The JCVI has advised ‘a preference for adults aged 30-39 without underlying health conditions to receive an alternative to the Oxford/AstraZeneca vaccine’.
However, it said this was ‘only where this is available and only if this does not cause any substantial delays in being vaccinated’.
It said this takes into account ‘the portfolio of vaccines available in the UK in the coming months and taking a precautionary approach in relation to the extremely small risk of thrombosis and thrombocytopenia following the first dose of the Oxford/AstraZeneca vaccine’.
This follows the 7 April announcement that all adults under 30 should be offered another vaccine.
The JCVI stressed that adverse events following the Oxford/AstraZeneca vaccine are ‘extremely rare’ and ‘for the vast majority of people, the benefits of this vaccine in preventing serious illness and death far outweigh any risks’.
JCVI Covid-19 chair Professor Wei Shen Lim said: ‘Safety remains our number one priority. We have continued to assess the benefit-risk balance of Covid-19 vaccines in light of UK infection rates and the latest information from the MHRA on the extremely rare event of blood clots and low platelet counts following vaccination.
‘As Covid-19 rates continue to come under control, we are advising that adults aged 18-39 years with no underlying health conditions are offered an alternative to the Oxford/AstraZeneca vaccine, if available and if it does not cause delays in having the vaccine. The advice is specific to circumstances in the UK at this time and maximises use of the wide portfolio of vaccines available.’
It comes as data published on Thursday (6 May) by Medicines and Healthcare products Regulatory Agency (MHRA) on adverse reactions from Covid vaccinations showed that up until 28 April:
- The MHRA had received Yellow Card reports of 242 cases of major thromboembolic events (blood clots) with concurrent thrombocytopenia (low platelet counts) in the UK following vaccination with the AZ Covid vaccine.
- The events occurred in 141 women and 100 men aged from 18 to 93 years and the overall case fatality rate was 20% with 49 deaths. Six cases have been reported after a second dose .
- Cerebral venous sinus thrombosis was reported in 93 cases (average age 47 years) and 149 had other major thromboembolic events (average age 55 years) with concurrent thrombocytopenia.
The estimated number of first doses of the AZ vaccine administered in the UK by 28 April was 22.6 million and the estimated number of second doses was 5.9 million.
This means the overall incidence of case reports of thromboembolic events with low platelets after first or unknown doses was 10.5 per million doses, the MHRA concluded.
Speaking in a news conference on Friday (7 May), deputy medical officer Professor Jonathan Van-Tam said: ‘I want to emphasize very strongly that this does not mean that JCVI advises against using AstraZeneca in 30-39s. Only if it’s possible, it prefers something else, consistent with maintaining pace and volume of the programme.’
He also clarified that the UK vaccination programme is still ‘on target for that first dose to all adults by the end of July’.
And he stressed that the JCVI’s advice remains that anyone under 40 who has had a first dose of the AZ vaccine without significant adverse events should go on to have their second dose of the same vaccine.
In response to the announcement, the Government said it ‘will follow today’s updated advice’ to offer 30-39s an alternative vaccine ‘only if doing so does not cause a substantial delay in accessing a vaccination’.
A spokesperson said: ‘More than 50 million vaccines overall have already been administered, and our current vaccine supply and rate of infection means we are able to take this precautionary step while remaining on track to achieve our target of offering a vaccine to all adults by the end of July.’
Speaking at the news conference, JCVI’s Professor Lim also stressed that this new advice should be followed ‘only where no substantial delay in access to vaccination might arise’.
He said: ‘The AstraZeneca vaccine is very helpful in that it requires less stringent transport and storage conditions compared to some other vaccines. That means that in certain settings, the AstraZeneca vaccine may be the only vaccine that is practical to offer. And in those circumstances, the AstraZeneca vaccine should indeed be the preferred vaccine.’
He said the advice was conditional upon three factors ‘remaining favourable’. Namely that:
- ‘There continues to be good control of Covid-19 infection in the UK;
- There is good availability of alternatives to the AstraZeneca vaccine;
- And there is strong vaccine rollout – in other words, we maintain the speed of vaccine deployment and a high level of vaccine uptake.’
He added: ‘Reductions in the vaccine uptake or the speed of deployment in the coming weeks will increase the size of any future wave and in that scenario any vaccine offered early is preferred to a vaccine offered too late.’
Professor Lim also said that – despite the MHRA investigating six reports of blood clots following a second dose – ‘there are no safety concerns in relation to the second dose of the AstraZeneca vaccine’.
He added: ‘We offer this advice, which places a high priority on safety, in the hope that it will further increase vaccine confidence, so that those of us who are being offered a vaccine in the coming weeks can feel more confident and feel more able to step forward.’
Also speaking in the news conference, MHRA chief executive Dr June Raine stressed that there has been no change to the approval for the use of the AZ vaccine in the UK.
She said: ‘I can confirm today that the position of the Medicines and Healthcare Products Regulatory Agency remains unchanged, that the benefits of the AstraZeneca vaccine against Covid-19, with the associated risks of hospitalisation and death, continue to outweigh the risks of the vaccine for the vast majority of people. There if therefore no change to the approval.’
However, she added: ‘The balance of benefits and risks of the vaccine is very favourable for older age groups, but it is more finely balanced for younger people. And so we advise that this evidence should be taken into account when considering the use of the vaccine.’
Anyone who has the following symptoms from around four days to four weeks after vaccination is advised to seek prompt medical advice:
- a severe headache that is not relieved with painkillers or is getting worse;
- a headache that feels worse when you lie down or bend over;
- a headache that is unusual for you and occurs with blurred vision, feeling or being sick, problems speaking, weakness, drowsiness or seizures;
- a rash that looks like small bruises or bleeding under the skin;
- shortness of breath, chest pain, leg swelling or persistent abdominal pain.
This story first appeared on our sister title, Pulse.