Astrazeneca vaccine to young people, Locatelli (Cts): “Supreme attention. Reflection also in the light of the changed epidemiological context”

A “reflection” on the administration of Astrazeneca vaccine to the young and the very young. Comes from the CTS coordinator and president of the Higher Health Council, Franco Locatelli and by other scientists. These days – after the cases of Genoa and Lucca with an 18-year-old and a 42-year-old hospitalized in serious condition after the inoculation of the compound developed by the researchers of Oxford – the debate on whether to make the vaccine (which in Italy is recommended by the AIFA for over 60s) has become heated. “There is in these hours supreme attention to capture all the signs that can alert you to any side effects that lead to consider changes in indication. The AstraZeneca vaccine is already preferentially recommended for individuals over 60 years of age, because the relationship between the benefits deriving from vaccination and any risks becomes incremental with age and particularly favorable above this threshold – Locatelli recalled this morning to Rainews24 – What happened in the unfortunate girl from Genoa, to whom all my attention and my affection for what happened puts a further reflection, also in the light of the changed epidemiological context, as the reduction of cases we have in the country makes this reflection even more compelling ”.

Professor Locatelli refers to a report of the European Medicines Agency (EMA) of 23 April – which wrote about a month ago – which contains several tables in which the hospitalizations and prevented deaths with the administrations in the face of cases of blood clots with platelet deficiency in three scenarios namely with a high rate of infection (886 cases of positivity per 100 thousand), with an average rate (401 per 100 thousand) and a low rate (55 per 100 thousand) for seven age groups: 20-29 years, 30-39 years, 40-49 years. 50-59 years, 60-69 years, 70-79 years and over 80. But with low virus circulation the administration of the vaccine in the 50-59 age range the risk / benefit ratio is not so favorable because only one death is avoided compared to 1.1 cases of thrombosis. With the lowering of the threshold in the younger population group – except for the 20-29 age group – the risk-benefit ratio remains in favor of the vaccine but the proportion thins a lot. With low circulation, the ratio in the 40-49 age range is also unfavorable. Thus, hospitalization and death are prevented in the face of 1.1 cases of thrombus. VITT, all experts keep repeating, is extremely rare and, above all, treatable when diagnosed early. with an ad hoc therapy with infusion of immunoglobulins and non-heparin anticoagulants.

And to think that just a few weeks ago the issue concerned the under 60s and in particular the 50-59 range. On this point, the immunologist Antonella Viola had said to evaluate the opportunity to administer the vaccine to men under 60 in consideration of the fact that the observations of the cases showed that women between 18 and 55 years old are those affected by thrombi. In Great Britain – homeland of the compound with which the 56-year-old premier was also vaccinated Boris Johnson – first the administration threshold was set for the over 30s and then subsequently raised to 40. The Oxford researchers also suspended the testing of the vaccine they developed on the under 18. With millions of doses still in refrigerators in Italy as well as in other European countries, Germany in primis, the open day initiatives have been launched to give those who wish to vaccinate themselves with a compound considered “effective and safe“. So much so that he is the Italian premier, Mario Draghi (73 years old), that the German Chancellor Angela Merkel (66 years old) were vaccinated with Astrazeneca. And the initiatives on a voluntary basis have mostly met with good success.

“For the AstraZeneca vaccine it could be It is useful to evaluate a limitation from 50 years upwards for women and from 40 years upwards for meni as a perspective element. But to decide it must be the Aifa in order for it to be official. An indication or a communication is not enough ”says the virologist Fabrizio Pregliasco, lecturer at the State University of Milan. In specific cases “it is a question of investigating and verifying what happened. It is necessary to see – says Pregliasco – if they are actually cases with clots and low levels of platelets. To date, there are 6 cases per million people ”the serious reactions to the vaccine. “The risk of AstraZeneca’s Covid vaccine for women under 50 is infinitesimal and remains so even now. However, from a purely operational and pragmatic point of viewor, if we want vaccination to be successful among young people, we use a different product now that vaccines are available in adequate quantities. So nobody talks anymore, ”he says Massimo Clementi, director of the Laboratory of Microbiology and Virology of the San Raffaele hospital in Milan and lecturer at the Vita-Salute University. “The vaccination of young people – underlines Adnkronos Salute – is important to break the circulation of the virus, especially with the resumption of activities and schools in September. But let’s do it with other vaccines and not with AstraZeneca, if we have enough, as it seems ”.

Clementi reflects on the ‘AstraDay’ aimed at young people, which have ended up at the center of some criticisms even from experts. “They could have been avoided – he admits – Also because, while the European Medicines Agency Ema opened to all ages for adenoviral vector vaccines, the Italian Aifa was slightly more stringent, more cautious, and suggested preferential use above the age of 60. The recommendation is a very weak rationale ”. The EMA has also made available a diagram showing how the risk-benefit ratio of the AstraZeneca vaccine is higher with increasing age. Young people “are aware that they do not get sick or get sick with mild symptoms. If they get the vaccine, they do so to defend their frail or elderly family members – reflects the expert – Increasing their membership can be positive, we try to encourage it. We can do it even if, in the face of vaccination, we give more freedom. I am thinking, for example, of the much discussed nightclubs: I would not think badly that a vaccinated person can go to the disco in July, especially if outdoors ”.

AstraZeneca “is a safe and effective vaccine. In some cases, however, there is a very rare association with a complication“, The rare thrombosis. Regarding the age range of the use of this vaccine “indications have been given, but there is a problem of consistency with respect to these indications. If there is an alternative ”to AstraZeneca in young people,“ this alternative must be used, ”he says Andrea Crisanti, guest at L’aria che tira su La7, commenting on the growing doubts about the administration of the AstraZeneca vaccine to 18-20 year olds during the Open Days in the various regions. Recalling that “there is a process that occurs naturally for each vaccine, which is authorized with certain indications. As data accumulates, the perimeter of indications changes. This is happening with AstraZeneca – he underlines – We need clarity, which can come from data and transparency, from data sharing with the scientific community“.

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