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The interim recommendations from the World Health Organisation (WHO) for use of the Oxford/AstraZeneca COVID-19 vaccine have been published.
Dr Penny Ward, Visiting Professor in Pharmaceutical Medicine at King’s College London and Chair of the Education and Standards Committee of the Faculty of Pharmaceutical Medicine, said:
“This guidance matches the recommendations for use of the Oxford/AZ vaccine following the scientific assessment from the UK MHRA and the Committee on Human Medicinal Products for the European Medicines Agency. The advice given is consistent with the recommendations of the UK Joint Committee on Vaccination and Immunisation.
“The WHO also recommend consideration for use of the vaccine in pregnant and breastfeeding women at high risk of infection and illness (e.g. healthcare workers).
“As has been observed in various EU member states, national authorities may take different decisions based on their own assessments, and possibly access to other vaccines, for populations living in individual countries. However, this is the third time that this vaccine has been approved for use in adults of all ages in three different jurisdictions, acknowledging the value of an effective vaccination in protecting against disease, hospitalization and death from COVID as well as the urgent need for access to effective vaccinations internationally.”
Prof Paul Hunter, Professor in Medicine, The Norwich School of Medicine, University of East Anglia, said:
“The advice produced by the WHO is compatible with the guidelines currently in place in the UK and indeed with the advice from the European Medicines Agency.
“It is notable that the WHO
“This recent opinion from WHO does not change anything within the UK vaccination policy but does provide extra reassurance that a credible and independent third party has come to the same conclusions as our own JCVI.
“Hopefully when the eagerly anticipated analysis of the first month or so of the UK programme is released in the next few days, this will answer several of the remaining questions. But even when that report is eventually published there are likely to remain several unanswered questions there will remain about the longer term duration and strength of immunity.”
Dr Jeremy Farrar, Director of Wellcome, said:
“It is excellent news that the WHO’s Strategic Advisory Group of Experts on Immunization has recommended the AstraZeneca/Oxford vaccine for use in all adults including those over 65 years old. This is an important step forward and clears the way for emergency use listing, which will help ensure vaccines are used in all countries, including low- and middle-income countries, and will be hugely beneficial in our fight against the virus. It’s right that South Africa is carefully considering its rollout, while collecting data on the efficacy against the new variant. This vaccine will still make an enormous difference to almost all countries and must be rapidly rolled out globally to save lives and get this pandemic under control.
“The world is at a critical juncture. These new variants are a powerful reminder that we’re now in a new and very unpredictable phase of this pandemic. It is vital healthcare workers and vulnerable populations in all countries are vaccinated as fast as possible.
“That means it is vital wealthy nations act now to begin sharing doses secured through bilateral deals and follow through on commitments to fair access. This should be done through COVAX and in parallel to national campaigns. Vaccinating a lot of people in a few countries, leaving the virus unchecked in large parts of the world will lead to more variants emerging and inevitably spreading between countries.
“At the same time we need to be rapidly developing second and third generation vaccines, developing a wider range of treatments and increasing testing and sequencing capacity and urgently increase manufacturing capacity. These are all key to long-term control and management of this disease.
“If we’re to get ahead of this pandemic and gain control, we must remain adaptive. That will not be achieved without significant step-up in international resourcing and co-operation. The US officially joining ACT-Accelerator today is a great and crucial step forward. But there is still, unbelievably, a staggering $27bn funding gap.
“Covid-19 is an endemic human infection. The scientific reality is that, with so many people infected worldwide, the virus will continue to mutate. Living with this virus does not, however, mean we cannot control it. We need to learn lessons from 2020 and act swiftly. Every day counts.”
Prof Anthony Harnden, Deputy Chair of Joint Committee on Vaccination and Immunisation, said:
“The latest WHO recommendations support the UK policy of giving the Oxford AZ vaccine to all adult age groups and delaying the second dose for up to 12 weeks.”
Prof Lawrence Young who is Virologist and Professor of Molecular Oncology at the University of Warwick, said:
“Interim guidance from the WHO recommends use of the Oxford/AZ vaccine on the basis that the immune responses (neutralising antibody response) induced by the vaccine in older persons was similar to that observed in other age groups where vaccine efficacy has been well-documented. On-going studies of the Oxford/AZ vaccine will soon provide more precise efficacy estimates. Comparisons with the antibody responses and efficacy estimates resulting from other COVID-19 vaccines provide further confidence that the Oxford/AZ vaccine will be effective in persons aged over 65. The guidance also highlights that the Oxford/AZ vaccine is safe in people with evidence of prior SARS-CoV-2 infection and that antibody levels were boosted in these individuals after the first vaccine dose with no further boosting after the second dose. This is consistent with data from the mRNA vaccines (Pfizer/BioNTech, Moderna) which shows that the antibody response to the first vaccine dose in individuals with pre-existing immunity is equal to or greater than the antibody levels induced by two doses of the vaccine in uninfected individuals. This study also found that side effects were significantly higher in response to vaccination if you have had a previous infection. This suggests that the first vaccine dose of either the Oxford/AZ vaccine or the mRNA vaccines are serving as a boost in naturally infected individuals giving levels of protective immunity equivalent to that achieved with two vaccine doses in individuals who haven’t been previously infected. Perhaps we should consider giving previously infected individuals just one dose of the vaccine which would save on vaccine doses thereby increasing vaccine supply and would also prevent side-effects in those who have recovered from COVID-19.”
Dr Michael Head, Senior Research Fellow in Global Health, University of Southampton, said:
“With the Oxford AstraZeneca vaccine, there is less phase 3 data currently available in older populations, than in younger people. Therefore, the UK and also the EMA made a pragmatic decision to recommend this vaccine in older populations. This was based on phase 2 data showing a strong immune response, and the limited phase 3 information that was available.
“These decisions are all in the context of a very high burden of COVID-19, with demand on vaccine procurement massively outstripping the available supply. Any decision to leave vulnerable populations completely unprotected is a risky decision at this point in time. Therefore, it is good to see the WHO recommend the use of the Oxford AstraZeneca vaccine in all ages groups, including older populations.
“It is also interesting to see they recommend the longer gap between first and second dose, which reinforces the UK vaccine roll-out approach and the recommendations of the JCVI.”
Comments from scientists in the Oxford vaccine group:
Prof Sarah Gilbert, Professor of Vaccinology, and Chief Investigator on the Oxford vaccine trial, said:
“It is excellent news that the WHO has recommended use of the SARS CoV-2 vaccine first produced in Oxford. This decision paves the way to more widespread use of the vaccine to protect people against COVID-19 and gain control of the pandemic.”
Prof Andrew Pollard, Professor of Paediatric Infection and Immunity, and Chief Investigator on the Oxford vaccine trial, said:
“The new guidance from WHO is an important milestone in extending access to the Oxford-AZ vaccine to all corners of the world and providing further endorsement that after rigorous scrutiny by the WHO Strategic Advisory Group of Experts the vaccine can be used to help protect populations from the coronavirus pandemic.”
https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccines-SAGE_recommendation-AZD1222-2021.1/
All our previous output on this subject can be seen at this weblink:
www.sciencemediacentre.org/tag/covid-19
Declared interests
Dr Penny Ward: “No COIs. I am semi-retired, but I am owner/Director of PWG Consulting (Biopharma) Ltd a consulting firm advising companies on drug and device development. Until July 2019 I was Chief Medical Officer of Virion Biotherapeutics, which was a company developing broad spectrum RNA therapy for the treatment/prevention of respiratory virus infections. Between December 2016 and July 2019 I served as Chief Medical Officer of Virion Biotherapeutics Ltd, a company developing antiviral treatments for respiratory viral diseases. Previous employee of Roche, makers of tocilizumab (anti IL6 antibody) and CMO of Novimmune, makers of empalumab (anti IFN gamma antibody).”
Dr Jeremy Farrar: “Wellcome co-founded and co-funds CEPI, which has provided support to the development and manufacture of the University of Oxford/AstraZeneca AZD1222 vaccine candidate.”
Prof Anthony Harnden: “Prof Anthony Harnden is Deputy Chairman of the Joint Committee on Immunisation and Vaccination.”
Dr Michael Head: “No conflicts of interest.”
Prof Sarah Gilbert: “Sarah Gilbert is Professor of Vaccinology at Oxford University, and was co-founder of Vaccitech. She has received research funding for coronavirus vaccine research from EPSRC, UKRI, CEPI and NIHR. Oxford University has entered into a partnership with Astra Zeneca for the development of a coronavirus vaccine.”
Prof Andrew Pollard: “Andrew Pollard is chair of the UK Department of Health and Social Care’s (DHSC) Joint Committee on Vaccination and Immunisation (JCVI), but does not chair or participate in the JCVI coronavirus committee, and is a member of the World Health Organization’s (WHO) Strategic Advisory Group of Experts. He has received research funding for coronavirus vaccine research from UKRI, CEPI and NIHR. Oxford University has entered into a partnership with Astra Zeneca for the development of a coronavirus vaccine.”
None others received.