Looks like if you're under 50 with 'moderate' asthma, you're not getting the vaccine

[denfit]

Since March, if you take a daily steroid inhaler (e.g. Symbicort), but you don't take steroid tablets (e.g. Montelukast), then you have been in the 'moderate' risk group and are clinically vulnerable instead of clinically extremely vulnerable.

So far so good, right?

Well the latest vaccine priority groups have chucked moderate asthmatics completely off the list for vaccination!

Link here. You only get a vaccine in priority group 6 if you take systemic steroids. Which a daily steroid inhaler isn't.

Unbelievable.

Asthma hasn't turned out to be as bigger risk factor as originally thought
It's a new virus, learning is taking place

What constitutes moderate/severe asthma? Obviously regular need for steroids is severe but does the type of inhaler dictate for example becotide - moderate, Fostair - severe?

Inhaled steroids are totally different to systemic steroids as they are very low doses which act almost entirely on the lungs and have very few side-effects rather than being absorbed into the body where they can reduce immune function. Asthmatics who need oral steroids are far more severely affected than those of us who inhale them.
It does look as though asthmatics may not be at as high a risk as was feared too

'Man' the Lifeboats and all that - if you really, really want the vax Op you can have mine if the roll-out criteria is the same when it actually starts happening.

I'm 58, no other underlying conditions except I smoke (not a vax criteria, even poss helpful according some CV19 reports) and I'm the Parent/Care of a Young Adult with Autism. so I might be ahead of you in the Vax Queue.

I quite understand the need to set out Criteria but I can wait for mine if it means you having yours sooner - High Anxiety could possibly be a Priority that needs including too.

@denfit

Since March, if you take a daily steroid inhaler (e.g. Symbicort), but you don't take steroid tablets (e.g. Montelukast), then you have been in the 'moderate' risk group and are clinically vulnerable instead of clinically extremely vulnerable.

So far so good, right?

Well the latest vaccine priority groups have chucked moderate asthmatics completely off the list for vaccination!

Link here. You only get a vaccine in priority group 6 if you take systemic steroids. Which a daily steroid inhaler isn't.

Unbelievable.

No Systemic (cortico)steroids are Prednisone and Prednisolone.

If you don't take these or have had hospital admissions due to exacerbations, then quite rightly, you're not as high risk nor priority as the other groups.

Fwiw, I am a shielder, chronic asthmatic,as well as being immunocompromised. I would be glad to be in your position, where you have such a lower risk.

@WouldstrokeTomHardy

What constitutes moderate/severe asthma? Obviously regular need for steroids is severe but does the type of inhaler dictate for example becotide - moderate, Fostair - severe?

At my doctors I’m classed as having mild asthma as I just use the blue reliever and brown preventor (used to be becotide before they changed it). Although the brown is a steroid inhaler it is the most basic one. When I was younger and was classed as having moderate asthma I was taking higher dose steroid inhalers (orange and green) and at one point oral steroids. So generally I would say if you are solely using standard brown and blue you are classed as mild and likely not to be included in that list. Just going by my experience though!

I'm on oral steroids long term as well as asthma inhaled steroids. Completely different.

I'm on Symbicort and have no problem with this. The evidence to date shows that I am at lower risk than many other groups, so of course the vaccine should be prioritised accordingly.

Being on the vulnerable (but not shielding) list doesn't mean anything. No extra precautions have been mandated beyond those that apply to the general population. I've used my own common sense and risk assessment to determine what activities I am happy to participate in, but I certainly haven't been isolating for the last 9 months, because there is no need.

Not sure what your problem is tbh.

Do you think you should be prioritised above people at higher risk than you OP? Unbelievable if so.

You’re at lower risk than originally thought.

I’m at higher risk than originally thought.

We’re still learning about this thing but they have to prioritise somehow.

I'm confused now (or in fact still confused!). One of the PP included an extract which referred to the moderate risk group. Where was that from?

It was @WouldstrokeTomHardy (great name btw). Where did that extract come from? Thanks

Also good news if those with asthma aren't as high risk. I also have bronchiectasis, and those on my facebook groups who have had covid coped better than expected.

@Lurkingforawhile it was from the Manchester evening news. Now I've read the official guidance it looks as though their journo has not interpreted it properly

I'm asthmatic and coeliac.

They've taken mild asthma off the list but added coeliac. As others have said, mild asthma has proved to be not as great a risk; I've seen some suggestions that using a steroid inhaler can actually be protective. Coeliac's gone on beause there's a risk that your spleen may not work properly.

Thanks @WouldstrokeTomHardy. I think that's happened a lot throughout this whole thing. Someone on national radio said cinemas had to close on tier two, just got it wrong. TBF it all changes so bloody quickly.

It certainly does @Lurkingforawhile. I also wonder if under the caviat of severe mental illness if autism and severe anxiety will be covered

I have mitral valve prolapse with very mild regurgitation. No symptoms (besides the murmur) and excellent heart function. I still qualify for a flu jab and to date no one has been able to tell me if I’m more at risk of Covid or not

I still cant figure out what asthma group I am in (symbicort and montelukast) I'm guessing am not at much more risk than the average 40 year old now, although I've had covid and was much more unwell that anyone else I knew but that might have been random or more down to having ME, being incredibly unfit due to that and being on a shit load of medications for a complex migraine disorder. Either way I'll just take the vaccine when offered it and want it to given to the people that need it most first.

@RagamuffinCat

I take montelukast and am not in the shielding group. I also take a steroid inhaler 5-8 times a day. They are prioritising people in the shielding group as they are more at risk of dying from covid.

Same I'm front line.

If you're not sure how 'at risk' you are but feel 'at risk' then lock yourself down as much as you can; every circumstance can't be configured for.

All the moreso if you completely rely on treatments and medications in order to live life to various degrees.

The new Tier categories are based on NHS Hospital Bed availibility per head of population, mostly by County, which doesn't work/add up right for many places, including my locality. But it's a starting point.

I wasn't a First Lockdown NHS Clapper - but right now I do see the point of not overwelming the NHS with CV19 - or there might not be the same medications and treatments available for people to 'live their lives' as they currently do so.

I'm asthmatic - how pleased I was on the day (MONTHS ago!) they showed research that actually asthmatics are NOT at greater risk from Covid.

It's not a respiratory disease in the way it was originally thought, it seems.

Therefore I'm not really understanding your 'unbelievable!', OP, unless it's actually YOU who have been "hiding under a rock" as surely all asthmatics knew this?

As others have said, mild asthma has proved to be not as great a risk

I think that's a big overstatement of the data. Mild chronic asthma was always only a criteria for CV. The last model I saw for trying to predict individual risk had actually increased the risk factor for milder asthma, bringing it in line with those who'd needed occasional doses of systemic steroids.

Crucially though, asthma alone doesn't create a huge increase in personal risk (even on the more pessimistic data). Someone with mild asthma at 49 probably doesn't have as much risk as the average 60 YO.

There have to be lines somewhere because the current generation of vaccines aren't much use to someone who isn't at significant risk and will cost a bloody fortune. I hope GPs are able to allocate doses to those with multiple vulnerabilities, just outside the cut off, who might get missed by the criteria.

I'm group 6. Twice though, so not sure if that will change my group when it's finalised. I'd rather have the health & age of lower groups, but I'm happy to have the vaccine ASAP.

I suppose we'll just have to be patient and hope it's sooner rather than later!!

@ReceptacleForTheRespectable

Do you think you should be prioritised above people at higher risk than you OP? Unbelievable if so.

I think under 60 asthmatics who have been defined as clinically vulnerable should get the vaccine ahead of under 60s who are not clinically vulnerable, yes.