Vaccination policy – time for a change

 

Sir, – In all of the commentary about the vaccination rollout, one aspect has hardly been mentioned. This is the fact that the rare and serious blood clotting events that resulted in the Astra Zeneca vaccine being withdrawn for use in the over-50s have subsequently been found to be equally prevalent in those over 50.

According to statistics published by the UK Medicines and Healthcare Products Regulatory Agency, quoted by Prof Kingston Mills (“Ireland’s testing and vaccination policies must be reviewed urgently”, Opinion & Analysis, June 24th), of 372 cases of serious clotting, 187 affected people under 50 and 185 were in people aged over 60.

On learning of this rare serious side-effect for those over 50, Astra Zeneca was quickly withdrawn for this cohort. With information now available on the fact that over 60s are as susceptible to this side-effect, the over-60s vaccination with Astra Zeneca continues.

Is there a reasonable explanation for this policy, or is it simply ageist? – Yours, etc,

MARY FITZGERALD,

Terenure,

Dublin 6W.

Sir, – Having read Kingston Mills’s opinion piece, I am extremely grateful that those of us in 60 to 69 cohort have such an eminent advocate as Prof Mills.

In early May, when I received my first dose of the Astra Zeneca vaccine, I did so under duress, having been threatened by Leo Varadkar that failure to accept this vaccine would push me to the back of the queue, despite being in a high-risk group. I informed my vaccine administrator that I wished to receive either the Pfizer or Moderna vaccine, but was told my choice was either the Astra Zeneca vaccine or nothing.

I, at almost 61, and being the eldest of six siblings, now find myself in the invidious position of being the least protected member of my siblings. They also enjoy the added benefit in that they have all received the more efficacious Pfizer or Moderna vaccines.

They have received an mRNA vaccine, which has over a 90 per cent efficacy rate, while I have received the significantly less protective Astra Zeneca vaccine, and one that provides an even lower protection against the Delta variant and minimal protection against the Beta (South African) variant.

The treatment meted out to the 60 to 69 cohort is reprehensible and is, quite frankly, both immoral and wrong.

Prof Mills references recent research, conducted in the UK, Spain and elsewhere, which shows that mixing the Astra Zeneca vaccine with the Pfizer vaccine, provides substantially greater protection from infection than two doses of the Astra Zeneca vaccine.

This specific point has also been made by Prof Luke O’Neill on several occasions. Countries such as Canada, Finland, Norway, Spain and others have advocated a mix-and-match approach, in the interests of their citizens.

Furthermore, I read in the Irish Times that Dr Emer Cooke, the head of the European Medicines Agency, has said “the best approach is a portfolio approach” (“Governments need ‘portfolio of vaccines’ to beat Covid, says EMA head”, News, June 15th).

Prof Mills in the final sentence of his article says, “The policy on vaccination needs to be addressed with urgency by Niac, Nphet, the Department of Health and the HSE.”

I appeal to the powers that be to change our vaccination policy, as many other countries have done, and offer the Astra Zeneca cohort a second dose of either the Pfizer or Moderna vaccine. – Yours, etc,

JOHN KIERNAN,

Terenure,

Dublin 12.

Sir, – Why the resistance to change in the face of overwhelming evidence that it’s the right thing to do? – Yours, etc,

AILBHE MURRAY,

Cabinteely,

Dublin.

Sir, – Public health officials should do as Kingston Mills suggests and address the confusing messaging around the further rollout of the Astra Zeneca vaccine to people in their sixties. While I will attend for my second dose of the Astra Zeneca jab this week, I will do so with a degree of trepidation.

Kingston Mills is an eminent immunologist who has become a household name among others and is a regular commentator in print and broadcast media, bringing balanced views on public health measures in a period of uncertainty for many who have a very limited understanding of the science and complexities of vaccines, their efficacy and suitability. When he raises contradictions with public health policy around mixing vaccines, we should take careful note.

In his view, based on published data, replacing a second Astra Zeneca dose with the Pfizer mRNA vaccine would provide higher levels of protection against Covid variants, specifically the Delta variant.

He has also suggested that reducing the interval between doses from 12 to eight weeks reduces the effectiveness of the Astra Zeneca vaccine, and leaves me asking if the decision was based on science or vaccine expiry dates. We need to be reassured how public health will grant equal protection against new variants and demonstrate that everyone is being treated fairly.

It is not too late to follow the lead of other countries that, according to Prof Mills, have or are about to adopt a policy of mixing vaccines.

This policy, if adopted for my generation, would substantially boost the level of protection against infection from the Delta variant.

Bear in mind that vaccine rollout policy was built upon a priority list guided by descending age order because age was seen as the main predictor of a bad outcome.

We have been told that policies change as new evidence emerges.

We should now act with urgency. – Yours, etc,

PHILIP CARR,

Roscrea,

Co Tipperary.