Dutch Health Council recommends AstraZeneca Covid vaccine for over-65s

The Dutch Health Council issued a new set of recommendations to the Ministry of Health on Monday, including the advice that the Covid-19 vaccine produced by Anglo-Swedish pharmaceutical company AstraZeneca be used for people aged 65 and up. It also said that those who have recently been infected with the SARS-CoV-2 coronavirus only need one vaccine dose and not two injections, and that there should be no delay in giving people who need a second shot their inoculation to speed up protecting the elderly.

Thus far, the AstraZeneca vaccine has only been used in the Netherlands to prevent the coronavirus disease in people between the ages of 60 and 64 at serious risk of Covid-19, and residents of long-term care facilities who are below the age of 64. At the start of February, the advisory panel said there was not enough research available on the efficacy of the vaccine in people above the age of 55, with greater concern for those over 65 "because the immune system begins to function less effectively with age."

However, new research from the United Kingdom published in The Lancet gave the Dutch independent government advisors reason to change their stance. "An observational study from Scotland shows that, for a month after vaccination, a dose of the AstraZeneca vaccine prevents hospitalization in the elderly. The efficacy was between 70 and 94% and was up to 81% in people aged 80 years and older," the Dutch Health Council wrote in a letter to the caretaker health minister, Hugo de Jonge.

The initial data appeared to show that the AstraZeneca vaccine is comparable to the one from BioNTech/Pfizer for protecting the oldest age groups. The Dutch advisory board's new stance was also backed by recent advice from the World Health Organization.

Additionally, the organization said that people who tested positive for the SARS-CoV-2 infection less than six months ago need only one dose of a coronavirus vaccine. The three vaccines currently in use all require two doses for maximum efficacy. It noted three recently published scientific articles that showed that "the immunity they have built up lasts for at least six months. It also appears that a single dose of vaccine causes a significant increase in the antibody levels built up within those six months."

The Council said it would continue to monitor the situation and revise its advice if needed.

The advisory board also said the Netherlands should continue to give the second dose of two-shot vaccines within recommended guidelines, instead of delaying the second injection in favor of giving more jabs to the elderly. "Extension of the interval therefore creates uncertainty about the degree of protection between the two doses. Inadequate protection against infection can not only lead to more disease, but in theory also increases the risk of the appearance and spread of virus variants that are less effective to combat," the researchers wrote.

In the Netherlands, the second Pfizer shot is given after six weeks, while the Moderna jabs are separated by about four weeks. The AstraZeneca vaccine doses are staggered by about 12 weeks.