Will the AstraZeneca vaccine finally work at full capacity in France?

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Fotoarena / Sipa USA / SIPA

  • This Monday, Olivier Véran indicated that vaccination with AstraZeneca would now be open to people over 65 years of age with co-morbidities.

    What the Haute Autorité de Santé (HAS) confirmed on Tuesday.

  • The British vaccine, which has sparked much controversy, is gradually returning to favor in France.

  • How to explain this return to the foreground of AstraZeneca?

Is AstraZeneca the ugly duckling of coronavirus vaccines?

The British vaccine has found itself at the center of several controversies in France and Europe: first for lack of doses delivered compared to what was initially planned, then in the face of a questioned effectiveness on the elderly - yet the more vulnerable to Covid-19 - and to the South African variant, finally by fevers in vaccinated caregivers having caused sick leave.

As a result, the vaccine has struggled to find a taker.

Of the 1.6 million doses of AstraZeneca received in February, only 270,000 were administered as of Saturday, February 27.

Gradually, however, the vaccine is coming back in favor.

20 Minutes

explains why.

What exactly was AstraZeneca criticized for?

The AstraZeneca vaccine has long been considered to be less effective than the Pzifer / BioNtech and Moderna vaccines, which use messenger RNA unlike AstraZeneca, a more “traditional” viral vector vaccine.

Thus, the first results in December indicated an efficiency of 70%, which could seem low compared to the rate of 94% claimed by Pfizer BioNtech.

There were also doubts about the good efficacy of the vaccine in the elderly.

In France, the Haute Autorité de santé (HAS) first ruled against its use in people over 65, and Emmanuel Macron declared it almost ineffective on this population, favoring the doses of Pfizer-BioNtech and Moderna .

"AstraZeneca suffered from shadow bias of phase 3 data and several different and contradictory studies", comments the doctor in immuno-oncology Eric Billy, vaccine specialist for the collective "On the side of Science".

Sometimes undersized studies, with different time intervals between first and second doses, and sometimes worrying results, in particular an Oxford study which showed low efficacy in the elderly and against the South African variant.

Not to mention the fact that people over 65 were poorly represented in the testing phases, hence doubting the effectiveness of the vaccine on them.

"Until the arrival of the population study, we had very little data on the elderly: so it was normal not to give a vaccine whose effectiveness we do not know," notes Eric Billy.

How is AstraZeneca regaining credibility?

Little by little, the data is accumulating and proving to be much more reassuring.

In particular thanks to studies in real population, in the United Kingdom and in Scotland, which massively vaccinate with AstraZeneca and obtain very clear results on the curves of cases, hospitalizations and deaths.

For example, a study carried out as part of the vaccination campaign in Scotland showed that four weeks after the administration of a first dose, the risk of hospitalization was reduced by 85% with the Pfizer / BioNTech vaccine and by 94% with that of AstraZeneca / Oxford.

These results should be qualified slightly, because another English study shows that 56.4% of English people over the age of 80 already had antibodies against the coronavirus.

“And in the face of people who are already infected, the first dose of vaccine acts as a booster.

It is therefore much more effective than a first dose administered to a person who has never been contaminated, ”points out Eric Billy.

Nevertheless, for the doctor, "things are progressing, the Scottish study shows that in population, the vaccine behaves well and is effective".

Faced with these new data, Dominique Le Guludec, president of the HAS, was confident on Tuesday: “AstraZeneca now has extended indications […] We had validated this vaccine on the basis of an efficacy of around 60 to 70 %.

Real-life data is superior, around 70-80% and even beyond for reduced risk of hospitalization.

These results allow us to be able to extend the use of the AstraZeneca vaccine without any upper age limitation.

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Should the population criteria be broadened?

Of the 270,000 doses administered in France, more than 130,000 were administered between Thursday and Saturday, with the opening of vaccination for 50-64 year olds with comorbidities.

And this Monday, Olivier Véran announced the opening to vaccination of people aged 65 to 75 years suffering from comorbidities.

A good decision?

Eric Billy is skeptical: “It is necessary to give the most vulnerable people the vaccines available as quickly as possible.

However, he recalls, in April and May, it is the messenger RNA vaccines which will constitute the bulk of the deliveries.

Ten million doses per month for Pfizer-BionNtech alone, enough to vaccinate ten million people with this vaccine (requiring two doses) by the end of May.

"As it stands, there are enough messenger RNA vaccines to vaccinate people over 65 in France", specifies the doctor, for whom the opening of AstraZeneca to over 65 years of age may above all complicate logistic.

Of course, the doses must be used in six weeks before expiring, and the government wants to avoid this at all costs, but Eric Billy reminds us: “In France, there are millions of fragile people unrelated to their age.

»What easily use the doses of AstraZeneca, without further disturbing the different vaccination schedules.

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