Covid-19 vaccines Q&A: Over-65s and the Oxford-AstraZeneca jab

European Medicines Agency rules that evidence supports approval for all over age 18

Are doubts about the Oxford University-AstraZeneca vaccine’s suitability for older people now resolved?

In short, yes. The European Union’s regulator has provided sufficient clarity on suitability and older people should have no major concerns about its suitability for them.

The European Medicines Agency (EMA) acknowledged a low number of older people took part in AstraZeneca’s clinic trials. But the balance of evidence supported approval for all age groups over 18, it ruled.

“Protection is expected, given that an immune response is seen in this age group and based on experience with other vaccines. As there is reliable information on safety in this population, EMA’s scientific experts considered that the vaccine can be used in older adults. More information is expected from ongoing studies, which include a higher proportion of elderly participants,” it added.

What was the problem?

In the initial trial just two of 660 participants over the age of 65 got Covid-19 – one in the vaccinated group and one in the control group – far below the number needed to draw firm conclusions.

This led to the independent commission advising the German government on vaccination policy to recommend it not be used for over-65s.

Its developers admitted there were not enough Covid cases among older adults at the time to explore just how well the vaccine protected them against the disease. A large trial showed the vaccine was 60 per cent effective in preventing people from getting sick from coronavirus, though it is unknown whether the shot stops disease transmission.

Older adults were recruited later, yet there has been less time for cases to occur, and, older adults are known to be more cautious in the pandemic, meaning the “attack rate” is lower, they pointed out. AstraZeneca stressed they were recruited later because the team wanted to be sure the vaccine was safe before administering it to older age groups.

Is there any risk the Oxford-AstraZeneca vaccine won’t work in older adults?

No, as there is encouraging data for older adults showing similar immune responses to younger people. AstraZeneca noted 100 per cent of older adults generated antibodies towards Covid-19’s spike protein after the second dose.

Independent experts say the vaccine is safe and valuable for older adults. What’s more, it brings added convenience. Its ability to be delivered to people in GP surgeries and care homes with easier storage requirements make it a vital component in reducing hospitalisation and deaths. This is especially so among older/more vulnerable people.

What are the vaccine options for older people?

The likelihood is older people in Ireland will be offered a vaccine from the first three approved by the EMA: the Pfizer-BioNTech and Moderna vaccines and now the Oxford-AstraZeneca one assuming supply issues are resolved.

Despite squabbling over EU vaccine supplies it has been a good week on the vaccines front. Johnson & Johnson confirmed its one-dose vaccine is 66 per cent effective in a diverse and broad population including 34 per cent (14,672 people) of participants over age 60 in late-stage trials. Efficacy against severe disease increased over time with no cases in vaccinated people reported after day 49.

In addition, the Novavax trial had 89 per cent efficacy, with 27 per cent of participants – almost 4,000 people – older than 65.

Over time further evidence will emerge confirming which vaccine suits what age cohort best, older people included.