The Italian government recommended a preferential use of the AstraZeneca vaccine in subjects over 60 years of age. Is the vaccine unsafe for younger people?
“The position of the Italian government, in line with that of other large European Union countries such as France and Germany, was inspired by the principle of maximum precaution. These rare thrombotic eventsthe associated with low platelet levels occurred mainly in people under the age of 60, mostly women: hence the recommendation for preferential use over 60 years. In elderly subjects the evaluation between benefits and risks is absolutely greater considering the risk of developing a serious disease, the need for intensive care and the risk of death ».
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So the risk of not getting vaccinated is greater than that of getting vaccinated?
“The point is exactly this, and the EMA writes it in bold in the first line of its statement: “The overall risk-benefit ratio remains positive“. No medicine is risk-free, and anti Covid-19 drugs are no exception. Ultra-safe vaccines that have been widely used for decades also have an adverse event rate. When we protect our children against measles, we put them at risk – one in a million – of developing an acute encephalitic complication. But if we didn’t vaccinate them, the risk would be 500 times higher ».
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And for Covid?
«The University of Cambridge has developed a mathematical model that estimates what is the risk of severe adverse events due to vaccination and what the risk of ending up in intensive care for Covid-19 without vaccinating. Well, for an incidence similar to the current one in Italy (200 cases per 100,000 inhabitants per week), the no-vax risk is seven times greater than the vax risk for 20-29 year-olds, 30 times greater for 30-39 year-olds, 100 times higher for 40-49 year olds, 240 times higher for 50-59 year olds, 640 times higher for 60-69 year olds “.
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So why recommend this vaccine for ages over 60?
“There have been a percentage higher number of thrombosis cases among people under the age of 60, and also because younger people are less likely to have severe forms of Covid-19. Hence the risk of an adverse effect tied, even if very low in absolute terms, for younger people it weighs more in relative terms because it protects them from a less probable event ».
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What does it mean «Preferential use» for the over 60s? Can the doctor decide that it is okay even under 60?
«It means that during the vaccination campaign, in conditions of wide availability of vaccines as we hope it will be starting this month, people under that age in the booking phase will be able to be directed to other vaccines. In the coming weeks, supplies of the Johnson & Johnson vaccine, which includes a single dose, will begin to arrive. If this is not available, and on the basis of the continuous review of the scientific data that will become available, it will be possible to decide to give AstraZeneca under 60 ».
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Who has already taken the first dose of AstraZeneca and is under 60?
«Professor Locatelli said so: there are no reasons why it should not also do the latter. Anyone who has not had a vaccine-related adverse event after the first dose is extremely unlikely to have it after the second. Logical deduction, confirmed by the data coming from the United Kingdom, where an independent report commissioned by the Government to the J. Craig Venter Institute found that to date no cases of thrombosis or thrombocytopenia following the second dose have been recorded ».
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AstraZeneca vaccine: decisions, data and insights
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April 8, 2021 (change April 8, 2021 | 22:43)
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