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Norway to retain suspension of AstraZeneca vaccine until at least next week

Norway said on Thursday it would wait before resuming use of AstraZeneca's Covid-19 vaccine even though it has been declared safe by Europe's medical regulator.

Norway to retain suspension of AstraZeneca vaccine until at least next week
(Photo by Miguel MEDINA / AFP)

The European Medicines Agency’s (EMA) said that after an investigation the AstraZeneca vaccine was “safe and effective” and not linked to an increased risk of blood clots.

The ruling, which was similar to the World Health Organization’s statement, led to European heavyweights Germany, France, Spain and Italy all saying they would soon resume vaccinations with the jab.

The Norwegian Institute of Public Health (NIPH) said it “took note” of the EMA’s finding, but deemed it “premature” at this point to come to a final conclusion.

The NIPH said it would issue its own guidance at the end of next week.

“Vaccinations with AstraZeneca will remain suspended until we have a full view of the situation,” institute director Camilla Stoltenberg told media.  

On Thursday, a Norwegian medical team claimed it found a link between the AstraZeneca vaccine and blood clots in patients who became seriously ill or died a few days after their first injection.

 “We obtained results that could explain the clinical evolution of our hospitalised patients,” said Pål Andre Holme, professor and chief physician at Oslo University Hospital.

“These results support our theory… that these patients had a strong immune response which led to the formation of antibodies that could affect the (blood) platelets and lead to a thrombus” or blood clot, he added.

READ MORE: Norwegian experts conclude ‘strong immune response’ from AstraZeneca vaccine linked to blood clots

 Asked if the death was caused by the vaccine, he replied: “I don’t see any other possibility at this point,” while emphasising that it was still a question of “indicators”.

Norwegian media said the results were recent and had not been taken into consideration by the EMA.

The European agency’s safety committee concluded that the vaccine was “not associated with an increase in the overall risk of thromboembolic events or blood clots”, according to EMA chief Emer Cooke.

She nonetheless declined to “rule out definitively” a link to a rare clotting disorder.

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HEALTH

When can doctors in Denmark refuse to continue treating patients?

General Practitioners in Denmark have the right to break off a patient-doctor relationship in specific circumstances.

When can doctors in Denmark refuse to continue treating patients?

Although doctors in Denmark have the right to decide not to continue treating a patient – requiring them to find a new GP – the circumstances in which this can happen are limited, and must be approved by health authorities.

The frequency in which the circumstances arise is also low. A doctor decided to no longer receive a patient on 375 occasions in 2016, according to the medical professionals’ journal Ugeskrift for Læger. The following year, newspaper Jyllands-Posten reported the figure at 458.

There are two main categories of circumstances in which a doctor can choose to take this step. The first is in instances of violent or threatening behaviour from the patient towards the doctor. 

The second (and most common) is when the doctor considers the relationship to have deteriorated to the extent that confidence has broken down, according to Ugeskrift for Læger.

It should be noted that patients are not bound by any restrictions in this regard, and can decide to change their GP without having to give any justification.

A patient also has the right to appeal against a doctor’s decision to ask them to find a new GP. This is done by appealing to the local health authority, called a Region in the Danish health system.

In such cases, a board at the regional health authority will assess the claim and if it finds in favour of the patient may order the doctor to attempt to repair the relationship.

Doctors cannot end a relationship with a patient purely because a patient has made a complaint about them to health authorities. This is because patients should have the option of making complaints without fear of consequences for their future treatment. 

However, if this is accompanied by the conclusion on the doctor’s part that there is no longer confidence in them on the part of the patient, they can remove the patient from their list.

The right to no longer see patients in the circumstances detailed above is provided by doctors’ collective bargaining agreements, the working conditions agreed on between trade unions and employer confederations under the Danish labour market system.

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