#MSCOVID19 Vaccine and Age

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There is a suggestion in the media that giving the Astrazeneca vaccine to the over 65s doesn’t work very well and so some Continental Europeans won’t be using it…So Good news for the Youngers who are less at risk as there will be more to go round, but nothing for the retirees…

Seems the New Headline is : No work No vaccine, sadly if means less options for some of our parents in BartsMS parents. However, most of you are not over 65 so no need to wory and if you are over 65, no need to worry. In the trial there were 56/15,980 =0.350438% and it seems 2/660 over 65 get disease = 0.303030%. Were old people less susceptibile that young people or is it that older people weren’t mingling as much?

The numbers are to day to say anything about efficacy except do more studies.

According to the MHRA website

“The level of protection gained from a single dose of COVID-19 Vaccine AstraZeneca was assessed in an exploratory analysis that included participants who had received one dose. Participants were censored (removed) from the analysis at the earliest time point of when they received a second dose or at 12 weeks post dose 1. In this population, vaccine efficacy from 22 days post dose 1 was 73.00% (95% CI: 48.79; 85.76 [COVID-19 Vaccine AstraZeneca 12/7,998 vs control 44/7,982])”.

So this is based on about 16,000 people.

Overall, among the participants who received COVID-19 Vaccine AstraZeneca, 94.1% of participants were 18 to 64 years old (with 5.9% aged 65 or older); 60.7% of subjects were female; 82.8% were White, 4.6% were Asian, and 4.4% were Black. So few old people and few non-white people got the vaccine

Indeed MHRA say there “were only 660 participants ≥65 years old were too few to draw conclusions on efficacy” as only two people had got COVID, so you have 1 and 1 in each group or 2 and 0. So if this group does not get vaccinated in Germany/EU if the news is correct. They are doing what the European Medicines agency do and say “the data isn’t good enough”. We won’t approve it. That is fine. This what the EMA (or should I say countries in the EU) have done and I guess the FDA in the States may do. More trials may be in order and are planned

This will delay access to this vaccine mean more for countries like: UK, Hungary, Argentina, El Salvador, Dominican Republic, India, Bangladesh, Mexico, Nepal, Pakistan, Brazil, Saudi Arabia, Iraq, , Thailand (Who have approved the Astrazeneca vaccine (RAPS.org vaccine tracker).

However, the biological effect of the vaccine young and old does not suggest much difference between over and under 65s

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32466-1/fulltext Ramasamy et al. VOLUME 396, ISSUE 10267, P1979-1993, DECEMBER 19, 2020

This shows that the level of antibodies increase for a month after the first dose and then it plateaus. But if you get the second dose the antibody levels increase further. There is very little diffference if you are over 70 or 55-69years old

If you look at the viral inhibition it is very similar between young and old

Now the T cells… the T cells are activated after the first dose and there is not alot of difference between the 18-55 to the over 70years

So the over 70s are a bit lower but not that much lower. So if there is a reduction in protection in the oldies it suggests it is not because of the adaptive immune system. As I have said many time the important cell types getting rid COVID-19 virus are cells from the Innate Immune system. The macrophages are the important cell types and this is why MS DMT do not affect Covid-19 very much. Macrophages are less effective as we age, which is why we don’t repair as quick. However immunology 101 says if you have an immune response it is likely that you will get rid of the virus quicker than not having an immune response against it.

High seroconversion (developing an antibody response) rates were observed in older adults (more than 65 years) after the first (97.8%; N=136) and the second recommended dose (100.0%; N=111).

Adverse reactions were generally milder and reported less frequently in older adults (≥65 years old).

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MouseDoctor

7 comments

Leave a Reply to Sarah Moore Cancel reply

  • Add Australia to the list of countries this may affect. Our regulator generally follows the EMA. This vaccine hasn’t been approved in Australia yet and I suspect when it is, it won’t be available for the over 65’s. This is problematic given we purchased 5 million odd doses and this age group (65+) was scheduled first to be vaccinated (along with frontline workers). The Pfizer vaccine has been approved in Australia (conditional for 2 years). So I guess the older folks will get that (more efficacious vaccine) and the younger will get the AZ (less efficacious) when approved. I wonder if the deaths in Norway factored into the EMAs findings….?

    Any vaccine is better than no vaccine. The more this thing replicates, the worse it will get. lol at the mess in South Africa.

  • …..Look at the mess in South Africa….definitely not laughing out loud…

    Thought it best to clarify that typo 😉

  • On what I’ve read and understood I’d be happy for my 73 year-old mother to have the vaccine.

    She’s in New Zealand though where they’ve only approved the Pfizer vaccine so far. (It’s a relief to me that she’s in very good health and I don’t have to worry about her catching the virus!)

    • New Zealand have done well keeping the virus under control to date. The ZAF strain has however, been circulating in one of their quarantine hotels over the last 5 days. So, only a matter of time before that genie escapes the bottle. AZ vaccine shown to be 50% efficacious when combating this strain (phase III AZ data reported widely this morning via the news. I’m yet to clap eyes on the publication). So, only a matter of time before that hits Australian shores. I hope I’m wrong but anything that binds to ACE II is an explosion waiting to happen.

      Lots of countries have cried victory prematurely (a la George W bush post Iraq invasion). I hope NZ and Australia aren’t on that list.

    • Perhaps it would be good if the US did not approve the Swedish/British drug it could take some heat of Astrazeneca as the product in the US (e.g.Baltimore) plants could be diverted to the EU as the EU contract (clause) says the stuff can come from non-EU sources. It seems that Brussels want this to come from the UK, but what would happen if it was taken from the US. My reading of the contract is that it what happens all boils down to the legaliseeze of what “reasonable” means in clasue 5.4. How good is the contract between the UK and astrazeneca to determine what reasonable means to zeneca, the US and astrazeneca and all the other manufacturers and the EU…These contracts and their schedules of deliver need to be made public I suspect as this row with grumble on.

      Will the US do this? It seems to me that the US wants more trial data and not sure they want to approve the AZ vaccine. I am not sure if the US trial has restarted and I think the half-dose is unlikely to get approval in USA without more trial data. There are now hundreds of thousands of UK residents that have taken AZ vaccine. Is this vaccine going to make a difference to the US?

      THe US has control of: 1. Pfizer (USA) BioTNtech, 2. Moderna (USA), 3 J&J (USA) Jansen, and now 4. novavax (USA), they would have had control of the oxford vaccine if the British Government hadn’t stopped the licencing to Merck Sharp Dome, but it seems they feared Vaccine Nationalism from the US.

      • CSL has got the license to manufacture the AZ vaccine in Australia. I have no idea how this plays out for Europe (we are a member of CEPI). The vaccine is still not approved in Australia. The TGA granted provisional determination in October 2019 which means AZ can apply for provisional registration. Why haven’t they? Perhaps they are awaiting the data from the ongoing phase III studies to allay concerns around efficacy and dose regimen (speculation on my behalf).

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