The National Advisory Committee on Immunizations (NACI) has recommended against using the Oxford-AstraZeneca vaccine in people aged 65 and older, although Health Canada has authorized it to be used in adults of all ages.
The committee, which makes recommendations to governments on the use of newly approved vaccines for humans, said in documents posted Monday it does not recommend the vaccine for those 65 and older “due to limited information on [its] efficacy” in that age group.
NACI said its recommendations are based on independent advice and reflect the best current available scientific knowledge.
Health Canada authorized the vaccine on Friday as the third option to protect against COVID-19.
Approval based on real-world evidence
Health Canada said the clinical trial results “were too limited to allow a reliable estimate of vaccine efficacy” in those aged 65 and older, but that it was comfortable approving it based on real-world evidence of its effectiveness in that age group.
One infectious disease specialist says he was taken aback by the different takes of Health Canada and NACI.
The vaccine has had good results preventing hospitalizations and deaths due to COVID-19 in the United Kingdom, says Dr. Sumon Chakrabarti, a specialist at Trillium Health Partners in Mississauga, Ont.
“We’ve seen real-world usage in the U.K., for example, and the results were really good including for people who are even 80 years of age and older. So I’m not certain what to make of this, it’s still approved for people 18 and over, and I just want to see how this plays out. But I would not hesitate to recommend it,” Chakrabarti said on CBC News Network.
Chakrabarti also said it is possible NACI may end up updating its recommendation.
‘This is science in real time’
Dr. Isaac Bogoch, an infectious disease physician and member of Ontario’s COVID-19 immunization task force, said not having enough data isn’t the same as saying a vaccine isn’t effective.
He said provinces and their health authorities will ultimately have the final say about which vaccines are administered in their areas.
“This is science in real time,” Bogoch said. “You can have multiple groups look at the exact same data and come to different conclusions.”
People over age 65 are disproportionately at risk of dying or being hospitalized from COVID-19.
“We know that any vaccine that’s currently available in Canada will help now,” he said.
NACI’s recommendations also include that the Pfizer-BioNTech vaccine may be offered to those aged 12 to 15.
