Regulators in Belgium are the the latest in Europe to advise against the administration of the Oxford/AstraZeneca vaccine to older people due a lack of data about its efficacy.
Frank Vandenbroucke, Belgium’s health minister, said the country’s superior health council, an advisory body, had suggested the jab should be administered to people younger than 55 for the time being.
Vandenbroucke said Belgium was reviewing its vaccination strategy. The Oxford/AstraZeneca vaccine had been a key part of the government’s plan to prioritise vulnerable groups in the early months of this year.
Quick GuideVaccines: how effective is each one?
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Pfizer/BioNTech
Country US/Germany
Efficacy 95% a week after the second shot. Pfizer says it is only 52% after the first dose but the UK’s Joint Committee on Vaccination and Immunisation (JCVI) says this may rise to 90% after 21 days.
Doses Clinical trials involved two doses 21 days apart. The UK is stretching this to 12 weeks.
Oxford/AstraZeneca
Country UK
Efficacy 70.4% 14 days after receiving the second dose. May have up to 90% efficacy when given as a half dose followed by a full dose. No severe disease or hospitalisations in anyone who received the vaccine.
There have been concerns it is less effective against the South African variant of the coronavirus, and that a rare type of blood clot can be a side effect.
Doses Two, four to 12 weeks apart
Moderna
Country US
Efficacy Phase 3 trial results suggest 94.1%.
Doses Two, 28 days apart
Novavax
Country US
Efficacy Phase 3 trials suggest 89.3%.
Doses Two
Janssen (part of Johnson & Johnson)
Country US
Efficacy 72% in preventing mild to moderate cases in US trials but 66% efficacy observed in international trials. 85% efficacy against severe illness, and 100% protection against hospitalisation and death.
Doses: One, making it unique among Covid vaccines with phase 3 results so far
Sinovac
Country China
Efficacy Unclear. Researchers in Brazil have found the efficacy of the Chinese vaccine to be as low as 50.4%, whereas Turkish officials reported interim data from trials showing efficacy was 91%.
Vandenbroucke said: “The superior health council says very clearly that the AstraZeneca vaccine is a very good vaccine for people between 18 and 55 years old.
“But it is also said we don’t have enough data today to say with certainty that it works so well in older people. If you are not sure, then the advice is to start using the vaccine in people under 55.
“It is a preliminary advice. Maybe we will have the necessary data in a few weeks. For the time being we are taking it safe. Of course, the vaccines from AstraZeneca will arrive next week. We will have to make decisions.”
The European Medicines Agency authorised use of the Oxford/AstraZeneca vaccine to all age groups over 18 last week but the lack of data in older groups had led to some caution among national advisory bodies in Europe.
The Oxford/AstraZeneca study had included only a small number of people in the older age range in its phase 3 clinical trials out of caution, given the speed with which the vaccine had been produced.
Only 6% of participants in the trials were over 65, with 341 people receiving a shot of the AstraZeneca vaccine and 319 given a placebo.
The Belgian decision echoes that of authorities in France, Germany, Poland and Italy, where regulators authorised its use in younger groups but either ruled out or cautioned against its use among people aged 65 and over.
On Monday, France’s Haute Autorité de Santé had recommended that the vaccine be administered among those under the age of 65.
The standing committee on vaccination of the Robert Koch Institute, Germany’s disease control agency, went further last week, saying the jab should not be given to people aged over 65.
On Wednesday, the Oxford Vaccine group director, Andrew Pollard said older people in the UK should be reassured that the vaccine was both safe and that there was data showing a “strong immune response” in older people.
He said: “I think the first really important point is that the European Medicines Agency has approved the vaccine for use in all ages in all countries in Europe. Our regulator, the MHRA, has approved for all ages and another 25 or so regulators elsewhere in the world have also approved the vaccine for all ages.
“But individual countries have their own [joint committee on vaccination and immunisation equivalent] committees, and they have to look at what vaccines they have available, what they make of the data and what’s best for their population. And so that’s obviously up to them.”
Asked about comments made by France’s president, Emmanuel Macron, who had described the Oxford/AstraZeneca jab as “quasi-ineffective” in an interview with the Guardian, Pollard expressed bemusement.
He said: “I don’t understand what the statement means. The point is that we have rather less data in older adults, which is why people have less certainty about the level of protection. But we have good immune responses in older adults very similar to younger adults, the protection that we do see is in exactly the same direction, and other similar magnitudes.”
“I think we’re confident that we’re going to see good protection in all age groups, just as global regulators have taken that view.”