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Covid-19: Booster vaccine gives “significant increased protection” in over 50s

BMJ 2021; 375 doi: (Published 17 November 2021) Cite this as: BMJ 2021;375:n2814

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It is time to distinguish Oxford Astra Zeneca COVID-19 vaccine from Pfizer BioNTech

Dear Editors

I have had a suspicion for some time that it is a mistake to discuss COVID-19 vaccines from Oxford Astra Zeneca (OAZ*) and Pfizer BioNTech (PBNT*) as a group; initial reasons may be in part due to the lower reported efficacy of OAZ product compared to PBNT and the heterogenous availability of the vaccine in UK during the first quarter of 2021 meant the need to vaccinate with either product was greater than trying to choose the "better" one. Hence the messaging and many subsequent post-marketing studies performed in UK (including those published in the BMJ) simply look at COVID-19 infection transmission and severity between those vaccinated vs unvaccinated, without any details on differentiating between those with OAZ vs PBNT products.

* I am aware that both have now allocated brand name Vaxzevria/Covishield and COMIRNATY respectively but not everyone is familiar with that.

For example, the "ourworldindata" website provides detailed breakdown on many countries based on vaccine type but one surprising omission is UK, where data was meant to be king in the well connected NHS system.

The reverberation of data poverty in this area is deafening.

And despite the warnings from many critics (including myself), the UK appears to have performed better than expected from July's Freedom day, compared to other countries in the EU just as when Israel (almost exclusively PBNT vaccine use) and the US (mixed PBNT and Moderna vaccine) are beginning to report a spike of infection attributed to waning immunity.

Of interest these are countries largely depending on mRNA vaccine whereas the UK, although the details are sketchy to me, appears to be roughy 50% OAZ and the other, PBNT.

And then Pascal Soriot, CEO of AstraZeneca, fired the first shot on this matter (ref 1), suggesting that OAZ vaccine may in fact have longer lasting immunity response by T-cell compared to mRNA competitors.

I am not swayed by "press release" particularly those which are essentially marketing announcements but I will be intrigued to hear more about this, and preferably with the input of BMJ journalists.

Perhaps after all the fury over the perceived higher side-effects of OAZ may be justified by better and longer immunity, and even without the need for booster shots with PBNT mRNA vaccine either.

Gelman M. Did Europe blunder in its Covid vaccine picks? Pascal Soriot points to a potential mistake — and jabs back over delays. Endpoints News 2021 Nov 23.

Competing interests: No competing interests

24 November 2021
Shyan Goh
Orthopaedic Surgeon
Sydney, Australia