Niac considers effect of early vaccination of young people with AZ jabs

The State's Covid-19 vaccine advisory group meets on Monday to consider whether to change guidance on using AstraZeneca (AZ) vaccines on younger people.

The National Immunisation Advisory Committee (Niac) of independent experts has been assessing what impact the faster rollout of the jabs to younger people might have on the spread of disease.

Niac met on Friday to discuss the issue and is due to meet again on Monday ahead of providing expected advice to the Department of Health after the State's chief medical officer, Dr Tony Holohan, requested fresh guidance on age suitability for the AZ and Johnson & Johnson (J&J) jabs.

AZ jabs are only recommended for the over-50s because of the risk of a rare blood-clotting side effect but the Government is under pressure to vaccinate younger people sooner with hundreds of thousands of spare AZ jabs becoming available as the more contagious Delta variant spreads.

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The rise of the variant and the need for speedier vaccinations is being considered as the Government weighs up whether to postpone the reopening of indoor dining from July 5th.

A further 340 cases of Covid-19 were reported on Sunday, with 47 people currently being treated for the disease in hospital including 15 in intensive care. The Department of Health said on Saturday that 443 cases had been detected.

Figures from the Health Protection Surveillance Centre show there were 52 reported deaths from Covid-19 in the period between May 13th and June 23rd.

Cyberattack

Daily death figures have not been published since a cyberattack on HSE IT systems and the total increased from 4,937 to 4,989 in the six-week period.

Paul Moynagh, professor of immunology at Maynooth University, said the reopening should proceed as planned because vaccination has brought strong benefits so far, primary schools are going on holidays and the seasonality effect of summer on respiratory virus had reduced transmission.

“Now is probably as good at time as any to open up. There are lot of factors working in its favour, whereas I am not quite sure what will be achieved by delaying it for two weeks,” he said.

Prof Moynagh said that going ahead with the July 5th reopening plans would ensure that further restrictions could be eased on a phased basis, with international travel due to return two weeks later on July 19th.

He echoed views expressed by UCD infectious diseases professor Paddy Mallon, who told RTÉ on Sunday that a two-week delay in reopening indoor dining would not stop the inevitable rise in variants or have a significant effect on the vaccination of young people.

Delta variant

Prof Moynagh pointed to the reduced case-fatality rates in the UK, with the more transmissible Delta variant showing a rate 10 times lower than the Alpha variant did when it emerged last winter.

“It is clearly telling us the effect of the vaccination programme and younger age groups that are less susceptible to severe Covid and death are getting it,” he said.

He said the AZ and J&J jabs should be offered to younger people, at least with the first dose and then a second dose of Pfizer or Moderna for "the strongest immune response".

“The benefits outweigh the risks,” he said.

Niac is considering further use of AZ in younger ages after limiting the use of the vaccine to the over-50s in late April because of the risk posed by blood clotting in the under-50s.

It said that when Covid-19 rates are high or increasing and Pfizer or Moderna vaccines are limited, AZ jabs “may be recommended for those aged 18-49 years to provide early protection.”

The guidance also says that healthy people aged 40 to 49 years of age “may choose” to avail of an earlier AZ vaccine “provided they have made an informed decision”.