France recommends people under 55 not take AstraZeneca in second jab

France's top health body has said people under the age of 55 who received a first injection of the AstraZeneca/Oxford Covid-19 vaccine should be given a jab from a different producer for their second dose, a ruling affecting more than 500,000 people.

A health worker prepares to give an AstraZeneca vaccination in the Wanda Metropolitano centre, 24 March, in Madrid © Gabriel Bouys AFP/Archives

Last month France's national health authority (HAS) said the AstraZeneca/Oxford vaccine should only be given to those aged 55 and over because of reports of potentially deadly blood clots in a very small number of those younger people vaccinated.

Officials in France initially said that those given the AstraZeneca jab in a first dose should go ahead with the second jab even if aged under 55.

But on Friday HAS said that those aged under 55 who had been given the AstraZeneca as their first dose would now get an mRNA vaccine - the Pfizer-BioNTech or Moderna vaccine - as their booster. 

It also said there should be an interval of 12 weeks between the two shots, in such cases, and recommended a study to assess the immune responses given by mixing the vaccine prescriptions.

Bérangère Couillard, an MP with the ruling LREM party, said the government would "always remain cautious with people's health in France".

@HAS_sante recommande pour les personnes de moins de 55 ans ayant déjà reçu une 1ère dose d’#AstraZeneca, d’avoir pour 2nde dose un #Vaccin ARN messager.
Nous resterons toujours précautionneux avec la santé des Français.
➡️Le vaccin Astra Zeneca reste efficace et sauve des vies ! pic.twitter.com/kVH3NLYpC9

— Bérangère Couillard (@BCouillard33) April 9, 2021

Need to learn more

France has been injecting health workers as a priority group meaning that many younger people have already received the AstraZeneca jab.

Some 533,000 people are affected by the decision, the HAS said.

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They include Health Minister Olivier Véran, a neurologist aged 41, who was given the AstraZeneca vaccine live on television on 8 February. 

"It is completely consistent to say that we do not recommend the AstraZeneca vaccine to people under 55 years of age while we learn more," the minister told RTL.

"Therefore, if you have received a first injection and are under 55 years old, you will be offered another vaccine 12 weeks after the first injection." 

Restrictions on use

But confidence in the AstraZeneca vaccine (now renamed Vaxzevria) is dropping in Europe and elsewhere since Europe's medicines regulator said this week it could cause very rare blood clots among some recipients.

A poll by Odoxa-Backbone Consulting commissioned by French newspaper Le Figaro and published on Thursday found 71 percent of French people did not trust the AstraZeneca vaccine.

On Friday, Australia joined a host of countries in restricting use of the vaccine due to clotting concerns. Local health authorities changed their recommendation to say the country's nearly 12 million people aged under 50 should take the Pfizer product instead of AstraZeneca. 

Hong Kong said on Friday it would delay shipments of the AstraZeneca's vaccine this year. 

Several clinical trials are looking at the efficacy of combining two types of vaccine.

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"Based on previous studies which combine different vaccine types, a combination of the AZ and Pfizer vaccines is likely to be safe but it's important that this is tested in the context of a clinical vaccine trial," said Helen Fletcher, professor of Immunology at the London School of Hygiene and Tropical Medicine.

The WHO currently recommends the same product be used for both doses but has said further research should be carried out on the interchangeability of vaccines in so-called "mix and match" strategies.

Target reached

Meanwhile, after a sluggish start, France's vaccination campaign is now gaining pace. More than 10 million people in France have now received a first shot of a Covid-19 vaccine, with the government's target for that number reached a week ahead of schedule, Prime Minister Jean Castex said on Thursday.

France fell behind its European neighbours after the start of vaccinations in January, but is now jabbing on average around 200,000-300,000 people per day.

It is hoping a ramp-up of its vaccination campaign along with a month-long nationwide lockdown in place since last weekend will help it regain control over the latest outbreak.