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* Britain restricts AstraZeneca to people aged over 40
* In Germany, all adults free to get AZ shot on doctor's
advice
* Germany, with eye on summer hols, shortens gap between
doses
* EU regulator looking at AZ on reports of neurological
illness
By Alistair Smout and Douglas Busvine
LONDON/BERLIN, May 7 (Reuters) - Britain restricted the use
of AstraZeneca's COVID-19 vaccine on Friday while
Germany said it would give the shot to anyone who wants it, in a
risk-management role reversal that reflects the divergent
progress of their vaccination campaigns.
The shifts in guidance on the Anglo-Swedish drugmaker's
vector-based shot demonstrate just how hard it is for policy
makers to weigh its benefits against risks in the form of very
rare - yet occasionally fatal - cases of blood clotting.
How choosy governments can afford to be depends to a large
extent on how far they have progressed towards vaccinating
enough people to drive down the spread of coronavirus infections
and cut the number of resulting deaths.
In Britain, which has relied heavily on the AstraZeneca jab
designed at Oxford University, 51% of people have received at
least one vaccine dose and daily fatalities have fallen to the
low double digits.
Against that backdrop, Britain's panel of vaccine advisers
said people under 40 should be offered an alternative to
AstraZeneca due to the small risk of blood clots, raising the
age cut-off from 30 previously.
Anthony Harnden, deputy chairman of Britain's Joint
Committee on Vaccination and Immunisation (JCVI), stressed that
the decision to propose alternative vaccines for the under-40s
was "based on the UK epidemiology".
He noted that the risk-benefit balance of the AstraZeneca
vaccine was different in Germany due to higher infection rates
there. In Germany, the seven-day incidence is 126 cases per
100,000 people and, although it is on a downward trend, it is
nearly six times the rate in Britain, official data show.
AN ATTRACTIVE OFFER
Britain's new-found caution follows bold earlier decisions
to issue emergency approval for the AstraZeneca vaccine,
aggressive ordering and a strategic choice to administer first
doses to as many people as possible.
Germany, by contrast, has relied on a European Union
procurement process that has been troubled by a dispute with
AstraZeneca after the company slashed its deliveries due to
production problems.
On the regulatory side, Berlin first banned AstraZeneca for
the elderly due to a lack of trial data, before saying people
under that age shouldn't receive it after monitoring identified
cases of blood clotting, in particular in younger women.
Now, Health Minister Jens Spahn is making the shot freely
available to those who want it, on a doctor's advice, and
allowing people to get a second shot as soon as four weeks after
the first.
The move comes with an eye to the summer holidays and
coincides with the rapid passage of legislation this week that
would free those fully vaccinated from social distancing
measures imposed by Berlin to fight the pandemic.
AstraZeneca vaccines stockpiled at vaccination centres will
now be used mainly to give second shots. Future deliveries will
be sent to family doctors, offering a hassle-free route for
those wanting protection in time for their summer vacation.
"We are convinced this offer is attractive for those who
would otherwise not get vaccinated so quickly," Spahn told a
news conference.
Even as Germany loosened its handling of AstraZeneca, the
EU's drug regulator said it was reviewing reports of a rare
neurological condition called Guillain-Barre syndrome in people
who had received the shot.
And, adding to confusion, the Spiegel news weekly reported
that Germany's vaccine committee planned to restrict the
one-dose vaccine from Johnson & Johnson to over-60s
following similar reports of blood clotting.
IN THE FAST LANE
The decision by the federal government follows moves by
several German states to make AstraZeneca more widely available
and comes as the pace of giving shots of mainstay vaccines from
BioNTech/Pfizer and Moderna picks up.
The share of the German population that has received a first
vaccine shot has reached 31.5%, putting the country in line with
the rest of Europe, where an official dashboard https://vaccinetracker.ecdc.europa.eu/public/extensions/COVID-19/vaccine-tracker.html#uptake-tab
shows that 31.3% of people have received a first dose.
Some German experts criticised the decision to allow people
to receive the AstraZeneca vaccine at shorter intervals, saying
studies had shown its efficacy to be only around 55% with a
four-week gap and 80% with a 12-week delay to the second shot.
"We have to make it clear that if people shorten the gap
between AstraZeneca doses to enjoy greater freedom of movement
sooner, they are doing so at the cost of their immune
protection," said Carsten Watzl, professor of immunology at the
Dortmund Technical University.
(Writing by Douglas Busvine; Additional reporting by Kate
Kelland, Paul Carrel, Riham Alkousaa and Maria Sheahan
Editing by Gareth Jones)
