The EU's medicines regulator on Friday gave AstraZeneca's coronavirus vaccine the green light to be used on adults of all ages, saying it believed it would be safe for older people too.
Malta has ordered a million doses of the vaccine, meaning that it could be a potential game changer for the island with a population of just under half a million people.
In his first reaction, Health Minister Chris Fearne said it was "imperative" that agreed delivery dates and quantities are maintained.
To put it into perspective, health authorities have ordered 750,000 doses from Pfizer-BioNTech and Moderna combined.
All eyes had been on whether the European Medicines Agency (EMA) would follow the lead of Germany, which on Wednesday declined to recommend the vaccine for over-65s, citing insufficient data.
"EMA has recommended granting a conditional marketing authorisation for COVID-19 Vaccine AstraZeneca to prevent coronavirus disease 2019 in people from 18 years of age," the Amsterdam-based EMA said in a statement.
The watchdog said that there were "not yet enough results in older participants" over 55 to show how it would work, but that "protection was expected" as an immune response was found in them, and based on experience with other vaccines.
"EMA's scientific experts considered that the vaccine can be used in older adults," it said.
"More information is expected from ongoing studies, which include a higher proportion of elderly participants."
The EMA has already approved the Pfizer/BioNTech and Moderna jabs for the 27-nation European Union, plus the European Economic Area (EEA) countries of Iceland, Liechtenstein and Norway.
The deployment of British-Swedish firm AstraZeneca's vaccine has been awaited with impatience by European countries as it is cheaper to produce than its rivals, and easier to stock and transport.
An age limit on the jab, developed with Oxford University, would have been a blow for governments that have based their vaccination campaigns on prioritising the frail and elderly.
'Accelerated timeline'
AstraZeneca has defended its vaccine's efficacy for all ages, along with Britain, which has already used the shot widely on older people.
Casting a shadow over the EMA decision is the bitter row over the supply of AstraZeneca doses between the EU and Britain.
The firm says there is not enough to go around as production issues have slowed promised deliveries.
The European Commission published a redacted copy of its contract with the drugs giant on Friday, demanding the company meet its prior commitments.
The EMA has meanwhile been under huge pressure to authorise vaccines as quickly as possible as frustration and pressure grow over Europe's stumbling start to the inoculation campaign.
While it has been working under what it calls an "accelerated timeline", the watchdog insists that ensuring safety and efficacy are paramount.
AstraZeneca formally applied for authorisation on January 12. The EMA had already been carrying out a "rolling review" of data on the vaccine since October.
Oxford and AstraZeneca had previously been criticised over a lack of clarity and transparency on trials that had shown varying outcomes in the jab's efficiency.
The EMA reached the decision after a four-day meeting of its Committee for Medicinal Products for Human Use (CHMP), which gathers experts from all EU and EEA countries.
Later on Friday, European Commission chief Ursula von der Leyen said the vaccine has been authorised for the EU market.
"I expect the company to deliver the 400 million doses as agreed," von der Leyen tweeted, as a row intensifies between Brussels and AstraZeneca over a production delay.
The jab is the third vaccine to be approved for use in the 27-nation bloc after rival ones produced by Pfizer-BioNTech and Moderna.
The EMA said separately on Friday that it had found no link between the Pfizer/BioNTech vaccine and a number of deaths of older people.
Other vaccine results
Meanwhile, American biotech firm Novavax said on Thursday that its vaccine showed an overall efficacy of 89.3 per cent in a major British clinical trial, and was highly effective against the variant first detected there.
But other results showed it offered significantly less protection against the South African strain.
Pfizer and Moderna have said their vaccines are effective against the variants.
Also released Friday, data from a mass trial of Johnson & Johnson's single-shot vaccine showed it was 66 per cent effective overall, with a better rate in the US and lower in South Africa.
The company is quickly expected to apply for a US emergency authorisation.
And in the EU, Hungary became the first member state to approve the Chinese-made Sinopharm vaccine, a week after it also broke ranks with Brussels by issuing a provisional permit for Russia's Sputnik V jab.
The Chinese "know the most" about COVID-19, Prime Minister Viktor Orban said, adding: "When I choose I will want the Chinese vaccine".