Sunday 7 February 2021

Vaccinations For Mature Europeans?

I must admit to having a vested interest in this topic, as I qualify on both counts. Spiegelhalter and Masters have provided an insightful review of the statistics behind the very different responses of European countries to Oxford/AstraZeneca's vaccine for Covid-19 (https://www.theguardian.com/theobserver/commentisfree/2021/feb/06/behind-the-numbers-efficacy-of-oxford-vaccine). Spiegelhalter and Masters point out that, although the Medicines and Healthcare products Regulatory Agency (in the UK) and the European Medicines Agency (in the EU) have both approved the Oxford/AstraZeneca vaccine for all adults, the responses of many individual European countries have been very different. France, Germany and 6 others, recommend it only for patients under 65. Belgium and Italy exclusively for those under 55 and Switzerland don't recommend it for anyone. The crux of the problem, according to Spiegelhalter and Masters, is that the Oxford/AstraZeneca vaccine 'only' recruited 660 subjects, who were aged 65 or over (6% of the total). They note, however, that some groups are always relatively unrepresented in medical trials (these cohorts may be more difficult to recruit). For example, the Pfizer/BioNTech trials, had only 4% of subjects from an Asian background and nobody was over 89. The Europeans all seem very happy to use this vaccine for all groups. Spiegelhalter and Masters note that, in the absence of certain data, 'bridging studies' can offer addiional reassurance. Although the currently approved vaccines use different technologies, none have shown a fall off in protection with age (so, why should the Oxford vaccine be any different?). The Oxford/AstraZeneca vaccine has also been shown to generate similar levels of blood antibodies in all age groups (and there is no reason to suppose the antibodies are less effective in older subjects). Older people are more at risk of dying from a Covid-19 infection than younger individuals. Many elderly subjects are in care homes or can be difficult to reach in their own homes (some have mobility problems). The Oxford/AstraZeneca vaccine has the advantage of being available in small dose vials that can be stored in standard refrigerators (the Pfizer and Moderna mRNA vaccines both need storage at -18 degrees Celsius or lower). It must clearly be easier to get the Oxford vaccine out to some older people who need urgent protection. It appears that some EU countries are being too restrictive in what is a health emergency. As Spiegelhalter and Masters point out we must distinguish between absence of evidence and evidence of absence!

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