The Oxford-AstraZeneca vaccine has been receiving numerous consideration lately. The EU has been dissatisfied with manufacturing hold-ups, whereas the German well being ministry has raised questions over its efficacy in older age teams. Because of this, Stiko – the German Standing Committee on Vaccination – has prompt in a draft suggestion that the vaccine shouldn’t be given to individuals over 65.
If Germany does resolve to not authorise the vaccine for over-65s, this might be as a result of it considers there have been inadequate individuals over 55 included within the vaccine’s part 3 trials to offer a superb estimate of efficacy in older age teams. This is a matter that has been raised earlier than.
In reality, within the peer-reviewed write-up of the Oxford-AstraZeneca trials, the authors admitted that following their assessments, “vaccine efficacy in older age teams couldn’t be assessed”. However whereas this isn’t excellent, it’s not a cause to panic.
Certainly, the European Medicines Company has now authorised the vaccine to be used in Europe in all adults over 18, regardless of German issues. The EMA acknowledged that efficacy information for over-55s was missing, however stated that it anticipated the vaccine to be protecting “on condition that an immune response is seen on this age group and primarily based on expertise with different vaccines”.
Over-65s ought to nonetheless take the jab if supplied
Though there’s not at the moment adequate information within the public area to estimate efficacy of the Oxford-AstraZeneca vaccine in older age teams, there may be nonetheless numerous proof that the vaccine might be efficient in older individuals.
As we get older, we have a tendency to reply much less nicely to vaccines and pure infections, in a course of often known as immunosenescence. However this isn’t a sudden drop in immunity when you get previous a sure age. For instance, the mRNA vaccines in opposition to COVID-19 made by Pfizer and Moderna – for which there’s extra information – present little or no drop, if any, in effectiveness in older age teams.
We additionally know from Oxford’s earlier part 2 trials (which checked that the vaccine stimulated an immune response in people) that there’s little or no distinction within the quantity of “IgG” antibodies produced in individuals over 70 years outdated in comparison with individuals within the 18-55 and 56-69 age teams. And there’s rising proof that these IgG antibodies shield in opposition to extreme illness, because of trials which can be taking a look at utilizing sure antibodies as a remedy for COVID-19.
There’s additionally good proof that the vaccine is protected on this age group. And older individuals report fewer side-effects from it than youthful individuals.
The vaccine makers have since recruited extra older individuals into their ongoing part 3 trials, and so higher information on efficacy might be out there quickly. The UK can also be placing numerous effort into post-vaccine surveillance, and this could result in good information on the vaccine’s effectiveness within the UK in coming weeks – particularly within the 80+ age group, who had been initially supplied the vaccine.
What concerning the 8% efficacy declare?
An additional declare – made by the German newspaper Handelsblatt – that the vaccine is simply 8% efficient in older age teams is nearly definitely false. The German ministry of well being has prompt that this determine arose from a misunderstanding of the vaccine’s trial information by the newspaper.
Certainly, taking a look at information out there within the public area, it appears there have been solely two circumstances of an infection reported in older individuals through the trials. One was within the group receiving the vaccine, and one in one other group receiving a placebo. With this information, it’s simply not potential to estimate the true efficacy with any precision.
The overwhelming steadiness of proof is that the Oxford-AstraZeneca vaccine is protected in older individuals and can present excessive safety in opposition to extreme illness, hospitalisation and loss of life. Talking as somebody in his mid-60s, I might fortunately settle for no matter vaccine I’m supplied once I finally make it to the entrance of the queue.
Paul Hunter receives funding from Nationwide Institute for Well being Analysis, World Well being Group and The European Regional Growth Fund.