Authorities in Berlin and Munich are again suspending the use of AstraZeneca’s coronavirus vaccine for residents under age 60 because of new reports of unusual blood clots in people who recently received the shots, officials said on Tuesday.

The action was taken as a precaution ahead of a meeting later on Tuesday of representatives from Germany’s 16 states and further recommendations expected from national medical regulators, said Berlin's top health official, Dilek Kalayci.

The decision came after the country’s medical regulator announced that it had received a total of 31 reports of rare blood clots in recent recipients of the AstraZeneca vaccine. Nine of the people died and all but two of the cases involved women aged 20 to 63.

Reports of an unusual form of blood clot in the head, known as sinus vein thrombosis, prompted several European countries to temporarily halt the use of the AstraZeneca vaccine earlier this month. After a review by medical experts, the European Medicines Agency concluded the benefits of the vaccine outweighed the risks.