picture is highly unusual and is currently being thoroughly investigated by the European Medicines Agency,” the agency said in a statement.

Denmark is one of six European countries to suspend AstraZeneca’s use despite the EMA’s recommendation.

  • Denmark: On Thursday, March 11, Denmark suspended AstraZeneca vaccinations for 14 days as a “precautionary measure” as it investigates “signs of a possible serious side effect in the form of fatal blood clots” after one Danish person died following vaccination, according to Danish health officials.
  • Norway: On Thursday, March 11, Norway chose to “pause” vaccinations following reports of the death in Denmark. The Norwegian Institute of Public Health said similar cases had been reported in Norway, but “mainly in the elderly where there is often another underlying disease as well.” 
  • Iceland: On Thursday, March 11, Iceland suspended use of the AstraZeneca vaccine. There have been no reports of patients developing blood clots in the country. 
  • Bulgaria: On Friday, March 12, Bulgarian Prime Minister Boyko Borissov ordered a halt to all AstraZeneca vaccinations until the EMA “rejects all doubts” about the vaccine’s safety.
  • Ireland: On Sunday, March 14, Ireland decided to temporarily suspend the use of the AstraZeneca vaccine to “maintain confidence” in its vaccine program, according to the Chairman of its National Immunization Advisory Committee.
  • Netherlands: On Sunday, March 14, the Dutch government said it would pause AstraZeneca vaccinations for two weeks “as a precautionary measure and pending further investigation.”

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