Sweden won't recommend Oxford vaccine for over 65's

[doireallyneedaname]

What do we think of this? It’s reported in several places.

I find it quite worrying as I have family over 65 in another country and it’s likely they’ll be getting the Oxford vaccine.

www.bloomberg.com/news/articles/2021-02-02/sweden-won-t-recommend-astrazeneca-vaccine-for-people-over-65

[Title edited by MNHQ at OP's request]

The EU and the UK have very different vaccine supplies available. Because the EU has a lot of Pfizer and less AZ than they were expecting then it makes sense for them to use Pfizer on the over 65s because it has a somewhat more solid evidence base on that age group.

"The EU" isn't doing that though. The EMA approved AZ for all adult age groups. 4 countries - Sweden, Poland, France and Germany - have limited it to younger age groups, but most EU countries seem to be planning to use it for all ages, whenever they get around to receiving any.

@Pluckedpencil

Clearly better with more data but I can't see of any logical reason why it would be so much less effective in the over 65s, the 4% of data they did have didn't hint at that. People should get the vaccine and stay vigilant, and very soon the data will follow.

It's not uncommon for vaccines to be less effective in the over 65s as the immune system is naturally in decline. I believe the flu vaccine is one of them and only gives between 50-70 efficiacy in older people. But 50% is still better protection than none.

Good news here about the Oxford AstraZeneca vaccine:
papers.ssrn.com/sol3/papers.cfm?abstract_id=3777268

@IcedPurple

The EU and the UK have very different vaccine supplies available. Because the EU has a lot of Pfizer and less AZ than they were expecting then it makes sense for them to use Pfizer on the over 65s because it has a somewhat more solid evidence base on that age group.

"The EU" isn't doing that though. The EMA approved AZ for all adult age groups. 4 countries - Sweden, Poland, France and Germany - have limited it to younger age groups, but most EU countries seem to be planning to use it for all ages, whenever they get around to receiving any.

Italy as well I think.

It’s a perfectly reasonable decision for countries to make, given the current lack of evidence for efficacy in over 65s. Especially if you have other vaccine supplies that do have better data at the moment.

I’d imagine it’s easy enough decision to reverse as and when better data becomes available. Probably easier than using it and then discovering that there were ma ch better vaccines to use in that age group.

*Italy as well I think.

It’s a perfectly reasonable decision for countries to make, given the current lack of evidence for efficacy in over 65s. Especially if you have other vaccine supplies that do have better data at the moment.

I’d imagine it’s easy enough decision to reverse as and when better data becomes available. Probably easier than using it and then discovering that there were ma ch better vaccines to use in that age group.*

It's not like Europe is awash in vaccines and can pick and choose. Spain and France had to pause vaccine programmes last week due to lack of supply of vaccines - any vaccines.

I believe the flu vaccine is one of them and only gives between 50-70 efficiacy in older people. But 50% is still better protection than none.

I think there are usually 2 flu vaccines used in the U.K.. one for the under 65s and one for the over 65s because of a difference in efficacy in older people.

Yes you’re right. When I had my flu jab last year most places had no stock for over 65’s and whenever I called to book I was asked my age.

France has now said not to give Oxford vaccine to over 65s. I think as more data comes in it will prove one way or another whether there is a preferred vaccine for this age group. In the meantime some protection is surely better than none. I’m sure someone can correct me but wasn’t it only in the last 5+ years that the flu vaccine was separated by age?

There are a lot of over the counter products for sale in Boots etc that are not recommended for over 65s. A pharmacist told me that it's not because they don't work its because companies can't be bothered to extend their testing to older people.

@CKBJ

France has now said not to give Oxford vaccine to over 65s. I think as more data comes in it will prove one way or another whether there is a preferred vaccine for this age group. In the meantime some protection is surely better than none. I’m sure someone can correct me but wasn’t it only in the last 5+ years that the flu vaccine was separated by age?

I think the problem with the AZ is there wasn’t any proof that it offered any protection in the over 65s. The confidence interval was a mile wide.

It’s assumed there should be some because of the antibody response which was why the MHRA and EMA approved it.

My FIL has had the Oxford vaccine so I’d love there to be some data saying it works...

Although I’ve just got a news alert from Sky while writing this saying the Oxford vaccine stops transmission by 67% and a three month break doesn’t reduce protection, so hopefully there will be more age related data soon.

I can’t blame EU states for giving the one with data to older people rather than the one without, it seems remiss that Oxford didn’t test on more older people.

Interesting calm/balanced article:
theconversation.com/germany-may-not-give-the-oxford-astrazeneca-vaccine-to-over-65s-but-that-doesnt-mean-it-wont-work-154306

AZ were being very ethical in their decision to choose to vaccinate the over 60s last, due to their vulnerability. They wanted to be sure that it would work on younger patients first.

In a few weeks the updated information and evidence will be available, and the world will then include their over 65s in their vaccine programme. It is okay for countries to take a different view until the information is updated. We can be quite confident of it here though.

My DH is a scientist here in Sweden and he told me that one of the unknowns with all the vaccines is how they interract with the others. So there isn't enough data regarding efficiacy in over 65s with the AstraZeneca one but there's also no data on whether you can be revaccinated with another vaccine if it turns out to not be as effective as hoped. The UK has decided to take that risk, others have decided not to and will wait to see what happens in the UK.

So there isn't enough data regarding efficiacy in over 65s with the AstraZeneca one but there's also no data on whether you can be revaccinated with another vaccine if it turns out to not be as effective as hoped.

Yes, this crossed my mind and is a concerning thought.

We are all part of a giant experiment, I think we have to be clear about that, however we can't continue as we are either.

In an ideal world, you'd use Pfizer/Moderna on an older population, but countries will have to do the best with the supplies they have.

Nobody is saying it doesn’t work. Some regulators are saying that there isn’t enough evidence that it works in over 65s. It’s not the same thing.

fatcat The UK do not have a vaccine shortage, so do not need to 'mix' vaccines, EU countries have limited and sparse supplies, so the very real problem of having to use different vaccines is almost certain, and unknown. I agree with Sweden and would feel the same if I were them with such limited vaccines coming through, ensuring the second dose is available and safe is paramount.

I understand their thinking but to me it's mad not to take what they can get when their vaccine roll out has been so slow. I'd rather have a vaccine now than in 3 months if I was old.
Can't help thinking that if this was the French vaccine, they'd be giving it to their elderly population. Maybe they should ask the population what they would like to do! Still, not our circus - our old people are getting vaccinated.

It’s a weird decision. But the UK can be rest assured that scientists monitoring blood samples in the over 65’s found an as robust immune reaction as they did in 20 year olds. Therefore we’ve extrapolated that it’s likely to be as effective despite a lower number of participants.

The news just coming out is fantastic about the Oxford vaccine. And shows a really good response in the elderly recently vaccinated. 72% after one dose, 82% after two doses and cuts transmission by half. AND 100% of the study not hospitalised. Incredible.

It's thrilling news. The confidence & relief of thinking that you've shed the risk of hospitalisation and worse! I cannot wait til I get mine.

I think the news this morning is generally pretty promising for the Oxford one, OP, hopefully that reassures you a bit more. My DF had the Oxford one and his partner had the Pfizer one, so they are doing both where we live.

Also for anyone who’s had it, antibodies for at least 6 months, the papers say today:

www.bbc.com/news/amp/uk-55914839

So how long will the over 65’s have to wait to be vaccinated in these countries that won’t use AZ?

The data that came out in the Lancet pre-print yesterday showed the antibody responses were as good in the over 55 group as the 18-55 group. It is to be expected that antibody levels will be lower with increasing age but it doesn't mean the vaccine won't work. I also think that there is probably no reason why an mRNA vaccine would prime a better immune response in older people than the AZ vaccine which delivers the DNA to the cells via the adenoviral vector to be converted into mRNA. Most of the vaccine trials are simply showing that targeting the spike protein with your vaccine gives a good response but it doesn't seem to matter which method you use to get the spike protein into the body.

@Baileysforchristmas

So how long will the over 65’s have to wait to be vaccinated in these countries that won’t use AZ?

They are buying later vaccines I assume