In spite of advice from the European Medicines Agency (EMA) to the contrary, the Dutch Medicines Evaluation Board (MEB) continues to advise the Dutch government to stick with the plan to push back the second dose of the Pfizer / BioNTech coronavirus vaccine from three weeks to six weeks. 

EMA and Pfizer: three weeks between vaccine doses

At the press conference on January 20, Health Minister Hugo de Jonge announced that the cabinet had made the decision to postpone the date of the second coronavirus vaccine dose in order to make stocks last longer and allow more people to receive the first dose. Since then, anyone who has received the first dose of the Pfizer vaccine will have to wait six weeks for their second jab. 

The government made this decision based on previous guidance from the EMA that stated “at least 21 days” were needed between the two doses in order to guarantee adequate protection against coronavirus. Now, the EMA advice explicitly states that there needs to be three weeks - no more, no less - between the two injections. The guidance from Pfizer says exactly the same. 

Six weeks between coronavirus vaccine doses

According to the EMA, there is insufficient evidence to show that extending the gap between the two injections is harmless, and furthermore that the recipient of the vaccine may not be completely protected if the second dose is administered more than three weeks after the first. 

But last week, the MEB concluded that a delay would be safe. And the MEB is reported to be sticking to this advice: “There is no new information to change our decision,” said Ton de Boer, MEB chairman, in Nieuws en Co. The cabinet is now waiting on a ruling from the Health Council of the Netherlands before deciding whether or not it will follow the new advice from the EMA or stick with the advice from the MEB. 

The Netherlands under pressure to speed up vaccinations

De Jonge has recently faced significant criticism for the slow vaccination rate in the Netherlands. Ernst Kuipers, chairman of the National Acute Care Network (LNAZ), has said vaccinations need to be carried out at a much faster pace, saying that the number of people immunised can be increased by 500.00 “within a week” with the help of hospitals and GPs. 

There are currently around half a million doses in stock, many of which are being kept in order to administer a second jab. Kuipers suggested that the government should stick with the plan to delay the second dose, stating that even if the protection isn’t optimal after only one dose, the chance that someone would catch the virus and end up in intensive care is “minimal”, and that the 500.000 doses could instead be used to provide more people with their first dose. 

On top of this, De Jonge has had to deal with the news that the Netherlands will receive significantly fewer AstraZeneca doses than it had initially hoped for. Speaking to the AD, he announced plans to scale up vaccinations over the coming weeks, but that it was important not to use up all the stock too quickly: “We have to make sure that in a while we also have enough in stock to be able to guarantee the scheduled injections," De Jonge said. "It's all about one thing: are enough vaccines coming in?"

Around 203.500 people in the Netherlands have been vaccinated since January 6. This means that for every 100 members of the population, one person is vaccinated. In Europe, only Bulgaria has a lower vaccination rate than the Netherlands. Malta leads the pack: more than four in every 100 inhabitants have been vaccinated.