After stopping the vaccine Astrazeneca for all over 60s, including second doses which will therefore be heterologous, i.e. with a different preparation, Marco Cavaleri, Chair of the Vaccine Task Force of theMom raises new doubts about the Oxford vaccine. The expert, interviewed by Print, when asked whether it is better to ban Astrazeneca even to over 60s, he replies “yes”: “It is an option that many countries such as France and Germany, consider in light of the greater availability of mRna vaccines”, he explains, highlighting however that “accidents were very rare after the first dose”And that the second, despite there being“ less data ”,“ in the UK is doing well ”.
A different idea from the opinion issued by the European Medicines Agency at the end of March, after the first doubts about the Oxford vaccine: “We had seen a probable very rare association between AstraZeneca and thrombosis – explains Cavaleri – but our position was and is that in a pandemic context the risk-benefit ratio remains favorable for all ages “. And therefore, now that infections are decreasing, at least in young people, in which “the risks for the disease are decreasing”, “the message could be to preferentially use mRna vaccines”, that is, at the moment, Pfizer or Moderna. As for the Open Day made by different Italian regions with Astrazeneca, Cavaleri underlines: “We would have liked a more cautious approach to the availability of vaccines“. If it is true, in fact, that the EMA has never banned the use of the Anglo-Swedish vaccine for young people, it is also true, the expert reiterates that “the choice was made in full pandemic, when the priority was get vaccinated with what was there ”, therefore,“ it is clear that once upon a time changed the scenario some countries could have used mRna vaccines earlier“. On the case of Camilla Canepa, the 18-year-old who died in Genoa about ten days after the first dose of the Astrazeneca vaccine, Cavaleri is clear: “Already for the age it would have been better to use an mRna vaccine, then even if the risk factors are not known, her situation health should have suggested prudence ”.
No contradiction on the part of the EMA therefore, just as, according to the president of Aifa, Giorgio Palù, interviewed by Corriere della Sera, there was no contradiction even on the part of the Italian regulatory agency: “We are talking about serious reactions such as very rare cases of thrombosis accompanied by platelet deficiency – observes on AstraZeneca – they had not emerged in the validative studies and in the course of mass vaccination on tens of millions of people. We couldn’t have foreseen them before; there is nothing contradicting ”. The current indications, therefore, specify, are “based on the principle of maximum caution for the use of adenoviral vector vaccines, therefore not only AstraZeneca but also Johnson & Johnson ”which should not be“ given under 60 ”. A principle of prudence also moved by Cavaleri: “Johnson & Johnson gave fewer problems than AstraZeneca, even if it was used little. With one dose it is useful for some categories that are difficult to reach, but it remains adenovirus and it is preferable to reserve it for over 60 “.
On the heterologous vaccination, ie made with two different vaccines, the head of the EMA task force is calm: “It has already worked in the past, we do not expect safety problems, even if there are no large studies on it and careful monitoring will be needed”. While for his part the president of Aifa reassures those over 60 who will continue to be immunized with the Oxford vaccine: “The relationship between the risk of having serious problems due to the dose and the benefit of avoiding Covid is clearly favorable to the latter even in a phase of low virus circulation which is the current one “. While with regard to the rare pericarditis discoveries from some studies after the mRna vaccine, such as Pfizer, Cavaleri reassures: “They seem rare and light, they appear a week after the second dose, but we are talking with the US and Israel to find out more. We will have more data by the beginning of July“.
New hope, both in terms of the vaccination campaign and in terms of vaccine efficacy, may soon come from other sera in the process of being approved: “On Sputnik we have concluded the site inspections and we are awaiting missing information. It is an adenovirus vaccine, of which we do not know what the future will be, even if as Ema we will only rely on the risk-benefit ratio for approval ”, explains Cavaleri. While for Curevac, the vaccine that should have given a significant boost to the European vaccination campaign, we will have to wait until September, according to Cavaleri, but being in mRna “it will make up for the shortcomings of Astrazeneca”. “In the same period – continues the expert – Novavax will arrive, a traditional vaccine that will also be useful”. Also according to Palù we should have “faith in science” and new “effective and safe” vaccines will soon arrive. A trust that should also be given to vaccinations for minors, according to the expert: “Italian parents shouldn’t be afraid, adverse reactions such as myocarditis recorded in Israel, which has already vaccinated a large part of the population, have occurred, in very rare cases, in young male adults over 16 years of age and have all resolved without serious consequences “.
Its a hypothetical third dose of recall, Cavaleri is not clear: “The idea is that both the immunity of the recovered and that of the vaccinated last at least a year, even if for the elderly it could be lower. We will start with a reminder for the fragile categories and then we will see if it will be necessary for everyone, even according to the variants “. Variants such as the Indian one which “seems to be under control” but which could “generate worrying mutations”. “The vaccinated population will put pressure on the virus, which it will try to escape – concludes the EMA expert speaking with the Piedmontese newspaper – Not to mention that despite the efforts of the international community vaccination in the rest of the world proceeds slowly and for years there will be a risk of return variants. Finally, there is the hypothesis that the virus continues to circulate even in the vaccinated. For this reason, pharmaceutical companies are working on vaccines that can be updated quickly and the EMA on more streamlined approval rules ”.