By NewsDesk  @infectiousdiseasenews

Finland’s National Institute for Health and Welfare (THL) instructed municipalities to provide only Biontech-Pfizer’s Comirnaty coronavirus vaccine to men and boys under the age of 30 for the time being.

Image by Wilfried Pohnke from Pixabay

According to a Nordic follow-up study, myocardial infarction is relatively more common with Moderna Spikevax than with Biontech-Pfizer Comirnacy, and young men are at higher risk of developing myocarditis after vaccination than women.

According to the study, myocarditis in coronavirus vaccinated people is rare in general. Myocarditis occurs continuously as a result of various infections, even in unvaccinated people.

The highest incidence of myocarditis observed after vaccination has been observed in young men within two weeks of receiving a second dose of mRNA vaccine. The risk is significantly lower in women and older men for both mRNA vaccines.

According to THL’s guidelines, Spikevax can be offered to all women over the age of 30 and women under the age of 30. As before, Comirnaty can be offered to all age groups to be vaccinated. All those aged 12 and over in Finland can receive coronavirus vaccination.

The THL guideline on the age limit for Spikevax is a precautionary measure and will be re-evaluated during November as the results of the study become available.

“The results now obtained are still preliminary. We are currently analyzing them and assessing whether they warrant more permanent changes to the coroner vaccination recommendations in Finland, ”says Hanna Nohynek , THL’s chief physician  .

A total of more than 95,000 first doses and more than 42,000 second doses of Moderna coronavirus vaccine have been given to men and boys under the age of 30 in Finland.

For young men receiving Spikevax, a second dose of Comirnatya

If a man under the age of 30 has received the first dose of Moderna’s Spikevax, the second dose will be Biontech-Pfizer’s Comirnaty.

“Research results from Finland and other countries on the administration of different vaccine products show that those who received two different vaccines receive at least as good protection against the coronavirus as those who have received the same product on both vaccinations,” says Nohynek.

“Taking a second dose is still very important to make the protection against a serious disease as strong and long-lasting as possible.”

THL has previously instructed that no third dose of the vaccine is currently offered to men under 30 years of age, as monitoring data on the association of third doses with the risk of myocarditis are still limited. The exceptions are severely immunocompromised individuals, who are significantly more at risk for severe coronavirus disease than others of the same age. THL also instructs to offer only Biontech-Pfizer vaccine as a third dose to severely immunocompromised men under the age of 30 for the time being.
THL instructs municipalities on the 3rd dose of coronary vaccine vaccinated with a short dose interval – the third dose is not yet available for men under 30 years of age

Women and men over the age of 30 have a significantly lower risk of developing myocarditis after vaccination than young men, so they can continue to be vaccinated normally with both vaccines. However, THL points out that the municipality should offer Comirnacy to the person to be vaccinated if the person to be vaccinated does not want to take Spikevax and it is possible to offer Comirnacy to the person to be vaccinated.

Data from other Nordic countries support Finland’s results

Data from the Swedish, Danish, Finnish and Norwegian health care registers have been used as data from the Nordic follow-up study, and THL has been involved in the study. Data from other Nordic countries on the number of cases of myocarditis treated in hospital are in line with previous results in Finland.

In its study, THL has examined the incidence of myocardial inflammation requiring hospitalization in different age groups. In boys and men aged 12 to 39 years, a total of 6 cases of myocarditis have been reported in Finland per 381,000 doses of Comirnaty and less than 5 cases per less than 49,000 doses of Spikevax in Finland. A total of less than five cases of myocarditis have been reported in girls and women of the same age, and the prevalence of myocarditis in women and girls after vaccination has not differed from that normally seen in the general population.

According to the THL analysis, cases found within four weeks of receiving the second dose of the vaccine have been included. The cases found in the age group have been mild and those who have experienced symptoms have recovered well.

“In Finland, too, the risk of myocarditis appears to be higher in those who received Spikevax than in those who received Comirnacy and higher in men than women, when the calculation also takes into account the different background factors of those vaccinated,” says Petteri Hovi , THL’s specialist researcher  .

“Nordic co-operation in the safety monitoring of coronary vaccinations is important, as the incidence of rare adverse events such as myocarditis is relatively small in each country. The 30-year age limit for Spikevax has been determined on the basis of jointly collected data from the Nordic countries, as reliable conclusions can only be drawn from a large number of vaccinees. ”

The results of the Nordic follow-up study are still preliminary and have been submitted to the European Medicines Agency (EMA) to support the safety monitoring of coronary vaccinations. Nordic co-operation will be continued to map the prevalence of pericarditis, ie coronary artery disease, in those who have received coronary vaccination. Preliminary results are expected to be completed during December.

Fimea and THL are working closely together to investigate myocarditis and evaluate possible regulatory action.