Less Participation in Childhood Vaccinations in Iceland

Participation in childhood vaccinations in Iceland has not recovered since the downturn that occurred during the pandemic, RÚV reports. There is still a shortage of vaccines due to production problems.

Children’s participation in general vaccinations in 2022 was lower than in previous years, according to a new report from the Chief Epidemiologist. Increased strain on healthcare centres and a shortage of vaccines have impacted the situation and the healthcare system has not been able to make up for the vaccinations missed during the pandemic. The number of unvaccinated foreign citizens may be skewing the data and is being looked at more closely.

The Icelandic Medicines Agency (Lyfjastofnun) reports that the Boostrix Polio vaccine, which has been unavailable in Iceland for some time, has arrived in the country and goes on sale on September 13. Shortages of other routine vaccines for children have also been reported. While pharmaceutical wholesalers are responsible for stockpiling medicines in Iceland, various factors can cause temporary shortages of vaccines and other medicines.

Systematic vaccination has largely eliminated many diseases that regularly lead to death within the population. Continued vaccination is crucial for herd immunity to develop and diseases to be kept under control. Statistics from other countries show that when routine vaccination is relaxed, outbreaks of diseases such as measles, diphtheria, and polio have occurred.

Imposing COVID Restrictions Now Would Have Limited Effect, Chief Epidemiologist Says

Chief Epidemiologist Iceland Þórólfur Guðnason

Iceland’s Chief Epidemiologist Þórólfur Guðnason told Kjarninn that imposing COVID-19 restrictions in Iceland now would have limited effect on the spread of the SARS-CoV-2 virus. The currently dominant variant, BA.5, is more contagious than the omicron variant, and a newer variant that is emerging elsewhere in the world, BA.2.75, appears to be still more contagious. Very strict measures would be needed to prevent the spread of these varieties, and their success would be far from guaranteed.

Most re-infections among those who caught the virus early

COVID reinfections in Iceland are by far most common among those who were infected early in the pandemic: before the Omicron variant became widespread. The reinfection rate among people who were infected with the Omicron variant is under 1%. Þórólfur says this could change, however, with the arrival of new variants that could be evading previous immunity. The Chief Epidemiologist noted that in almost all cases, reinfections have been milder than the initial infection.

The Chief Epidemiologist observed that likely neither the Icelandic public nor the government is likely to welcome restrictions at this time, but luckily the COVID-19 situation in Iceland has been relatively stable. Around 30 people in Iceland are in hospital due to a COVID-19 infection, most infected for the first time, and one or two of them in the ICU.

Þórólfur expressed his hope that immunity against COVID-19 would continue to build up and infection rates and rates of serious illness would begin to decrease soon. Iceland’s herd immunity is already very high, he added, and fourth doses are not recommended except for at-risk groups.

Iceland’s Chief Epidemiologist Resigns

Chief Epidemiologist Þórólfur Guðnason

Chief Epidemiologist of Iceland Þórólfur Guðnason has sent in his resignation. The Directorate of Health announced the decision on its website this morning. Þórólfur is leaving the job both for personal and professional reasons.

According to the Directorate of Health, the main reason for Þórólfur’s resignation is that the current wave of COVID-19 infection has mostly subsided and a new chapter is beginning in the Chief Epidemiologist’s role. “This new chapter includes, among other things, a review of the response to the COVID pandemic with the aim of improving response to future pandemics,” the notice from the Directorate states. The Chief Epidemiologist will also be shifting focus back to the routine projects that were largely put on hold due to the pandemic.

Pandemic far from over

Led by Þórólfur, Iceland’s response to COVID-19 received global attention early in the pandemic. With a focus on testing, tracing, and isolating cases, the country managed to contain the first wave with relatively few infections and deaths – and without ever instituting a total lockdown or closing schools.

“While Iceland is currently in a good place in the COVID pandemic, it is far from over globally and while such is the case, it will be necessary to closely monitor the emergence of new variants of the virus and how well and for how long the immunity that individuals have achieved will last,” the notice on Þórólfur’s resignation states.

Another reason for Þórólfur’s resignation is that he turns 70 next year: the age at which the Chief Epidemiologist is required by law to leave the position. His resignation will take effect September 1.

Þórólfur recently reflected on his work throughout the pandemic in an interview with Iceland Review.

 

 

COVID-19 in Iceland: 10% of Imported Vaccines Sent Abroad Again

Around 10% of all the COVID-19 vaccines imported to Iceland have been exported again, RÚV reports. Some 2,000 doses expired this month while in storage at Distica, the company responsible for COVID-19 vaccine imports to Iceland.

Since the first shipment of COVID-19 vaccine arrived in Iceland on December 28, 2020, Iceland has imported around 1 million doses Pfizer, Moderna, and Janssen (Johnson & Johnson) COVID-19 vaccines. The country has since exported around 10% of those, or 100,000 doses, to Thailand.

Distica CEO Júlía Rós Atladóttir says the import company is now receiving around 10,000 doses of vaccine monthly, considerably fewer than at the height of the vaccination drive. Júlía says no doses delivered to Iceland had expired until this month.

“We have not discarded any vaccines and none of them have expired until just recently. This April, the 2,000 doses that we had in storage here expired, a completely insignificant [proportion],” Júlía stated.

Flu Epidemic Likely Following Decline in COVID Cases

Chief Epidemiologist Þórólfur Guðnason believes that the waning COVID-19 pandemic is slowly being replaced by an influenza epidemic. The health authorities encourage individuals with underlying conditions to receive flu shots.

Brynjar Níelsson gets the flu

Last week, Brynjar Níelsson, Assistant to the Minister of Justice, published an essay on the subject of “pushy people” on his Facebook page.

While the former MP’s meditations were mildly interesting, the disclaimer that accompanied his post was even more noteworthy.

“I am extremely sick with the flu and nearly delirious,” Brynjar wrote (ensuring that any controversial statements could be chalked up to the delirious effects of the flu).

… but Brynjar Níelsson isn’t the only one who’s been suffering.

Up to 3,000 visits daily

In an interview with the radio programme Reykjavík síðdegis on Wednesday, Óskar Reykdalsson – Director of Capital Area Health Clinics – observed that the annual flu appeared to be “circulating among the populace in full force.”

Óskar estimated that up to 3,000 people visit capital-area clinics every day, complaining of common-cold symptoms, fever, and a cough.

Among those who have had reason to complain is singer Heiðar Örn Kristjánsson (who competed with Pollapönk in the 2014 Eurovision Song Contest) whose upcoming gig at Gamli Enski in Hafnarfjörður was cancelled for this very reason.

“Heiðar Örn has the flu and has lost his voice,” Gamli Enski announced on its FB page in early March. “In light of this, DJ Drinkalot will be filling in.”

If only Heiðar Örn had taken preventive action …

Flu shots are sensible

The health authorities in Iceland imported 95,000 doses of flu vaccine last year, and an estimated 68,000 individuals have been vaccinated since last fall. There is still plenty of vaccine available.

“It’s not too late to get vaccinated,” Óskar Reykdalsson stated in his interview with Reykjavík síðdegis, “so long as you haven’t been exposed to the flu.”

Chief Epidemiologist Þórólfur Guðnason made the same point in an interview with RÚV this morning, where he encouraged everyone to get their flu shots. “Especially those with underlying conditions.”

“We’ve also been encouraging doctors to treat people with underlying conditions as quickly as possible in the event that they become sick. That undoubtedly helps prevent serious illness.”

Social restrictions to blame

The reason why the influenza epidemic is so forceful this year owes to the social restrictions imposed to curb the COVID-19 pandemic over the last two years.

According to Chief Epidemiologist Þórólfur Guðnason, these restrictions prevented common annual bugs from spreading.

“So we can expect a significant circulation of these bugs now, because the flu hasn’t been spreading for the past two years,” Þórólfur remarked this morning. “This usually means that immune systems are much weaker than they otherwise would be.”

“What’s happening now is what I suggested could happen, that is, that we’re getting an extensive influenza epidemic,” Þórólfur continued. “We don’t know how extensive it will be, or how serious, because it’s just beginning.”

Iceland to Lift All COVID Restrictions on Friday

Health Minister Willum Þór Þórsson and Prime Minister Katrín Jakobsdóttir

There will be no more COVID-19 restrictions in Iceland or at its borders as of Friday, Iceland’s Health Minister has just announced. Iceland’s remaining restrictions, including a 200-person gathering limit, will be lifted on Thursday night at midnight. Health Minister Willum Þór Þórsson stated that those who are sick are still encouraged to stay at home.

Willum announced the restrictions in an informal press conference just after 1:00 PM, following a cabinet meeting, where he says the decision was unanimous among ministers. Prime Minister Katrín Jakobsdóttir stated in the press conference that the lifting of restrictions is in line with recommendations from the Chief Epidemiologist.

The current border regulation has been in effect since October 1, 2021 and will expire at midnight Thursday. Travellers will no longer be required to register prior to arrival or to present vaccination certificates. Unvaccinated travellers will no longer be required to be tested and quarantine for five days.

Katrín pointed out that around 110,000 residents of Iceland, of the total population of some 370,000, have already had COVID-19, according to official numbers. However, research suggests the true number is significantly higher. “The virus is still with us, and we know that many people will still get infected,” Katrín stated, adding that workplaces and communities will be affected, “but we believe we can live with the virus.”

Both Willum and Katrín emphasised that people are still encouraged to test and isolate if they are sick, though access to PCR tests has now been limited. Asked about strain on the healthcare system, Willum stated: “The going will be tough for some weeks moving forward,” due to covid infections among both patients and staff disrupting services.

Asked whether COVID-19 measures could be reimposed in the future, Katrín stated: “We are always ready for the possibility that a new variant could emerge,” and added that authorities would continue to monitor the state of the pandemic domestically and globally.

COVID-19 in Iceland: Chief Epidemiologist Preaches Patience as Authorities Adapt to Omicron Impact

Chief Epidemiologist Iceland Þórólfur Guðnason

Icelandic health authorities are reviewing their pandemic response measures to adapt to the impact of the Omicron variant, the country’s Chief Epidemiologist Þórólfur Guðnason stated at a briefing in Reykjavík this morning. Children are no longer required to submit to a nasal swab when they are tested for COVID-19, and authorities have loosened quarantine regulations for triple-vaccinated people. Þórólfur stated that isolation and quarantine regulations were under continuous review.

 

The Omicron variant now accounts for over 90% of COVID-19 infections in Iceland, the Chef Epidemiologist stated. As a result, hospitalisation rates due to COVID have dropped to 0.2-0.3%, down from around 2% when the Delta strain was dominant in Iceland. Nevertheless, Iceland’s National University Hospital is experiencing strain due to the sheer number of cases. Work has begun on researching and assessing the changing nature of COVID-19 illness as a result of the Omicron variant, which will help authorities refine their response efforts.

 

Þórólfur stated he would likely not recommend changes to Iceland’s domestic restrictions before the current restrictions are set to expire, on February 2. He emphasised the importance of proceeding slowly, as loosening restrictions too early could backfire and lead to a surge in infection rates.

 

The following is a lightly-edited transcription of Iceland Review’s live-tweeting of today’s briefing. 

 

On the panel: Chief Epidemiologist Þórólfur Guðnason and Director of Civil Protection Víðir Reynisson. The special guest at today’s briefing is Selma Barðdal Reynisdóttir, who will discuss how pandemic measures impact children and schools. 

 

Iceland reported 1,488 domestic cases yesterday (50% in quarantine) and 93 border cases, a total case number that has only once been higher, on December 30, 2021. Hospitalisations have, however, decreased in recent days. 

 

The briefing has begun. Viðir starts the briefing by introducing the panel and complimenting school staff and parents for their perseverance in keeping schools operating throughout the pandemic. Víðir says there is a “light at the end of the tunnel” and turns the briefing over to the Chief Epidemiologist. 

 

Þórólfur takes over and goes over the day’s numbers. With an increase in new cases but fewer people in hospital, the Omicron variant is still dominant in Iceland, at around 90% of new cases. The hospitalisation rate among COVID-19 cases is at 0.2-0.3%. When the Delta variant was dominant, it was at 2%. COVID-19 hospitalisations fall into three groups: people with severe COVID illness; people hospitalised for other issues who contract COVID at the hospital; and people hospitalised with other diseases where it isn’t clear if they’re related to COVID or not. 

 

The spread of COVID in Icelandic society has caused a great deal of interruption in the economy even if serious illness is now rare, Þórólfur says. Tightened restrictions took effect five days ago to temper the spread of infections. Þórólfur: we still haven’t seen success from the new restrictions, but in the past, we haven’t seen the effect of tightened restrictions until a week has passed. 

 

If infections are around 1,000 per day, we can expect 54 hospitalisations, according to one projection model, Þórólfur says. Another model of 2,000 infections per day and a 0.3% hospitalisation rate would have around 60 people hospitalised by the end of this month. The number of community infections affects the number of people who have to be hospitalised or require intensive care. Þórólfur emphasises that projection models always have a margin of error, one of the reasons we must try to minimise the spread of infection. 

 

Work is in progress to analyse the nature of the illnesses requiring hospitalisation to better assess which infection prevention restrictions will prove most effective in Iceland. Some modifications have already been made: children’s COVID tests no longer include nasal swabs, and quarantine regulations for those who are triple vaccinated have been relaxed. 

 

Þórólfur addresses criticism on his recommendations to the government, noting the extensive cooperation and consultation his work involves before each assessment is made. The list of collaborators includes healthcare workers, scientists, and university researchers, as well as police and international colleagues. While we wait for the tightened restrictions to make an impact, we must ensure to minimise the number of community infections in order to protect the healthcare system, Þórólfur says. 

 

Selma Barðdal Reynisdóttir takes over to discuss schools and children. The situation in schools varies across the country, from good to very difficult. Everyone is doing their best to keep up the daily routine for children and keep schools open. Luckily, quarantine and isolation usually only affects schools temporarily, but some have had to close for days due to infections. Staffing is a challenge in smaller municipalities, Selma says. The goal is always to keep up as much of normal services as possible, communication is key, says Selma. 

 

Selma maintains that for children and teenagers, including her own, the biggest threat of the pandemic is that schools will close and sports training will be cancelled, although she notes that there’s a difference between the capital area and smaller towns. Voices from the capital area, where the situation in schools is tougher, have been louder than in smaller societies where there are fewer difficulties in keeping schools open. 

 

Selma discusses her work on the surveillance team (vöktunarteymi), a helpful resource for schools, that is a ministry-run cooperative team with representatives from several educational institutions and municipalities. The team ensures oversight over the pandemic situation as it affects children, and meets regularly to keep an eye on things. Víðir takes over and agrees on the importance of this cooperative platform. 

 

The panel opens for questions. 

 

“Are you considering relaxing quarantine restrictions for fully vaccinated children?” Þórólfur says authorities are already making changes, such as not requiring nasal swabs for children’s COVID-19 testing. He agrees the situation must be monitored daily and updates implemented regularly. 

 

Þórólfur is asked if he is willing to reconsider his position to wait to issue new recommendations until the current regulations are set to expire on February 2. Þórólfur states that the work has already begun, with quarantines and testing processes being revised. It’s important not to move too quickly, as relaxing restrictions can backfire and lead to a surge in infections. 

 

Þórólfur is asked about the mandatory isolation period of at least 7 days: are you considering shortening periods, relying instead on quarantine and lighter options? Þórólfur met with Nordic colleagues this morning, who he says have imposed very similar rules to Iceland, though opinions differ on whether isolation can be shortened. But this is part and parcel of the ongoing process of rethinking quarantine and isolation, Þórólfur says. 

 

The National Hospital is working on assessing changes in the virus and associated illness, with more hospitalisations but fewer patients requiring intensive care, the hospital’s challenges are changing. The change in the virus’ behaviour due to the Omicron variant taking over is leading to changes in how healthcare authorities deal with the situation. 

 

Selma is asked about remote learning. Many schools offer options for remote learning and counselling, but that adds to teachers’ workload, and not all schools are able to offer it. 

 

Þóróflur is asked if the tightened restrictions last week were an overreaction. He replies that hospital management has consistently pointed out the strain on the hospital. While some doctors have offered other opinions, healthcare authorities’ message has remained consistent. Þórólfur also notes that all of Iceland’s healthcare institutions are now working according to contingency plans. 

 

Þórólfur is asked about vaccine safety, replying that the Iceland Medicine Agency issues marketing licenses after all requirements have been met. He denies accusations that the public is participating in “drug experiments”. Víðir closes the briefing by restating the authorities’ goals of tempering infections and protecting the healthcare system. The briefing has ended.

COVID-19 in Iceland: Vaccination of Children 5-11 Begins Today

COVID-19 vaccination children

Starting today, children aged 5-11 will be invited to Laugardalshöll stadium in Reykjavík for vaccination against COVID-19. The invitations have been sent to their parents or guardians, who make the decision on whether or not their children will receive the vaccination. Around 33,000 children between 5-11 are eligible for vaccination against COVID-19 in Iceland and some within the demographic have already been vaccinated.

Both in the capital area and in other regions of Iceland, the registered parents and guardians of children aged 5-11 will receive an email from school nurses with information on when their children can get vaccinated. Vaccination for the age group will take place every afternoon this week in Laugardalshöll in Reykjavík. As of this time, only the Pfizer COVID-19 vaccine has been approved for use in those 15 and younger in Iceland.

Open house for boosters

Fully vaccinated adults who have yet to receive their booster shots can do so at Laugardalshöll on weekdays between 10:00 AM and 3:00 PM, where Pfizer, Moderna, and Janssen (Johnson & Johnson) COVID-19 vaccines are on offer at all times. Adults do not need to have received an invitation for a booster shot, but are recommended to come between 10:00 AM and 12:00 PM this week as children’s vaccination will be taking place in the afternoons. All those who received their second dose of any COVID-19 vaccine five months ago or more are welcome to receive a booster shot. Staff will ask for a kennitala (national ID number) at the location.

Chief Epidemiologist recommends vaccination for children

Iceland’s Chief Epidemiologist Þórólfur Guðnason told RÚV that while a small minority in Iceland are against COVID-19 vaccination for children, its benefits are clear. “It’s just clear that the risk from [contracting] COVID is much, much greater for children than the risk from vaccination. It should really be a fairly clear choice for most people, so we will just continue to present those facts and see how it goes.”

Over 90% of Icelanders 12 years of age and older are fully vaccinated against COVID-19, and 44% of the total population have receive a booster shot. Over 70% of children aged 12-15 have been fully vaccinated against COVID-19 and 6% have received their first dose. 

Icelandic health authorities have provided information on COVID-19 vaccination for children in English and other languages on this website. 

Chief Epidemiologist to be Appointed by Health Minister if Amendment Passes

Þórólfur Guðnason Chief Epidemiologist

If proposed amendments to Iceland’s pandemic legislation are passed, the Chief Epidemiologist would be appointed by the Health Minister rather than Iceland’s Director of Health. An epidemiological committee would also participate in the drafting of the Chief Epidemiologist’s recommendations for infection prevention measures. Both the incoming Minister of Health Willum Þór Þórsson and Chief Epidemiologist Þórólfur Guðnason have a positive view of the amendments, which are intended to clarify Iceland’s infection prevention legislation.

Experts say that Iceland’s current legislation on infectious diseases is adequate but could use streamlining, particularly in decision-making when disease control measures are implemented that affect the public. The amendments also aim to clarify the role of the Chief Epidemiologist within the administration.

Chief Epidemiologist and Minister of Health approve

The proposals are built on a report written by Páll Hreinsson, President of the EFTA court at the request of the Icelandic government last year. “When we made changes in the parliament as a response to the pandemic and relatively quickly, there came a report from Páll Hreinsson that stated that we needed to do a comprehensive review of the legislation,” Willum Þór told RÚV. He expressed support of the idea that the Minister of Health would be responsible for appointing the Chief Epidemiologist. “I think it could be a good arrangement. I think it’s perhaps a constitutional issue in terms of responsibility and communication.” He added that he looked forward to hearing other points of view on the matter from fellow MPs and from critics.

While the Chief Epidemiologist is currently appointed by the Director of Health, Iceland’s Chief Epidemiologist has pointed out that the Director of Health is appointed by the Health Minister. “I think [the amendments] are not illogical because the law stipulates that the Chief Epidemiologist works under the Minister and submits his proposals to him,” Þórólfur stated in an interview this morning. “The administrative position of the Chief Epidemiologist is being clarified, I think it’s time to do that.”

A working group has been appointed to draft the bill, consisting of representatives from the Health Ministry, Ministry of Justice, capital area healthcare centres, the Directorate of Health, the Chief Epidemiologist’s office, the National Committee on Prevention and Control of Communicable Diseases, the National University Hospital, and the National Police Commissioner’s Office. It is expected to submit a draft of the amendments by February 1.

Chief Epidemiologist: Rise in COVID Cases a Reason for Concern

Iceland National Hospital COVID-19

Iceland’s National Hospital has once again converted the infectious diseases ward into a COVID-19 ward to address a rise in COVID-19 cases, RÚV reports. Iceland’s 14-day COVID-19 incidence rate has more than doubled over the past month, from 108.3 four weeks ago to 241.3 as of yesterday. Iceland’s Chief Epidemiologist Þórólfur Guðnason says the development gives reason for concern.

“In recent weeks, there has been a fairly rapid increase in the number of diagnosed COVID-19 infections in Iceland,” Þórólfur wrote in a statement published on Iceland’s official COVID-19 website. “The infections have been diagnosed in almost all regions of the country, around 50% were in quarantine at the time of diagnosis and about 50% were fully vaccinated.” Þórólfur continued on to say that hospitalisation rates due to COVID-19 had also risen: “In recent weeks and months, about 2% of those diagnosed have been admitted to hospital, 0.4% have been admitted to the intensive care unit, and about 0.2% have required the assistance of a ventilator.”

Personal infection prevention not enough to control pandemic

Þórólfur underlined that there is “every reason to be concerned about the current development of COVID-19 in Iceland,” adding that the spread of infection has increased hand-in-hand with the loosening of restrictions, and “it is clear that personal infection prevention is not enough to control the pandemic. Although widespread vaccination prevents infection, and especially serious illness, it does not seem to be enough to stop the current wave nor to prevent hospitalisation of those who are seriously ill.”

Read More: COVID-19 Vaccination and Herd Immunity in Iceland

The Chief Epidemiologist encouraged locals to practice personal infection prevention measures such as handwashing in order to reduce the need for social restrictions. He also reminded the public that higher hospitalisation rates impact not only the care of those with COVID-19 but also other hospital services.

Iceland is set to lift all domestic restrictions on November 18. Þórólfur stated today, however, that if the situation worsens significantly he would consider recommending harsher restrictions. He added that he did not know how the government would react to such recommendations.

Hospital affected by COVID-19 outbreak

The National University Hospital has not only been impacted by rising case numbers in the wider community recently, but also within its walls. Five patients and one staff member in the hospital’s Cardiac and Pulmonary Ward tested positive for COVID-19 this week. At least 30 other staff members are in quarantine and some of them are expected to test positive, stated Már Kristjánsson, head physician of the Infectious Diseases Ward.

Seasonal viruses were also hitting children harder than usual this year and the Hringur Children’s Hospital was over capacity, Már stated. He encouraged the public to continue personal infection prevention such as handwashing and using masks in public spaces. “The healthcare system’s infrastructure is in a weak position when facing these major shocks.”