As promised, the Campania Region wrote to Ministry of Health asking for clear and precise information on the administration of vaccines. “Following the in-depth analysis carried out during a meeting of the crisis unit convened today – reads the letter signed at the bottom by five managers of the Campania task force – it is deemed necessary to submit the technical assessments carried out by the specialists to the reflection of the ministry on the subject of the circular and the attached opinions, which involve issues of evident complexity, relevance and urgency, due to the rights and interests involved “.
«There are still doubts about the potential risks associated with the use of viral adenovirus vaccines in any age group – however, already legitimate taking into account the fluctuating orientation recorded in relation to the cases of adverse events related to the indicated type of vaccines – and the need for greater clarity of the CTS opinions is strengthened, in which, at present, mere “recommendations “On the use of vaccines. Furthermore, it still does not seem sufficiently clear, in terms of compliance with the precautionary principle, the effective recurrence, in safe conditions, to combined vaccination, which is also proposed in the accompanying circular, which would in any case pose problems of implementation on site. administration of the third dose, the need for which is now considered probable by the manufacturers themselves “.
And again: «On the issue of the“ mixed-heterologous ”approach of vaccines against Sars-Cov-2, it was noted, in particular, that the current scientific literature does not yet appear to have taken a univocal position. In detail, two studies are currently available in terms of data in this sense: the Spanish study CombivacS trial, which enrolled 663 people (18-59) who after a first dose of Oxford-Vaxzevria vaccine, received a second dose at eight weeks with Pfizer-Biontech mRNA vaccine and found good results in terms of efficacy and safety with a type of adverse events that are not severe and manageable on an outpatient basis; and the study UK based Combi-CoV (Pfizer-Biontech boost after first dose Vaxzevria), which demonstrated, in an interim analysis that in a population over 50, an increase in systemic reactogenicity after the boost dose reported by participants in heterologous vaccination programs compared to similar vaccination programs, and this was accompanied by an increase in the use of acetaminophen. It should be noted that these data were obtained in participants aged 50 and over and that the authors state that reactogenicity may be higher in younger age groups effectively suggesting caution in this category, for which a program is recommended. of mixed vaccination in Germany, France, Sweden, Norway and Denmark among those who received a primary dose of ChAd, in light of concerns about thrombotic thrombocytopenia after the first dose of ChAd. The reported data, objectively discordant regarding the reactogenicity of such a combined strategy, in a context in which a third dose of vaccine appears increasingly probable, seem to indicate a certain caution in approaching a heterologous vaccination strategy too quickly. In particular, giving people the first and second dose of different vaccines could probably make sense, but on the basis of the data available to date, there does not seem to be adequate margins of reliability and safety for citizens. To avoid new imprudence – as in the case of post-marketing adverse events detected with the Vaxzevria and Johnson & Johnson vaccines – it also seems necessary to question what will happen if people need a third dose to prolong immunity or protect themselves against emerging variants of the coronavirus . It is known, in fact, that repeated doses of virus-based vaccines such as Oxford-Vaxzevria tend to be less and less effective, because the immune system increases the response against the adenovirus; and that RNA vaccines, on the other hand, tend to trigger stronger side effects with added doses. It has also been noted that interesting data have recently been presented in Great Britain on a rather significant series of subjects in post-vaccination surveillance. In particular, the University of Oxford, in collaboration with the Office for National Statistics and the Department of Health and Social Care for England, finalized a study in which it included data from 1.7 million self-reported swab results taken from 370,000 British adults between 1 December 2020 and 3 April 2021. In addition to this evidence, data were also presented. data from a study by Merryn Voyssey et al. The above data, from these cohorts in the UK, specifically found that 21 days after a single dose of the Vaxzevria or Pfizer vaccine the rates of all new Sars-Cov-2 infections had decreased by 65% (range 95% confidence from 60% to 70%), symptomatic infections by 72% (from 69% to 74%) and asymptomatic infections by 57% (from 64% to 47%). In particular, therefore, a dose of Vaxzevria vaccine determined protection further corroborated and enhanced by the second dose ».
Hence the conclusions: “In the health interest of Campania citizens, also in light of the scientific data on the protection provided by even a single dose of Vaxzevria, pending scientifically more substantial clarifications in terms of number and scientific validation, it was considered it is necessary to temporarily implement the following precautionary actions: suspend the administration of first doses of viral vector vaccine, for all age groups; continue mass vaccination with Pfizer and Moderna vaccines; allow those who have already received the first dose of Vaxzevria to complete the cycle with a second dose of Vaxzevria, only if over 60 years of age; for subjects under the age of 60 who have received the first dose of Vaxzevria, wait for the acquisition of further indications from the ministry, also based on the evaluations reported above and, in the meantime, do not proceed with the administration of different vaccines, in consistency with the scientific concerns expressed, with the exception of only those subjects for whom the twelfth week from the first dose is due and who expressly request it “.