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AstraZeneca’s stabbing and the cost of fragmented decision-making | News about the pandemic coronavirus

Elena Hugony was sure of one thing when she entered the COVID-19 vaccination center in the Italian city of Palermo last week: she wouldn’t be allowed to get the AstraZeneca vaccine.

Sure enough, when a health care worker approached her with an injection developed by Anglo-Swedish pharmaceutical giant and University of Oxford, this 75-year-old woman stood firm with her conviction. mine. With Hugony refusing to leave, a doctor finally gives in after four hours and gives her a Moderna vaccine.

Hugony said: “There’s no way I could have AstraZeneca, with all the confusion surrounding it.

The confusion Hugoni – and many others around the globe shared – appears to be the result of some mistakes that have left a vaccine considered one of the best hopes in the world to defeat the coronavirus. ages ago long ago. Experts say messy clinical trial data and manufacturing issues have harmed AstraZeneca jab’s reputation, while recent reports linking it to very rare blood clots further do loss of public trust.

All of this, although both the European Pharmaceutical Authority (EMA) and the World Health Organization (WHO) have consistently insisted that the benefits of vaccines far outweigh the risk of side effects and recommend against any adverse effects. Any restrictions on the use of the vaccine. However, national health authorities have gone ahead with their own risk and benefit assessments that have, notably, reached different conclusions – from limiting vaccine use in Age groups vary to suspend use and even give up altogether.

Such sporadic decision-making could be detrimental to public confidence-building efforts, as well as having undesirable effects on countries that lack the ability to recycle, experts warn. access to other immunization options in addition to the AstraZeneca vaccine, which is currently in the most recent clinical trial in the US showing 76% efficacy. symptomatic prevention.

Penny Ward, a visiting professor of medicine at King’s College London, said: “It’s not transparent about why certain countries make certain decisions, especially when regulators don’t. It is suggested that there should be age-based restrictions.

“There was a lot of heat, but little light,” she added, “showing that vaccines are clearly effective in preventing death and hospitalization.

The European Health Authority emphasizes that the benefits of the AstraZeneca vaccine outweigh any risks. [File: Alessandro Garofalo/Reuters]

The possible link between a blood clot and the AstraZeneca vaccine was first discovered in Norway in early March, followed by cases found in Germany and the Netherlands. The findings have prompted at least 16 European countries suspend or limit Their AstraZeneca vaccine implementation is pending further investigation.

In the UK, the health agency of this country, as of April 5, has received 100 cases of blood clots, 22 cases of death. The country injected more than 20.6 million doses of the AstraZeneca vaccine at the time. After the review, the UK regulator assessed that the risk of hospitalization with COVID-19 was higher than the risk of serious vaccine harm for all age groups but for those under 30 years old who they recommend using an alternative injectable drug. .

For its part, the EMA to speak Its surveillance system, as of April 4, has received 169 cases of intracerebral coagulation (CVST) and 53 cases in the abdominal vein (SVT), out of a total of 34 million doses that have been used. in the European Union and Great Britain. Most cases occur in women younger than 60 years old within two weeks after the first shot is given.

On April 7, the regulator conducted an in-depth review of 62 CVST cases and 24 SVT cases, 18 of which were fatal. It says their analysis has found that the benefits of the vaccine outweigh the risk, and there is no evidence of specific risk factors such as age.

The UK, which is leading the way in vaccine rollout with nearly 50% of the population already vaccinated, has chosen a more relaxed approach to exchange vaccines only to those under 30 years of age. [File: Tolga Akmen/AFP]

Even so, Germany Experts say the decision to suspend the administration for people under 60 years old is in line with the country’s “more conservative approach”.

Italy does the same, while France and Belgium restrict the use of vaccines to those under 55 years of age. Meanwhile, Spain has caused health professionals to scratch their heads when it chooses to limit the use of vaccines to people aged 60 to 70 years.

German and French health authorities have gone further by recommending that people who have given the first dose of AstraZeneca jab use a different vaccine for their next injection, although there is very little clinical data available. to aid in the efficiency of mixing products.

Norway suspended the use of the vaccine pending further investigation, while Denmark on Wednesday became the first country to completely remove the vaccine from its national vaccination program.

Explaining their reasons, the Danish authorities said that in addition to the possible risk of clot binding, they could opt for such a move since the epidemic curve is currently under partial control. large, as well as thanks to the country’s access to the COVID-19 vaccine developed. by Pfizer and Moderna.

Indeed, it is this access to alternative services that underpins the decisions of some richer countries regarding the AstraZeneca vaccine.

Johannes Oldenburg, professor of blood transfusion medicine at the University of Bonn, said: “In Germany we have other vaccines in large quantities, so we can give the AstraZeneca dose only to those who Over age 60″.

“This way, we can use all of our vaccine sources while reducing the risk of complications,” he added.

However, with the coronavirus pandemic still wreaking havoc on the world (the number of reported global infections per week has nearly doubled over the past two months), experts warn countries with more access. With vaccines, they should think further than their domestic counterparts and be more responsible for the message they convey. countries are grappling with shortages.

WHO estimates that out of all doses given globally, one in four people in high-income countries have been vaccinated, compared with one in five in low-income countries.

The AstraZeneca vaccine, a “non-profit” product that is cheaper to buy and easier to store than other vaccines, is seen as the key to achieving vaccine equity as it is an essential component of COVAX, a global mechanism designed to ensure that poorer nations get their share of jabs. COVAX aims to provide 600 million injections, mainly AstraZeneca vaccine, to about 40 African countries.

“When information comes out and you poison an idea, such as an idea,” says Abdhalah Ziraba, an epidemiologist and research scientist at the African Center for Population and Health Research in Nairobi. Vaccine safety, it is very difficult to withdraw that idea.

However, Ziraba notes that in Kenya, a country affected by a massive resurgence of the virus and where only 0.7% of the population gets a single dose of the vaccine, people “would rather grapple with Side effect is more than needing an ICU bed and not finding one “.

Regina Osih, medical doctor and infectious disease specialist at the Aurum Institute in Johannesburg, says a “joint approach” is needed to address such challenges.

“What has happened in the UK and the US has consequences for other countries,” she said, referring to South Africa’s decision last week as immediate. pause use of vaccines Johnson & Johnson injected one shot after the United States suspended the administration of vaccination.

The move, which US officials said was carried out in “extreme caution”, came after reports of six cases of blood clotting, one of which became fatal. To date, the United States has used about seven million doses of the Johnson & Johnson vaccine.

But while the United States has vaccinated about 37% of its residents, South Africa has barely reached 0.5% of its population and faces supply challenges after abandoning the AstraZeneca vaccine. February followed reports of its limited effectiveness for a dominant variant there.

“Everyone was tired before; Now the number of rejections will increase with serious consequences for our immunization efforts, ”said Osih.

“This pandemic has shown us that global solidarity does not exist and that everyone is for themselves,” she said.



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