The Oxford and AstraZeneca covid vaccine will not be used to immunize those over 65 in much of Europe. A growing number of scientific committees in the states are adding to the recommendation to puncture with this drug only to those under that age, which is among those who have shown efficacy. Those of France, Germany, Poland, Austria, Sweden, Italy and the Netherlands (where almost two thirds of the population of the EU live) have already taken a position against vaccinating the elderly, unlike the United Kingdom, which does has been doing since she started using the drug, on January 4. In Spain it is foreseeable that the Interterritorial Council of the National Health System (CISNS) will align itself this Wednesday with the aforementioned European countries.
In its clinical stage, the vaccine generated a good immune response in all groups, but the trials with a population over 65 did not present a sufficiently representative sample to establish their level of protection against the coronavirus. The United Kingdom clings to the first evidence to prick the elderly with this drug, but the European scientific committees of European countries are being more conservative, despite the fact that the European Medicines Agency authorized its use in people over 18 years of age, without set an age limit above. Ultimately, it is up to each State how to proceed with each vaccine; Those who are speaking out claim that they will use this in other younger population groups and will reserve the Moderna and Pfizer ones for the older ones, since they have proven effective between them.
In Spain, the presentation of vaccines of the National Health System, made up of technicians from the Ministry of Health and the autonomous communities, met on Tuesday to give a recommendation to the CISNS, which will have to position itself, predictably this Wednesday. Sources in this group indicate that the council will probably follow the same path as that of other European countries. It was also hinted on Monday by Fernando Simón, director of the Center for the Coordination of Health Alerts and Emergencies, who is not part of this committee, but whose opinion will be heard when making the final decision: “It is possible that in the European Union we have to the recommendation that Germany is making [el primer país que anunció que la reservaría para menores de 65]It is prudent, but in order to decide it, the presentation has to analyze the technical file of the vaccine ”.
A decision in this sense will force to rethink the vaccination plan, which after its first phase (residences, health and large dependents), towards March, plans to start with those over 80 years of age. Although they do not have an arrival date, European countries have the AstraZeneca vaccines this month. The French minister even said that they will receive them at the end of next week. As Simón explained on Monday, Spain has the capacity to vaccinate more population than it does now: if there is a funnel, it is not this, but the number of vials that arrive. It would not make sense to save those that arrive while waiting to immunize the elderly. It would be necessary to start with them as soon as possible to achieve the objective of puncturing 70% of the population in summer.
As Amós García Rojas, president of the Spanish Society of Vaccination, explains, if the elderly are not finally vaccinated with the AstraZeneca remedy, another priority group will have to be established, whether they are younger people with pathologies that make them vulnerable to coronavirus, such as obesity or diabetes; or essential professionals. “By these I am referring to police, firefighters or perhaps teachers,” he clarifies. In Rojas’s opinion, it makes sense not to vaccinate the elderly with the Anglo-Swedish drug: “Taking into account that there is a wide availability of vaccines with different benefits, each one should be aimed at the population in which there is a guarantee that it will be more effective. That is what we do, for example, with those of the flu: there are several available and some are dedicated to people over 65 and another to minors with underlying diseases. I think the same should be done with the SARS-CoV-2 vaccines; each group must be offered the one that will have the greatest impact on it ”.
This will not necessarily mean a delay in the vaccination of those over 80 years of age, which will depend on the Pfizer and Moderna vaccines that arrive from March. Health foresees that 2.3 million doses will arrive in February: added to those that already had (1.76 million), they are enough to cover almost all of the members of the first group: 2.5 million people, at that you have to subtract a percentage that will not be immunized because they do not want to or because they cannot due to some condition or intolerance.
This reality leads Pedro Gullón, from the Spanish Epidemiology Society, to defend that this injection be reserved for the youngest: “If there were a great shortage of vaccines to reach those over 65, we could think about vaccinating them with AstraZeneca. But it seems that even if there are delays, they will come from Pfizer and Moderna in the next few weeks or months, and these are being tested in older people ”. Gullón is “struck by” that the United Kingdom has decided to vaccinate the elderly with this drug despite the small sample of this population that was used in the trials “Perhaps they have a lot of production capacity and it gave them a big difference to be able to vaccinate a large population. I guess they are already testing its effects in a kind of phase IV trial [la que siguen los medicamentos una vez aprobados, en su uso real]”, Add.
The decision is reversible. It is likely that this phase IV that Gullón mentions will soon yield results that can more accurately quantify the effectiveness of the AstraZeneca vaccine in the elderly, which is between 62% and 90% in the rest of the population (depending on whether the injection was first full or only half dose, something that makes it more effective). The German health authorities have already warned that if it is tested, they will also prick the elderly with it.
It is the same thing that the French High Health Authority (HAS) argued on Tuesday, which was the last to pronounce, reports Silvia Ayuso. “There is a lack of data for patients over 65, who should arrive in the next few weeks. In the meantime, we recommend its use only for those under 65, ”Dominique Le Guludec, president of the independent body in which the Government of Emmanuel Macron has relied widely to guide its policy against the coronavirus since the outbreak of the pandemic, told the press. This recommendation “will be reviewed with the complementary clinical data that we expect soon,” he added. In an interview on the TF1 news program, Macron assured that France “will respect the slogan” of the health authorities. AstraZeneca vaccines “will be used first for healthcare personnel under 60 years of age. Later, it will be proposed by age groups. But we will not propose it to those over 65 ”.
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