* France staggers shots after hospital staff call in sick

* Sweden pauses AstraZeneca jabs in two regions

* In Germany, doses unused, health minister says shot safe

* AstraZeneca: vaccine reactions in line with clinicaltrials

By Caroline Pailliez and Johan Ahlander

PARIS, Feb 18 (Reuters) - Health authorities in someEuropean countries are facing resistance to AstraZeneca'sCOVID-19 vaccine after side-effects led hospital staffand other front-line workers to call in sick, putting extrastrain on already-stretched services.

Such symptoms, as reported in clinical trials for theAstraZeneca shot, can include a high temperature or headache andare a normal sign that the body is generating an immuneresponse. They usually fade within a day or so.

The other shots approved in Europe, developed by Pfizerand Moderna, have been linked to similartemporary side-effects, including fever and fatigue.

But with the AstraZeneca shot the latest to be rolled out,health authorities in France have issued guidance to staggergiving the shot, two regions in Sweden paused vaccinations, andin Germany some essential workers are refusing it.

A spokesman for AstraZeneca said: "Currently, the reactionsreported are as we would expect based on the evidence gatheredfrom our clinical trial programme."

People receiving the vaccine are closely monitored throughroutine pharmacovigilance activities, the Anglo-Swedish drugmaker said, adding that it was continuing to keep a close eye onthe situation.

"There have been no confirmed serious adverse events," thespokesman said.

'MORE SIDE-EFFECTS'

In France, which started administering the AstraZeneca shoton Feb. 6, staff at a hospital in Normandy experienced strongerside-effects than seen with the alternative vaccine from Pfizerand German partner BioNTech.

"AstraZeneca caused more side-effects than the Pfizervaccine," said Melanie Cotigny, communications manager atSaint-Lo hospital in Normandy.

"Between 10% and 15% of those vaccinated may haveside-effects from this vaccination, but it is only a feverishstate, fevers, nausea and within 12 hours it goes away."

Following similar reports from other hospitals, the Frenchmedicines safety agency said on Feb. 11 that such side-effectswere "known and described" but should be subject to surveillancewith regard to their intensity.

It also issued guidance to stagger vaccinations offront-line staff working together in teams to minimise the riskof disruption to operations.

The agency put out the advice after receiving 149 alerts ofoften strong flu-like side-effects from the AstraZeneca vaccine.During this period a total of 10,000 people received the shotnationwide.

Some U.S. hospitals and other organisations with front-linestaff adopted a similar strategy when the country's vaccinationprogramme started in December. The United States isadministering shots from Pfizer/BioNTech and Moderna.

In Britain, home to the AstraZeneca vaccine developed atOxford University, the policy has been to make vaccinationsreadily available to hospital staff. As many work shifts, thatnaturally spaces out the process.

The issues in France highlight how some doctors andhospitals are still learning how best to administer vaccines asgovernments race to tame the pandemic and get shots in arms asquickly as possible.

It's also the latest setback for the French vaccinationcampaign which has been criticised for a slow start. Last week,the government said just over 3% of the population had receivedtheir first dose.

In Sweden, two of 21 healthcare regions paused vaccinationsof workers last week after a quarter called in sick aftergetting the AstraZeneca shot.

The Sormland and Gavleborg regions said that around 100 outof 400 people vaccinated had reported fever or fever-likesymptoms. Most cases were mild and in line with previouslyreported side-effects.

Both regions said they would resume vaccinations, and theSwedish Medical Products Agency saw no reason to change itsvaccination guidelines.

NO SHOWS

AstraZeneca's vector-based vaccine is the third to winregulatory approval in the European Union.

As part of the European Medicines Agency's positiverecommendation on Jan. 29, the watchdog concluded it was about60% effective, compared to more than 90% for the vaccines fromPfizer/BioNTech and Moderna.

It also deemed the product safe to use and it will monitorreports of side-effects as a matter of routine.

In Germany, Health Minister Jens Spahn responded onWednesday to reports that essential workers were reluctant toreceive the AstraZeneca shot after some experienced strongside-effects, saying it was both safe and effective.

"I would be vaccinated with it immediately," Spahn toldreporters.

Like most European countries, German states typically do notoffer people a choice of which vaccine they will get, leading insome cases to people not turning up to appointments to get theAstraZeneca vaccine.

Germany has taken delivery of 737,000 doses from AstraZenecabut only administered 107,000, according to figures from thehealth ministry and the Robert Koch Institute that leads itspandemic response.

"This vaccine is an excellent way to prevent serious COVIDdisease," said the health ministry in the eastern state ofSaxony. "Still, we note that there are still vacant vaccinationdates for AstraZeneca.

"From our point of view, it is wrong that this vaccine isavailable but not being used," it said, adding that it wasreallocating spare shots to teachers and public health workers.(Caroline Pailliez reported from Paris, Johan Ahlander fromStockholm; Additional reporting by Caroline Copley in Berlin,Ludwig Burger in Frankfurt, Richard Lough in Paris and PaulSandle in London; Writing by Douglas Busvine; Editing byJosephine Mason and Nick Macfie)