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Countries across the Asia Pacific are demurring on AstraZeneca PLC’s COVID-19 vaccine, or restricting its use, in moves that may delay protection for the region amid concerns that the shot could trigger a rare and potentially deadly blood clotting condition.

After guiding against the vaccine’s use in people under 50 and saying that it didn’t expect shipments from Europe to arrive on time, Australia’s government abandoned a pledge that everyone in the country would receive a first dose by October.

In Hong Kong, officials said they wouldn’t take delivery of the vaccine supply they’ve ordered from the British drugmaker this year, as the city plans to rely on vaccines from BioNTech SE and Sinovac Biotech Ltd.

While South Korea said it would resume inoculations with the AstraZeneca shot this week after a suspension, it will limit use to those between 30 and 60 years old.

The shrinking usage mirrors developments in Europe, where the potential links between the AstraZeneca vaccine and rare occurrences of blood clots in the brain, accompanied by low platelet levels, was first identified. In Asia, where the virus has been far better contained and people don’t run a high risk of contracting or dying from COVID-19, resistance to the shot may be even stronger.

“When some overseas regulators say the benefits may still outweigh the risk, they are referring to a situation where potentially the vaccine could still save more lives from COVID-19 related deaths than are lost due to this syndrome,” said Nikolai Petrovsky, a professor at the College of Medicine and Public Health at Flinders University in South Australia.

“In the context of Australia, where we currently have no COVID-19 deaths, the risk-benefit relationship of the AstraZeneca vaccine is very different, particularly when other vaccines are potentially available that do not appear to share this risk.”

Like Australia, COVID-19 fatalities across Asian economies like China, Singapore and Taiwan are near zero at present.

Lower vaccination rates have implications for global herd immunity. The world will only be safe when enough people have protection thanks to natural infection or vaccination, and the virus is no longer able to easily spread. Until that days arrives, there remains a risk that novel variants will arise as the pathogen mutates, potentially negating immunity gained from earlier exposure.

South Korea’s situation is a reflection of the dilemma faced by governments whose supply strategy is reliant on the AstraZeneca shot. In its first phase of inoculating nursing home residents, hospital patients and front-line health care workers, the vaccine accounted for about 90% of the more than 1 million shots administered so far.

Last week, the government temporarily suspended the use of the vaccine for those below 60 on blood clot concerns, before saying that among three cases of blood clots identified locally after an AstraZeneca inoculation, two were not linked to the vaccine. A third didn’t fall under the European Medicines Agency’s definition of the side effect since the patient didn’t have a reduction in platelet levels.

Regulators determined the vaccine’s benefits didn’t outweigh the risk of the rare blood clot for those under age 30 and will continue to closely monitor the safety those who are still able to get it.

The Hong Kong government said it doesn’t need the AstraZeneca shots it was expecting in the second half of this year. The city has enough vaccine already and is in talks with suppliers to procure a new generation of immunizations that will protect better against the novel variants that have arisen.

Australian Prime Minister Scott Morrison said he’s not sure when everyone in his country will have access to vaccination due to the issues with the AstraZeneca shot. While the government hopes it will be widely available by the end of the year, “it is not possible to set such targets given the many uncertainties involved,” he said.

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