Prime Minister Boris Johnson has rejected the ruling by Germany not to recommend the Oxford/AstraZeneca Covid-19 vaccine to those aged 65 and over.
German advisers have said there was insufficient data about the effectiveness of the jab in older age groups, and as such should only be given to people aged 18 to 64 for now.
‘A good immune response’
Mr Johnson has said he is not concerned by the ruling and argued that evidence shows the vaccine does provide a good immune response across both young and older age groups.
He backed the advice from the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) and said he did agree with the verdict in Germany, stating: “I think the MHRA, our own authorities have made it very clear that they think the Oxford/AstraZeneca vaccine is very good and efficacious, gives a high degree of protection after just one dose and even more after two doses.
“And the evidence they’ve supplied is they think it’s effective across all age groups and provide a good immune response across all age groups.”
The Prime Minister joined Public Health England (PHE) in defending use of the jab after a draft recommendation from Germany’s vaccination advisory committee said the lack of data for this age group meant it should not yet be recommended to the over 65s.
Dr Mary Ramsay, head of immunisations at PHE, acknowledged that there had been “too few cases” of coronavirus in older people in Phase 3 clinical trials to determine the level of efficacy in older people, but added that other data on immune response had been “reassuring”.
She said: “There were too few cases in older people in the AstraZeneca trials to observe precise levels of protection in this group, but data on immune responses were very reassuring.
“The risk of severe disease and death increase exponentially with age - the priority is to vaccinate as many vulnerable people as possible with either vaccine, to protect more people and save more lives.”
Vaccine approval imminent
The European Medicines Agency (EMA) is expected to approve the vaccine for use in the EU on Friday (29 January), although it is not yet clear whether it will set an age limit.
German authorities have said there is currently not sufficient data to assess how effective the vaccine is from 65 years, although the MHRA have argued that despite the limited information, “there is nothing to suggest lack of protection”.
MHRA chief executive Dr June Raine said: “Current evidence does not suggest any lack of protection against Covid-19 in people aged 65 or over.
“The data we have shows that the vaccine produces a strong immune response in the over 65s.
“More data is continually becoming available for this age group and our Public Assessment Report, available on our website, will be updated to reflect this.”
A Phase 3 Lancet study published in December said older age groups had been recruited later into the study so “efficacy data in these cohorts are currently limited by the small number of cases, but additional data will be available in future analyses”.
In that particular analysis, only 12 per cent of people given two doses of the vaccine in the UK arm of the trial (285 out of 2,377) were aged 56 to 69, while nine per cent (213) were over 70.
Some 12 per cent of people in the control group were also aged 56 to 69 while nine per cent were over 70.
Older people made up similar proportions in the Brazilian section of the trial, which was made up of 4,088 people.
Previous work published in November included findings for 560 people. Of these, 160 were aged 18 to 55, 160 were aged 56 to 69, and 240 were 70 or older.
Those results found that all age groups, including older people, had an immune response to the vaccine after two doses.
Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine, said an attempt to work out the exact efficacy in older age groups based on extremely small numbers was “so uncertain as to be meaningless”.
He said: “There is no reason at all for anyone in the UK or elsewhere to think that this Oxford/AstraZeneca vaccine is ineffective at any age.
“Its ability to be delivered to people in GP surgeries and care homes makes it a vital component in the attempts to reduce hospitalisation and deaths, especially in the elderly.”