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No decision on J&J, AstraZeneca for under-50s until NIAC advice - Holohan

Updated / Monday, 10 May 2021 23:41

The Chief Medical Officer has said no decision on the use of Johnson & Johnson and AstraZeneca vaccines for under-50s will be taken until the National Immunisation Advisory Committee issues advice.

Speaking to RTÉ News, Dr Tony Holohan said he wrote to NIAC last week, asking for updated advice on the use of the vaccines that are recommended for the over-50s only - the Johnson & Johnson and the AstraZeneca vaccines - and he said he expects to receive this advice in the coming days.

"We've asked for advice in the context where the over-50s would all be vaccinated, what should then be the next set of priorities in respect of that particular vaccine, and I'll have that advice in the next number of days," he said.

Dr Holohan said he will make this advice available to the Minister for Health and the Government to inform the vaccine roll-out programme.

He said, at the moment, he is not concluding that Johnson & Johnson cannot be used for the 45-50 age group.

There will be a vaccine to offer in all of the age groups for whom a vaccine is recommended, "as to which of the vaccines for a particular age group, that's going to depend on the advice," Dr Holohan added.

"I'm not at the moment going to operate on the basis that the advice is going to prevent us from using the vaccine for any particular age group until I receive that advice."

The CMO said if the situation is where the evidence is that the vaccines should not be used for the under-50s, that is then what will be concluded, but that is not necessarily the situation.

He said the use of the Johnson & Johnson vaccine has a risk-benefit for many other age groups, including the under-50s, but the advice up to now has been to use it primarily for the over-50s.

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Dr Holohan said the vaccination of children and teenagers is being considered.

He encouraged adults to maintain the high uptake of vaccines, saying "we're doing really well with the adult population" and said if the public can keep up that high uptake, then "the question of potentially vaccinating people under the age of 18 or 16 may well arise and I know that some of the vaccine companies are seeking to extend their licences for those uses".

The CMO also urged the public to concentrate on the measures permitted this month and not "to get ahead" of what is advised by public health guidance.

Dr Holohan said that the emphasis for May remains on outdoor activity, meeting up where it is safe to do so, and continuing to have measures in place to limit the spread of the virus.

"We need to stay focused on May and the measures now being introduced," he said.

Dr Holohan said it will take time for people to feel confident about feeling safe interacting with others, but he advised people who are vaccinated to get out and about and meet others who are vaccinated from up to two other households.

He said that people who are vaccinated can also meet indoors without restrictions once those they meet are in low-risk groups.

Dr Holohan said that changes introduced on the back of National Public Health Emergency Team (NPHET) advice previously has led a minority of people to go beyond the advice and have indoor activities and parties and he urged people not to do this.

He said the age profile in reported cases is very different to a year ago and is mostly confined to people under the age of 45 and these factors are taken into account when considering the easing of restrictions.

The CMO said anyone diagnosed with Covid-19 needs to strictly isolate and their close contacts need to restrict movements and if this happens there is "real hope of keeping this disease" under control in May and June.

Dr Holohan said the ambition is to get through May and then, if safe, on 7 June to move on to more measures safely for June and then "express ambition" about further easing later in the summer.

Dr Holohan said that "it really requires us all to stick to the measures in place - things are possible today that weren't possible in the weeks and months gone by".

He said that he would really like to see spectators at the All-Ireland finals in Croke Park in August.

However, he said large outdoor gatherings for sport or concerts will depend on the numbers who are vaccinated and whether there are any problems with variants of the virus over the coming weeks and months.

"If we found ourselves in a situation where we had really good progress in terms of the vaccine, where we did not run into any difficulties in terms of variants and so on, that some of the things which are not now possible including outdoor events... might be things we can think about."

In relation to antigen testing, Dr Holohan said: "It's not a question of the trust on the part of the public, it's the trust in the outcome of the test. The test doesn't give a reliable enough negative test for us to know for certain that it's going to pick up that in every single situation."

"What we really could be inducing here is a situation where people feel, having taken this test, 'I don't need to go with my symptoms to my GP and get a PCR test', or they may feel that they can undertake activities that are in fact not safe for them to undertake and spread the disease to other people.

"It's not the same as a home pregnancy test."

Dr Holohan said his concern is about "people's interpretation of what the test means". He said it is really important that the use of antigen testing is underpinned by really good evidence that it works.

He said he was not critical of retailers, but advising people in terms of their behaviour and not to buy these in retail environments and then use them.

The risk they see is that if a person gets a negative result, it might falsely reassure the person, he said. The CMO said for every two cases of the disease where an antigen test is done, it will miss in one of those cases.

He said: "If it falsely reassures a person who for example is going to a wedding that's happening because you're using antigen tests, now you've got the potential for a superspreading event to take place."

Dr Holohan added: "We have to be careful that we don't find ourselves in a situation whereby we have people behaving as though they don't have the disease when in fact they do".

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