Professor Karina Butler:

I would like to come in on that. I can understand why the Deputy is asking that question. The 60s to 70s age cohort, particularly, has concerns and feel they are singled out for what they might perceive as a less safe vaccine. Part of that has arisen from a misunderstanding of the messaging when AstraZeneca was first restricted from the over-70s. The reason it was held at that stage in the beginning did not arise from any safety concerns whatsoever. It was simply that there had been a very small number in that age group in the original trials of AstraZeneca. In the phase 2, 3 and 4 trials there were only about 222 individuals over 70 years of age. It was for that reason, while waiting for more information to come out, that in the beginning it was recommended that the mRNA vaccines be given preferentially to the over-70s.

This was coupled with the fact that as we get older our immune systems do not always respond so well. We wanted to make sure that the vaccines were equally effective in older age groups. That data then came out from Scotland and the UK. Thus, the advice from NIAC was revised to state that these vaccines could be used across all age groups. There are no concerns about the safety of AstraZeneca in those older age groups.

However, somehow that has not translated into common public knowledge. It was felt there was a danger at the older ages and now we are saying that perhaps they are less safe in the lower age group, so that middle age group is feeling a little squeezed. It is about trying to get that information out and realising that there were never any safety concerns there. In fact, we have said, in terms of the 60 year age group and even, perhaps, the 50 year group, that really has been redirected out of an abundance of caution, a phrase that has become hackneyed in a way, but that is what it is. What one wanted to see was that a very wide safety margin was being maintained. We know that the risk of Covid-19 for somebody aged 60 years is 84 times the risk of anything associated with the vaccine. That is not just the risk of Covid-19 in somebody who contracts it, that is the risk for somebody who is of that age in the population taking into account the risk of acquiring it and the risk of what happens after one gets it.

I understand where people are coming from, but it is about trying to inform them so they may feel confident in that. We are aligned with many other countries in Europe in taking those age cut-offs, be they around 60 years of age. We know the UK has taken a much lower age cut-off, but it must be said that it was at a different stage in its pandemic as well. We also have to take into account the availability of alternative vaccines. All of those factors came into play.