The AstraZeneca laboratory vaccine placed on the European flag -

Action Press // SIPA

The subject of a commercial controversy with the EU, AstraZeneca's anti-Covid-19 vaccine is also at the center of a scientific debate on its effectiveness in the elderly, which has led several countries to advise against it for this population, contrary to European recommendations.

One of the next states to decide will be France.

Its High Authority for Health (HAS), whose opinions are normally followed by the government, will say this Tuesday if this vaccine is authorized for all adults, as recommended on Friday by the European Medicines Agency (EMA), or s 'it should be reserved for the less aged.

Not recommended for those over 65, or even those over 55

The first to arbitrate in this direction was the German vaccine authority, which recommended on Thursday not to authorize this vaccine for people 65 years and over.

She judges that there is "not enough data" on its effectiveness in this age group and the German Minister of Health, Jens Spahn, indicated that he would follow this advice.

The Austrian National Vaccination Committee aligned itself with the same position on Sunday.

On Saturday, the Italian drug agency recommended, in more cautious terms, "preferential use" of this vaccine for "18 to 55 years".

For the "older and / or more fragile", she advises "the preferential use of messenger RNA vaccines" from Pfizer / BioNTech or Moderna.

The 55-year-old bar was also retained by the head of the anti-Covid coordination unit in Bulgaria.

"It is clear that seniors will not be vaccinated with this vaccine," finally assured Monday Michal Dworczyk, in charge of vaccination in the Polish government, even before the National Medical Council decides.

Not enough data available

These opinions do not mean that the vaccine is not effective in older people, but that we cannot assess this effectiveness on the basis of current data.

"We must not confuse absence of proof and proof of the absence" of efficacy, summarizes an English expert, Dr Peter English, quoted by the British organization Science Media Center.

These reservations come from the way the clinical trials of the vaccine were set up.

To grant its authorization, the EMA relied on trials carried out from May-June in the United Kingdom and Brazil on 11,000 volunteers.

However, most were between 18 and 55 years old: less than 1,500 were over 55 years old, of which only 450 were over 70 years old.

If the general effectiveness has been evaluated at about 60%, "there are not yet enough results in participants over 55 years to have a figure on the performance of the vaccine in this age group", concedes the EMA in its opinion.

"However, protection is expected to exist as an immune response is seen in this age group and based on experience with other vaccines," she argues.

This is why she considers that this vaccine "can be used in older adults", which is already the case in the United Kingdom.

On January 4, this country was the first in the world to authorize this viral vector vaccine, the result of a partnership between one of its most prestigious universities, Oxford, and the Anglo-Swedish laboratory AstraZeneca.

Other studies underway on the AstraZeneca vaccine

“More information will be provided by ongoing studies which include a higher proportion of older participants,” the EMA concluded.

In the meantime, according to the leaflet, "the data from clinical trials currently available do not make it possible to estimate the effectiveness of the vaccine in people over the age of 55".

This debate comes in an already turbulent context for AstraZeneca, which has suffered the wrath of European leaders because of significant delays in deliveries.

The two controversies came together on the occasion of remarks made by Emmanuel Macron.

"Today, we think that it [the vaccine] is almost ineffective for those over 65," he said Friday during a meeting with the foreign press, before the opinion of the EMA.

"I suspect that there is some demand management on the part of Mr. Macron there," one of the Oxford officials, Sir John Bell, replied on the BBC.

The vaccine trials of Pfizer / BioNTech and Moderna, the other two approved in Europe, have given a larger share than those of AstraZeneca to people up to 75 years of age.

But beyond this age, the proportion of volunteers is also low.

"We use the Pfizer vaccine in people over 80, but we do not know its effectiveness in these people", noted Monday on the channel BFMTV the French infectious disease specialist Eric Caumes.

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