Italy approves AstraZeneca vaccine for adults up to 65

Italian health authorities have raised their age limit for AstraZeneca's Covid-19 vaccine by an extra ten years, approving it for use on people up to 65.

Italy approves AstraZeneca vaccine for adults up to 65
A dose of the AstraZeneca vaccine being prepared in Rome. Photo: Tiziana Fabi/AFP

Previously the vaccine, developed at the University of Oxford in the UK, was only indicated in Italy for adults aged 55 or under.

But the Italian health ministry published a circular on Tuesday that says the vaccine can be used on everyone between 18 and 65, with the exception of “extremely vulnerable” people.

READ ALSO: Where to register for a Covid-19 vaccine in your region of Italy

The change is due to “new scientific evidence that gives higher estimates of the vaccine's efficacy than those previously reported”, the note said, along with more data about the immune response it produces in people over 55, and guidance from the World Health Organisation that the AstraZeneca vaccine is safe for older adults.

Italy's medicines agency AIFA, as well as the government's panel of scientific advisors, have already signed off on the move. 

AIFA had previously recommended reserving the vaccine for younger adults until more studies had been done on the effects on over-55s. Regulators in Italy and other EU countries have been cautious over the AstraZeneca vaccine on the grounds that the first clinical trials were carried out mainly on younger adults with fewer older participants.

That position had significant consequences for Italy's vaccination schedule, since doses of AstraZeneca began arriving this month but could not be used on over-80s, who are the top priority after health workers. 

READ ALSO: Who is in Italy's Covid-19 vaccine priority groups?

The Health Ministry therefore advised using the Pfizer-BioNTech and Moderna vaccines on people over 80 or with severe medical conditions, while offering AstraZeneca jabs sooner than expected to under-55s working in key sectors like schools or the police service.

Now key workers up to the age of 65 will also be eligible for the shot and, with most regional health services vaccinating in age order, they can expect to get it ahead of their younger colleagues. 

People born before 1956, or those with a serious health condition, will continue to be offered the Pfizer or Moderna vaccines, while others born later – including people with health conditions that make them more vulnerable to Covid-19 but not “extremely vulnerable” – will receive the AstraZeneca version, depending on availability. 

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Semen ‘a vehicle’ for monkeypox infection, say Italian health experts

Researchers in Italy who were first to identify the presence of monkeypox in semen are broadening their testing, saying early results suggest sperm can transmit infection.

Semen 'a vehicle' for monkeypox infection, say Italian health experts

A team at Rome’s Spallanzani Hospital, which specialises in infectious diseases, revealed in a study published on June 2nd that the virus DNA was detected in semen of three out of four men diagnosed with monkeypox.

They have since expanded their work, according to director Francesco Vaia, who said researchers have found the presence of monkeypox in the sperm of 14 infected men out of 16 studied.

READ ALSO: EXPLAINED: How is Italy dealing with rising monkeypox cases?

“This finding tells us that the presence of the virus in sperm is not a rare or random occurrence,” Vaia told AFP in an interview.

He added: “The infection can be transmitted during sexual intercourse by direct contact with skin lesions, but our study shows that semen can also be a vehicle for infection.”

Researchers at Spallanzani identified Italy’s first cases of monkeypox, found in two men who had recently returned from the Canary Islands.

The latest results reported by Vaia have not yet been published or subject to peer review.

Since early May, a surge of monkeypox cases has been detected outside of the West and Central African countries where the disease has long been endemic. Most of the new cases have been in Western Europe.

More than 3,400 confirmed cases and one death have now been reported to the World Health Organisation from more than 50 countries this year.

The vast majority of cases so far have been observed in men who have sex with men, of young age, chiefly in urban areas, in “clustered social and sexual networks”, according to the WHO.

It is investigating cases of semen testing positive for monkeypox, but has maintained the virus is primarily spread through close contact.

Meg Doherty, director of the WHO’s global HIV, hepatitis and sexually-transmitted infection programmes, said last week: “We are not calling this a sexually-transmitted infection.”

Could antivirals curb the spread of monkeypox?

Spallanzani researchers are now trying to ascertain how long the virus is present in sperm after the onset of symptoms.

In one patient, virus DNA was detected three weeks after symptoms first appeared, even after lesions had disappeared – a phenomenon Vaia said had been seen in the past in viral infections such as Zika.

That could indicate that the risk of transmission of monkeypox could be lowered by the use of condoms in the weeks after recovery, he said.

The Spallanzani team is also looking at vaginal secretions to study the presence of the virus.

A significant finding from the first study was that when the virus was cultured in the lab, it was “present in semen as a live, infectious virus efficient in reproducing itself”, Vaia told AFP.

Vaia cautioned that there remained many unanswered questions on monkeypox, including whether antiviral therapies could shorten the time in which people with the virus could infect others.

Another is whether the smallpox vaccine could protect people from the monkeypox virus.

“To study this we will analyse people who were vaccinated 40 years ago before human smallpox was declared to have disappeared,” Vaia said.