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.

I'm in group 6 because I'm a carer. I should also be entitled to a flu vaccine for this exact reason, my GP refused to give me one because I wasn't elderly. So I'm not holding out much hope they'll vaccinate me against COVID either.

@notevenat20

You certainly won't be vaccinated until all the categories of people more likely to die are vaccinated. That's reasonable isn't it?

Yes definitely reasonable. Which is why the initial cutoff should be 40 or 45. Not 50.

I suspect the reason for increased hospitalisations and deaths (and disabling Long Covid) from 40 is because lots of people start developing underlying conditions in their 40s - but are often not diagnosed until later on because early symptoms aren't obvious.

One of the highest risks for Covid deaths is hypertension. Sometimes known as the silent killer because of no symptoms until very late on.

Wrt inhaled steroids as a potential Covid treatment.
www.itv.com/news/2020-11-27/covid-uk-trial-to-look-at-inhaled-steroid-to-treat-coronavirus-at-home

@AnxiousAlpaca

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

@AnxiousAlpaca Have you checked with your consultant?

The BHF have some info on their website that might help too. It looks like it's worse if you have symptoms but obviously you should remain cautious as much as possible.

You may be at particularly high risk from Covid-19 if you have heart valve disease that is severe and associated with symptoms such as shortness of breath despite medication, or if you are waiting for valve surgery.

www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health/coronavirus-and-heart-valve-disease

I think cardiovascular conditions should definitely be included as a priority for the vaccine, especially the over 40s. Covid seems to be a vascular and inflammatory disease.

I think I will stay in group 6 as I am a carer as well as being asthmatic. How do I find out if my asthma is mild or moderate though? I take fostair and the occasional ventolin. I have been offered prednisilone tablets occasionally but I have always declined as I have had an awful reaction to them in the past.

I don’t see why you think it’s a waste?

Because that sort of level of mass vaccination would typically only be useful if a vaccine provided sterilising immunity, which they won't.

Taking the Pfizer as an example (because it works well)- the risk/benefit balance would be arguable for anyone under 50 who wasn't CV. Young, healthy folk will derive no benefit, unless it performs way better than expected on medium term immunity.

The plan is definitely for all adults to be vaccinated, have a relative involved in distribution planning.

The plan is definitely for all adults to be vaccinated, have a relative involved in distribution planning.

Presumably that is just planning for if we need to do so? We still need logistics for 20Mish people so it makes sense to be able to carry on to 55Mish.

Similarly presumably 100M doses of the Oxford is over 2-3 years for the CV population?

I'd love to be wrong, but I haven't read anything giving a lot of hope for long term immunity from the current vaccines.

Maybe they are banking on 3 months solid immunity giving us enough momentum to squash it before next winter? Then what, seal the borders?

@Inkpaperstars

The plan is definitely for all adults to be vaccinated, have a relative involved in distribution planning.

Thanks for confirming.

It makes sense. Obviously there's lots of people in their 40s (and even younger) with undiagnosed underlying conditions.

The NHS can't run normally with lots of 30 and 40 somethings in hospital for Covid. (It was widely reported a couple of months back that lots of women in their 30s were hospitalised with it).

Also, the economy can't start to recover when large numbers of the workforce are long-term sick with Long Covid.

There was talk of potentially needing a vaccine every year but that's not definite. It's very possible they'll last longer. Certainly it's more than 3 months.

I read everyone over 18 who wants it will have it by April anyway. Not long to wait OP. You should be pleased that you are not as such a high risk as you originally thought. I did read a BMI of more than 40 puts a person ahead of over 60's but under over 65's.

@SheepandCow I spoke to my GP (I only see my consultant once every 5 years) and they were unsure as my heart function is normal. I sometimes get antibiotics as a precaution as apparently the valve couldn’t be more prone to bacterial infection. Truth be told I don’t think I even really need the flu jab I’m offered each year but I always think, “Might as well.”

I think there is evidence that moderate asthmatics are somewhat more at risk, it remains on the WHO list of people more vulnerable. The new list looks shorter I’m wondering if asthma isn’t the only thing to come off. Moderate asthma would be treated with at least 3 different medications.

It appears from that list that not all NHS staff will receive the vaccine.

For those talking about risk, the prioritisation is age based not directly risk based. So somebody who is male, 49, black with asthma will probably be more at risk than a 60 year old healthy female. If you have multiple risk factors you may be more at risk than somebody on the shielding group. Doing an individual risk assessment for everyone is obviously not going to happen

As an asthmatic trying to crawl out from under a rock(!) so to speak could anyone link me to any resources/ news stories related to the lowered risk discussed on this thread - I have been unsuccessfully searching for relevant COVID-19 asthma updates for a while many thanks in advance.

What does 'repeated use of systemic steroids' mean? Twice a year? Six times a year?

somebody who is male, 49, black with asthma

Nope. Being black is not considered a risk factor. The fact that black people are overrepresented in the death stats is (probably, mostly) not due to being black.

@donquixotedelamancha

I don’t see why you think it’s a waste?

Because that sort of level of mass vaccination would typically only be useful if a vaccine provided sterilising immunity, which they won't.

Taking the Pfizer as an example (because it works well)- the risk/benefit balance would be arguable for anyone under 50 who wasn't CV. Young, healthy folk will derive no benefit, unless it performs way better than expected on medium term immunity.

You're totally right but don't tell people that - half of mumsnet will be isolating in their homes for the rest of their lives!

I've always said that most people will get the virus, vaccine or not. The vaccine will hopefully minimise the health effects of getting it resulting in lower hopital resource requirement for at risk groups.

As you say under 50 there is no real benefit, but given the unwarranted fear that now exists lots of people will demand one. Personally if I were in charge I'd give all the non-at-risk group placebos just to reduce fear levels.

What does 'repeated use of systemic steroids' mean? Twice a year? Six times a year?

3 times a year was used as the CEV cut off during the first lockdown. Not sure whether that's still it.

The ECV cut off is now 4 times in 6 months. But maybe it will be less to stay in the CV group?

Certainly it's more than 3 months.

Is it? Do you have a link?

My understanding is that we have no clue whether any of these vaccines provide any antibody immunity. I didn't think even the preliminary data had been released on that because they are only supplying efficacy data for disease modification.

From what I was told, that the current plan is to vaccinate all adults and I got the impression boosters/repeats are expected to be needed...whether that would be everyone again I didn't ask. I suppose plans may change. Careful border control was mentioned as an issue, one that could be a problem with effectiveness.

As you say under 50 there is no real benefit

I worry that some people read my comments and think I'm saying Covid 19 isn't bad. In fact I'd guess that even if all of the CV were vaccinated tomorrow we'd still get around 10-30k deaths over a year or two as it starts raging through the unvaccinated.

My point is simply that the vaccine is less Efficacious for non-elederly. If everyone were vaccinated, some people will still die.

At that point you are comparing two very low levels of risk between a new vaccine and a small reduction in Covid risk for the healthy young. We don't allow medical treatments unless there is sufficient efficacy.

I don't see how anyone can say that everyone will get vaccinated, let alone by April. It would take until at least then for NICE/PHE to assess efficacy for immunity. The Oxford vaccine is still a way off approval and the Pfizer one is slow to make and distribute.

I think some of these statements are the government massively overselling, like it always does- which leads to lack of confidence in public health when the claims don't materialise.

It would take until at least then for NICE/PHE to assess efficacy for immunity.

Sorry, that should be 'to assess efficacy for transmission reduction'.

@Lemons1571

Wonder what will happen with me. I’m BMI 35 and losing more weight as on a diet. However my medical records have me recorded at bmi 40. I did tell the gp over the phone that I am now under BMI 40 so not so vulnerable, and she just re-recorded me as BMI 40. But I’m not allowed an in person appointment to prove the weight loss. God knows what they’ll do with me

Chances are that your BMI will be close to or over 40 again when the vaccine is available to you and your GP knows this.

I am not being negative, that is just statistics ( like the increased risk of Covid) . The vast majority of obese and morbidly obese people do not maintain their weight loss for more than a year or so.

I fall into this category too of having lost weight and now being obese rather than morbidly obese so I really do understand but If when you are actually offered the vaccine your BMI is still not 40+ and you are completely confident it won't go higher at some point soon you can refuse the vaccine saying your BMI is now no longer an issue.

Its an aside but this is currently depressing me about obesity. On one hand all the threwds about personal responsibility but I've read so often recently stats like this that show its near impossible to lose the weight. It frightens me.