Filenews 30 January 2021 - by Marilena Panagi
The gaps in the studies so far on the indications and contraindications of vaccines against coronavirus are being analysed by scientists around the world, while in Cyprus, following the establishment of the Special Committee on the Categorization of Vulnerable Groups in order to give priority to people with various diseases, the need for proper information to citizens, belonging to this category , it becomes absolutely imperative.
The Cyprus Institute of Neurology and Genetics yesterday made public the data on people with neuromuscular and other chronic and mainly autoimmune neurological diseases. In its report, it analyses the data, stressing that 'at present there are no published data on vaccination against coronavirus in patients with specific neurological diseases, therefore, the recommendations are based on the data in the literature concerning other vaccines such as H1N1 influenza, and on suggestions from other organisms'.
At the same time, the ING points out that in any case the opinion of the treating physician must be agreed prior to vaccination.
1. For patients with hereditary myopathies, hereditary neuropathies and degenerative diseases: It is recommended that individuals undergo vaccination. Older patients with other underlying diseases and with respiratory function disorder or severe motor disability should be vaccinated as a matter of priority.
2. For patients with: Autoimmune neuromuscular diseases such as Myasthenia gravis, Multiple Sclerosis, Optical Neuromyelitis and other autoimmune central nervous system diseases, it is noted that, "phase 3 studies for the approval of vaccines available in Cyprus today (BioNTech/Pfizer BNT162b2-comirnaty and mRNA-1273 vaccine from Moderna) did not include individuals taking immunosuppressive drugs".
Therefore, 'we do not know whether the high levels of efficacy observed with mRNA vaccines so far will also be achieved in immunocompromised patients'.
However, as ING states, "based on the literature and experience of vaccinating patients with other vaccines, the administration of these vaccines will be sufficient to protect them from crown virus infection".
- In myasthenia and multiple sclerosis: Vaccination against SARS CoV-2 is recommended'.
- With regard to autoimmune polyneuropathies, 'there are reports of vaccinations against other viruses that have caused GBS (demyelinative syndrome). At the same time, however, "studies have shown that GBS is more likely to occur after an infection with influenza virus than after the vaccine". At present, "there are no reliable publications showing the exact probability of recurrence of neuropathy following a vaccine for SARS CoV2".
- Patients with immunosuppression "can be vaccinated with the two vaccines currently administered in Cyprus, since there is no risk of being infected with COVID-19 infection from the vaccine". If possible, 'measuring the title of antibodies 4-8 weeks after the second dose of vaccine would be desirable'.
In general, 'vaccination should be provided to immunosuppressed patients unless they have a serious, other type of contraindication'. ING suggests that "vaccination, if possible, is as far away from immunosuppressive therapy as possible with the aim of increasing response to it. In practice, where possible, vaccination should be carried out at least 4 weeks before the initiation of immunosuppressive therapy'.
If the patient is already receiving stable immunosuppressive therapy, "there is no time limit on the administration of the vaccine. In patients receiving intravenous immunoglobulins (IVIG) it is recommended that the vaccine be given in the interval between the shapes and at least 2 weeks after the last or before the next administration'.
In patients with Multiple Sclerosis: Taking Tysabri it is recommended that vaccination be carried out within one week of the last Tysabri administration and completed 2 weeks after the next.
In patients receiving biannual treatments that suppress B-lymphocytes: It is recommended if vaccination can be completed 4 weeks before the start of treatment.
Anxiety about developments in the European Union
Cyprus is anxiously following what has been recorded in the last week at European level, following the dispute that has arisen between the competent European Commission and AstraZeneca. Yesterday, and as agreed on Thursday by the two sides who disagree on the interpretation of the agreement between them, the relevant convention was published.
The "war" that has broken out between the company and the EU also endangers the vaccination programme of Cyprus since, as the scientific advisor of the Ministry of Health, Christos Petrou, said, "the planning is done according to the doses received each week". The plan, "has so far been to have the vaccination of over-80s and health professionals completed, and with the arrival of the AstraZeneca vaccine the remaining age groups would start in February. The company was expected to provide Cyprus with 120,000 doses, which were ready to be delivered by the end of 2020, and 160,000 doses for the first quarter of 2021. These doses don't exist. If we fall to 30% of these doses, so the percentage will be much less by the end of March when it is vaccinated. And in early autumn that was the forecast to get to a rate in the community of 70-75%... Merry Christmas at this rate."
With mobile units vaccination in mountain communities
The mobile units of the Ministry of Health have already entered the battle of vaccinations, which, on the basis of the relevant vaccination programme, will meet the needs of mountainous Cyprus and especially the elderly people who are not easy to go to the cities for their vaccination. In this context, the Ministry of Health, in consultation with the local authorities, plans visits of mobile units to mountainous and remote Communities where there are needs. Already, similar visits have been made to some Communities and the programme will concern and apply to all Provinces.
It should be noted that the Vaccination Programme is developing on the basis of the availability of vaccines and the priority made for vaccinating the population by the relevant advisory committee.
Pfizer vaccine safe
Pfizer's first extensive safety update for the COVID-19 - Comirnaty vaccine was published yesterday by the European Medicines Agency, which in its report concludes that "the safety data collected for the use of Comirnaty in vaccination campaigns are in accordance with the known safety profile of the vaccine, and no new side effects have been identified". At the same time, it makes it clear that "any deaths recorded are not related to this".
"The safety and efficacy of Comirnaty will continue to be monitored as it is used in all Member States and globally, through the EU pharmacovigilance system, additional studies by the company and independent studies coordinated by European authorities," The EMA said.
