WHO recommends wide use of AstraZeneca vaccine, including over 65s

Doctors do not expect a reversal in Irish plans to favour Pfizer, Moderna for over 70s

A view of packs containing multiple-dose vials of the vaccine against the coronavirus disease by British-Swedish multinational pharmaceutical company AstraZeneca. Photograph: Luca Zennaro/EPA
A view of packs containing multiple-dose vials of the vaccine against the coronavirus disease by British-Swedish multinational pharmaceutical company AstraZeneca. Photograph: Luca Zennaro/EPA

Scientists advising the World Health Organisation (WHO) have recommended the use of the Oxford/AstraZeneca Covid-19 vaccine in all adults.

WHO scientists have issued interim recommendations on the vaccine, saying that the jab could be given people aged 18 and above “without an upper age limit”.

It comes after a number of countries have opted not to give the jab to those over the age of 65, due to a lack of trial data on this age cohort.

The WHO’s Strategic Advisory Group of Experts on Immunisation — also known as Sage — also said that the jab should be given in two doses — with the second dose delivered between four and 12 weeks after the first.

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But Dr Alejandro Cravioto, chairman of the advisory group, told a press briefing that the window of eight to 12 weeks was “the best time” to give a second dose because the delay produces a “much better immune response”.

He said: “We had a long review of the evidence, talked to the experts and the people who are directly involved with a trial.

“Based on the current evidence, Sage recommends that these vaccines should be administered in two doses of half a millilitre each with an interval of between four and 12 weeks between the first and the second dose.”

He added: “In the case of the data coming from clinical trials, we have seen that there was a small participation of people over 65 years of age.

“However, the results of the efficacy estimate for persons up to 65 and older, had a wide confidence interval. And therefore we feel that the response of this group cannot be any different to groups that are of a younger age.

“Since we have identified people over 65 was one of our priority groups in the prioritisation roadmap... looking at the safety and immunogenicity data... we recommend for the vaccine to be used in people 18 years and above, without an upper age limit.

“That means people over 65 years of age should be given the vaccination.”

HSE plans

Doctors do not expect a reversal in the Government’s decision to favour the Pfizer and Moderna vaccines over the AstraZeneca jab for the over-70s - the next group to be vaccinated, starting next week - until there is harder evidence to show its effectiveness among older people.

“The only thing that would change that is solid evidence that it is effective in the over-65s. The WHO statement doesn’t tell me that,” said Dr Denis McCauley, chair of the GP committee of the Irish Medical Organisation.

Ireland revised vaccine rollout plans last week after deciding not to give the AstraZeneca jab to over 70s but to use the Pfizer and Moderna vaccines only.

HSE chief executive Paul Reid said on Sunday the decision to change plans and not to use the AstraZeneca vaccine for the over-70 age group was likely to delay the completion of the process by only a couple of weeks. He said all those over 70 should receive their first dose of the vaccine by mid-April and their second by mid-May.

Chief medical officer Dr Tony Holohan said on Sunday the Pfizer and Moderna vaccines had a superior effectiveness and were considered to be more appropriate for people over 70. The first batch of AstraZeneca vaccines, which arrived in the State at the weekend, were due to be given to healthcare workers this week.

The Oxford jab is an important vaccine for the global supply.

The jab is easier to transport than some of the other Covid-19 jabs because it does not need to be stored at ultra-low temperatures.

Not-for-profit

Meanwhile the University of Oxford and pharmaceutical company AstraZeneca have said that they will provide the vaccine on a not-for-profit basis for the duration of the pandemic across the world, and “in perpetuity” to low and middle-income countries.

Dr Soumya Swaminathan, the WHO’s chief scientist, said the guidance was an “important milestone”.

She added: “These guidelines that are being released today are very, very important, because the Oxford/AstraZeneca vaccine is one of the main vaccines at this point in the Covax facility — it’s going to be procured in hundreds of millions of doses, and distributed around the world.

“And so many countries will be receiving their first tranches of the vaccine from the Covax facility later in February.

“This is one of those vaccines which can be stored in ordinary refrigerator temperatures, and therefore it’s going to be very useful for a large number of countries with different situations on the ground so logistically, it’s easier to use.”

Shares in the London-listed company AstraZeneca dropped heavily after the announcement, losing 1.3 prt vrny of their value and wiping around £1.2 billion off its stock market valuation in just half an hour.

The pharmaceutical giant is producing the vaccine on a non-profit basis, so does not stand to gain from the rollout. –PA