# Overview of approved COVID-19 vaccines in the EU, recommendations for use in Sweden and vaccine uptake over time: Report from the Swedish Medical Products Agency and the Public Health Agency of Sweden

## TL;DR

This report summarizes the approval, safety, and usage of COVID-19 vaccines in Sweden, including recommendations and vaccination rates.

## Contribution

The report provides a detailed overview of vaccine licensing, safety monitoring, and uptake in Sweden.

## Key findings

- EMA identified safety risks like thrombosis and myocarditis, leading to updated recommendations.
- 85% of Swedes aged 12+ received at least one vaccine dose, with high coverage in older age groups.
- Vaccination was prioritized for high-risk groups and nursing home staff.

## Abstract

The aim of this review is to describe the regulatory background of the COVID-19 vaccines, the national recommendations for use issued and vaccine uptake in Sweden. It includes an overview of licensing and relevant safety aspects identified by the European Medicines Agency (EMA) and the national vaccination plan issued by the Public Health Agency (PHA) of Sweden.

Information on dates of licensing and safety aspects of importance identified by EMA published on its website, was compiled and presented in a chronological order. National recommendations on COVID-19-vaccination and vaccinations-data on uptake and coverage using the national-vaccine-register are presented.

COVID-19 vaccines development, assessments using rolling review and licensing of the covid-19 vaccines was done in 2020 during less than a year. Large-scale production was implemented. Monthly safety reviews performed by the EMA identified risk for thrombosis with thrombocytopenia syndrome with adenoviral vaccines and myocarditis for mRNA vaccines which led to restrictions in national recommendations for specified groups.

National vaccinations were launched in a phased manner during 2021. Persons of high age, risk groups and nursing home personnel were prioritised during primary vaccinations and for initial boosters. In the Swedish population, 85% recieved at least on vaccine dose from the age of 12. At least two doses were recieved by 81% from age 18 and 95% from age 80.

Recommendations for national use adhered to relevant adverse drug reactions identified. The vaccine coverage was high. Timelines presented should be considered in follow-up studies of COVID-19-vaccines to manage possible selection bias and confounding.