No 28/33 - 2021

Guidance on covid-19 and vaccination

During the COVID-19 pandemic, the Department of Infectious Disease Epidemiology and Prevention has guided healthcare workers on COVID-19 and vaccination, partly by providing daily phone-based guidance, partly through the SSI website and partly via the dedicated e-mail covidinfo@ssi.dk.

The Department’s consultancy team continually identifies specific problems related to COVID-19 vaccination that are then addressed via the website; partly at the COVID-19 subsite and partly at the main site under the menu item “Vaccination”.

Among others, the COVID-19 subsite has a section with frequently asked questions and answers about COVID-19 vaccination.

The below illustration provides an overview of the contents presented at the COVID-19 subsite.

Below, we answer frequently asked questions and provide links to the answers at the SSI website or other information sources.

How do you register COVID-19 vaccines given abroad correctly on the Shared Danish Medicine Card (in Danish: Fælles Medicinkort (FMK))?
Answer: The Danish General Practitioners’ Association (PLO in Danish) and Danish Regions have agreed that physicians may charge a fee for subsequent registration of previously given COVID-19 vaccines. The health professional instructions are available here.

How long an interval is recommended between COVID-19 vaccines and other vaccines?
Answer: No special recommendations exist on the administration of COVID-19 vaccines and other vaccines. They may be co-administered (in separate syringes and at separate injection sites) or at any interval, see questions and answers. This also applies to COVID-19 and HPV vaccination of 12-year-olds.

How many people have been administered one or more injections?
Answer: This figure changes constantly. The updated figure is available (in Danish Language) at the SSI’s Vaccine Dashboard.

How many people have received a vaccination invitation, and how many have booked an appointment?
Answer: This answer is not available at the SSI’s website. Instead, please see the latest status report from the Danish Health Authority (published on 12 August), where the shares of “Completed”, “Initiated”, “Vaccination appointment booked”, “Invited” and “Waiting” are stated by age and age group for ages from 12 to 39 years.

How long a period must pass after a woman receives COVID-19 vaccination before she becomes pregnant?
Answer: We recommend that couples who are planning for pregnancy or fertility treatment accept their vaccination offer regardless of any planned pregnancy or initiated fertility treatment. This applies to the person who wants to get pregnant and her partner. The Danish Health Authority has prepared a memo on COVID-19 vaccination of pregnant and breast-feeding women.

When should pregnant or breast-feeding women be vaccinated?
Answer: Vaccination of pregnant women is recommended in the second trimester, alternatively in the third trimester. Women who are breast-feeding may be vaccinated without delay.

For pregnant women with a special increased risk of running a severe COVID-19 disease course, vaccination may - following individual medical assessment - be administered at any time during the pregnancy, see questions and answers.

(The Consultancy Team, Department of Infectious Disease Epidemiology and Prevention)

Frequently asked questions about influenza vaccination in the 2021-2022 season

The Consultancy Team of the Department of Infectious Epidemiology and Prevention has also received a number of questions about influenza vaccination in the coming season. These are answered in brief below.

Has an executive order on free influenza vaccination been published?
Answer: Currently, no executive order on free influenza vaccination in the coming season has been published. Shortly after an executive order is published, this will be announced at the SSI website.

Is it possible to order influenza vaccines with the SSI now?
Answer: It is not yet possible to order influenza vaccines with the SSI. When we start taking orders, this will be shown here.

Which influenza vaccines will the SSI provide?
Answer: The influenza vaccines provided for the coming season will be:

• InfluvacTetra from Viatris (previously Maylan)
• VaxigripTetra from Sanofi Pasteur
• Efluelda/Fluzone HD from Sanofi Pasteur
• Fluenz Tetra from Astra Zeneca

The three first-mentioned vaccines have been used in Denmark previously. The fourth vaccine is a nasal spray that is approved for use in children aged 2-17 years. All vaccines and their use will be described in more detail in an issue of EPI-NEWS, planned for publication in Week 39.

When will the influenza vaccines be provided?
Answer: The vaccines will be provided in time to initiate vaccination as per 1 October 2021.

(The Consultancy Team, Department of Infectious Disease Epidemiology and Prevention)

Extended free whooping cough vaccination for pregnant women

On 30 June 2021, the Danish Ministry of Health notified that pregnant women will continue to have access to free whooping cough vaccination until 31 March 2022.

Due to the whooping cough epidemic in 2019/2020, the Danish Minister of Health in the autumn of 2019 decided to introduce a temporary offer of free whooping cough vaccination for pregnant women in their third trimester.

The offer was introduced on 1 November 2019 and initially remained in place until 31 January 2020. The offer has been extended repeatedly and is currently in place until 31 March 2022.

Whooping cough vaccination is safe for mother and child, and provides good protection of the child against whooping cough in the initial months of life. The Danish Health Authority recommends that pregnant women in their third semester receive whooping cough vaccination. The third semester includes the period from the start of the 29th week of gestation until the full 40 weeks.

The Danish Health Authority recommends that in connection with the third routine pregnancy examination pregnant women are vaccinated with the GP at approx. 32 full weeks of gestation.

Pregnant women who may be expected to give birth within one week are not recommended vaccination as a prophylactic effect may not be expected for the neonate. Pregnant women who are expecting twins or triplets and other pregnant women who are at risk of giving birth prematurely should discuss whooping cough vaccination with the maternity ward following them.

If a pregnant woman has received a DTaP vaccine after the programme came into force in November 2019 and she has become pregnant again, she should be vaccinated once more during her current pregnancy to ensure that as many antibodies as possible are transmitted to her child before she gives birth.

Even if the pregnant woman has had verified whooping cough before her whooping cough vaccination, she should be offered a DTaP vaccine.

If the pregnant woman has been given a Td booster, a minimum interval of four weeks should be allowed before administering a DTaP vaccine due to the risk of a strong local reaction at the injection site. If a Td booster vaccination or a Td-containing vaccine has been given within the preceding 12 months, the risk remains increased of a local reaction at the injection site.

(S.B. Asmussen, P.H. Andersen, Infection Disease Epidemiology and Prevention)