Updated WHO Interim recommendations for use of the COVID-19 ChAdOx1-S [recombinant] vaccine (AstraZeneca COVID-19 vaccine AZD1222, SII Covishield, and SK Bioscience)

27/04/2021

On 21 April 2021, the World Health Organization (WHO) published an update to the document “Interim
recommendations for use of the ChAdOx1-S [recombinant] vaccine against COVID-19 (AstraZeneca COVID-19
vaccine AZD1222, SII Covishield, SK Bioscience),” based on the recommendations issued by the Strategic Advisory
Group of Experts on Immunization (SAGE) at its extraordinary meeting on 8 February 2021 (1), updated on 21 April
2021.


Under ‘precautions’, this update includes information on thrombosis with thrombocytopenia syndrome (TTS), which
has been reported approximately 4 to 20 days after vaccination with the ChAdOx1-S [recombinant] vaccine.
The indication is that in countries with continuous transmission of SARS-CoV-2, the benefit of vaccination in
protecting against COVID-19 far outweighs the risks. However, since benefit-risk assessments may differ from country to country, countries should consider their situation, individual-level and population-level risks, availability of
other vaccines, and alternatives to mitigate risk.


It has also been established that people who have had blood clots associated with low platelet levels (TTS) after their
first dose should not receive a second dose.


In terms of interchangeability with other COVID-19 vaccines, this update indicates that all ChAdOx1-S [recombinant]
products (AstraZeneca AZD1222, SII Covishield, and SK Bioscience) are considered equivalent and interchangeable
for both doses; it is recommended that both doses be administered with ChAdOx1-S products.
These recommendations could be updated as more information becomes available from studies being conducted to
assess whether COVID-19 vaccines using a different platform can be used interchangeably in the vaccination
program.


Link: https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccines-SAGE_recommendation-AZD1222-2021.1

 

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