The Ministry of Health has issued the circular that puts pen to paper the possibility, for the under 60s who have received the first dose of the anti-Covid vaccine of AstraZeneca and refuse the recall with a different product, to complete the vaccination course with the same Vaxzevria of AZ, after a medical interview and after signing an informed consent form.
Freedom of choice on vaccines, white Italy is protected, Draghi: “I’ll be heterologous”
AstraZeneca, the circular of the Ministry of Health
“According to what was highlighted by the Cts – reads the circular, signed by the Director General for Prevention of the ministry, Giovanni Rezza – without prejudice to the priority indication of second dose with mRna vaccine, inspired by a principle of maximum caution aimed at preventing the onset of Vitt phenomena (vaccine-induced immune thrombocytopenia, ed) in subjects at low risk of developing Covid disease- 19 serious, and to a principle of fairness that requires to ensure all subjects equal conditions in the balance of benefits / risks, if a subject under the age of 60, after receiving the first dose of Vaxzevria vaccine, even in the face of documented and accurate information provided by the vaccinating physician or by the operators of the vaccination center on the risks of Vitt, refusals without the possibility of convincing the crossing to the mRna vaccine, to the same, after acquiring adequate informed consent, the second dose of Vaxzevria can be administered “.
“This option – reads the text – is coherent and balanced by the benefit deriving from the cancellation of the risk connected to the partial protection conferred by the administration of a single dose of Vaxzevria”.
AstraZeneca, in Lazio the recall with the ok of the general practitioner also for the under 60s
J&J to over 60, or under in which single-dose is preferable
The single-dose Covid vaccine of Janssen (group Johnson&Johnson) is recommended for people over 60, but the benefit-risk ratio of its use could be favorable even in people under 60 in whom single-dose vaccination is preferable. This is the meaning of the clarification contained in the circular with which the Ministry of Health, in addition to giving the green light to the AstraZeneca recall for those under 60 who refuse the mix with an mRna product, also provides clarifications on how to use the Janssen vaccine. With an opinion sent on 11 June last, we read in the circular signed by the Director General for Prevention, Giovanni Rezza, “the CTS has recommended the Janssen vaccine for people over 60 years of age, also in light of what was defined by the Technical Scientific Commission of Aifa ».
In fact, since it is an adenoviral vaccine like that of AstraZeneca, the same precautionary principle also applies to J&J aimed at avoiding the rare risk of Vitt (vaccine-induced immune thrombotic thrombocytopenia) in the younger population. However, the text continues, “the CTS has also provided for the possibility that specific situations arise in which the advantageous conditions of the single administration are evident, and that, in the absence of other options, the Janssen vaccine should be preferentially used, subject to the opinion of the Territorially competent ethics committee “.
“In particular – specifies the circular – the vaccine in question could be administered in certain circumstances, such as in the case of specific vaccination campaigns for non-permanent populations and / or characterized by high labor mobility and, more generally, for the so-called hard to reach population groups. In fact, in these circumstances, already indicated by the CTS, considering the criticalities relating to the logistics and timing of the administration of a two-dose vaccine cycle, the benefit / risk ratio of administering the Janssen vaccine in subjects under the age of 60 could be favorable “.
Second dose AZ, the opinion of the Cts
The green light for the booster with AstraZeneca anti-Covid Vaxzevria vaccine even in the under 60 who, after receiving the first dose AZ, refuse the mix with an mRna product, has received a favorable opinion from the Scientific technical committee for the coronavirus emergency also because “there is to consider the benefit deriving from the cancellation of the risk connected to the partial protection conferred by the administration of a single dose of Vaxzevria”. That is, the danger that the vaccinated in the first dose does not undergo the second to avoid the heterologous scheme.
This is one of the points highlighted by the CTS, in the opinion expressed yesterday 18 June and attached to the circular issued on the subject by the Ministry of Health. Another consideration of the Cts is that “thromboembolic phenomena are less frequently observed after administration of the second dose” AZ: “According to estimates from the United Kingdom – reads the opinion – they are equal to 1.3 cases per million, a value less than a tenth of the already rare phenomena observed after the first dose. According to what was reported by the general manager of Aifa – it is recalled – to date, in Italy, no cases of Vitt have been recorded after the second administration of Vaxzevria ».
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