The World Health Organisation’s Strategic Advisory Group of Experts on Immunisation on Tuesday issued a series of recommendations for use of the Moderna mRNA-1273 vaccine against COVID-19.
The SAGE on Immunisation is charged with advising WHO on overall global policies and strategies, ranging from vaccines and technology, research and development, to delivery of immunization and its linkages with other health interventions.
The experts had, last week, discussed the Moderna vaccine, which, like the Pfizer-BioNTech one, uses mRNA technology and is being rolled out in a number of countries.
The WHO vaccine advisory group recommends the administration of two doses (100 µg, 0.5 ml each) with an interval of 28 days between doses.
However, SAGE recommends at present that, if judged necessary due to exceptional circumstances of COVID-19 disease burden in a country, the interval between doses may be extended to 42 days.
It warned though that “the evidence for this is not strong, but this was the longest interval in the primary analyses of the Phase 3 trial; the great majority received the second dose after a shorter interval. SAGE does not recommend halving the dose,” the statement made available to PUNCH HealthWise read in part.
SAGE also recommends that the Moderna vaccine only be administered in settings that can deal with a potential anaphylactic reaction.
The experts also advised that the vaccine not be used on pregnant women unless they are health workers or have conditions putting them at high risk.
“SAGE recognized the importance of vaccination of pregnant women, especially given the priority for protection of health workers, of whom a large proportion globally are women. WHO recommends not to use mRNA-1273 vaccine in pregnancy, unless the benefit of vaccinating a pregnant woman outweighs the potential vaccine risks, such as in health workers at high risk of exposure and pregnant women with comorbidities placing them in a high-risk group for severe COVID-19.
“SAGE acknowledged lack of data on the safety of the vaccine in lactating women but given the mechanism of action of the vaccine, considered it unlikely to pose a risk. SAGE recommends that a lactating woman who is part of a group recommended for vaccination, e.g. health workers, should be offered vaccination.
“SAGE recommends that COVID-19 vaccination be offered regardless of a person’s history of symptomatic or asymptomatic SARS-CoV-2 infection. Available data currently indicate that symptomatic reinfection within 6 months after an initial infection is rare. Thus, in the context of limited vaccine supply, persons with PCR-documented SARS-CoV-2 infection in the preceding 6 months may choose to delay vaccination until near the end of this time period.
SAGE reemphasized that national programmes should take specific steps to identify groups disproportionately affected by COVID-19 and those who face health inequities due to social or structural inequities in order to address barriers to vaccination and achieve equitable access to vaccination.
SAGE does not recommend COVID-19 vaccination of travelers unless they are also part of a high-risk group identified in the WHO Prioritization Roadmap.
“In the current period of very limited vaccine supply, preferential vaccination of international travelers would counter the principle of equity. Because of this and the lack of evidence that vaccination reduces the risk of transmission, SAGE currently does not recommend COVID-19 vaccination of travelers (unless they are also part of a high-risk group identified in the WHO Prioritization Roadmap,” it said.
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