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.

Isn't it 'not yet ' as opposed to never getting it? I have no risks and I'm not 'getting back fo normal' until I get a vaccinne either.

@NothingInterestingToDeclare

ebm.bmj.com/content/early/2020/09/02/bmjebm-2020-111506

There’s evidence that the respiratory component of the disease may put asthmatics at risk, but that it’s the vascular component which puts you at increase risk of death. There were slightly more asthmatics admitted to hospitals than there are asthmatics i. The general population as a %. However, some of the other conditions are linked with age, obesity etc so it’s very difficult to compare like with like. If adjusted for co-morbidity you would probably find asthma would come out slightly higher. It appears to be a risk of hospitalisation rather than an increase risk of death. Incidentally many of the other conditions which are still on the list for vaccination do not have evidence that they increase risk and are not on the WHO list.

Regarding ethnicity, correcting for deprivation and health factors doesn’t completely account for the increase risk, especially in men.

@BungleandGeorge many thanks that’s exactly what I was after much appreciated for taking the time to post the link

I think for most people in relation to Covid it’s trying to establish the actual risk being run that’s so hard - the panic I had in April time where the initial warnings were based on not much have now mostly subsided.

As a mild to moderate asthmatic who is not obese and is under 50 it sounds as though my risks aren’t too different from my theoretical non asthmatic equivalent which is a better situation than I thought previously.

@NothingInterestingToDeclare

Me too, have had pneumonia before and it was awful, unless you’ve been there yourself I think it’s hard to understand just how scary it is. It does seem that the risk of covid is more about exacerbation and infection risk like we get with every other respiratory virus, so it feels less unknown!
Adverse outcomes have also been linked to uncontrolled asthma, so I think the important message is for everyone to religiously take their inhaled steroid. As someone mentioned there is a clinical trial starting looking at whether inhaled steroids can reduce the uptake of covid through the lungs and reduce severity of the disease, so another reason to take them!

@BungleandGeorge ditto re Pneumonia a few years ago now and agree it’s absolutely terrifying isn’t it - and the sense of doom not helped when they say you are more likely to have it again once you have had it!

I can’t fault any of the treatment I have had as an asthmatic on the NHS - will be interesting to see where we do end up in the priority ordering in the end for Covid vaccine as even following all the details with a logical head on, the emotion part is saying me me me what about me(!)

We react in a similar way to young children who also get a lot of colds.

That's interesting because I can get croup just like my children.

@NothingInterestingToDeclare

I’ve had pneumonia twice in the last few years. This is anecdotal but I was vitamin d deficient and since I’ve been taking supplements I haven’t had any more respiratory infections. So that is an easy thing you can do to potentially reduce the risk too.

@BungleandGeorge thanks yes I had clocked the vit d connection already and do take a supplement.

Yes I've found I'm suffering much less with better Vit d.

I'm still none the wiser as to who it includes in number 6.

@NeurotrashWarrior

Although it’s still draft, it’s the link in the original post.

I have asthma, been hospitalized twice, on fostair and montelukast have at least 2 chest infections a year, last year I had 4. Was not considered ECV but have just had covid and have been extremely ill. In hospital for 2 weeks, now have double pneumonia. I'm 54, in the scheme of things my perfectly healthy husband would have got vaccinated before me as he is older but has no health issues. I had a very strong suspicion that this virus, which does affect the lungs, would not be good for me and I was right. I have no idea how asthmatics can be taken off the priority list.

Is it worth asking asthma uk to challenge this?
Or at least amend the guidelines eg add asthmatics on steroid inhalers who have previously had pneumonia and are therefore at high risk for secondary pneumonia and hospital admission?
Is anyone a member of Asthma UK?

I'm still none the wiser as to who it includes in number 6.

Isn't that clinically vulnerable people?

Also, Table 2 of this is more up to date.

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/939119/Greenbook_chapter_14a___provisional_guidance_subject_to_MHRA_approval_of_vaccine_supply_.pdf

It's changed the terminology if so, as clinically vulnerable included those on certain double steroids for some time. Eg I was classes as CV on Fostair. Which is fine but it's v confusing.

I have to say that list time I looked at data, asthma was still defined as being an issue, not as much as diabetes. Info never defined those asthmatics as people who had systematic steroids. Asthma can change quickly.

Table 3 has the clinical risk table.

I've seen that, my asthma wouldn't count. But previously, although not shielding, people like me have been told to take extra care and wfh (first lockdown) - second lockdown we were told to take care to minimise contacts (impossible in teaching.)

I believe they've found you're at higher risk of long Covid if a female who is over 50 and has asthma.

As I say, fair enough but it is confusing.

Nhs still describe it as moderate risk.

www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/whos-at-higher-risk-from-coronavirus/

Hey ho.

[quote notevenat20]Also, Table 2 of this is more up to date.

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/939119/Greenbook_chapter_14a___provisional_guidance_subject_to_MHRA_approval_of_vaccine_supply_.pdf[/quote]
Looks a bit more sensible, giving the vaccine to all over 65s before all CEVs never made much sense as most over 65s won't be working, but a lot of CEVs under 65 will be.

1.3 million over 65s work apparently. www.google.com/amp/s/amp.theguardian.com/society/2019/dec/31/over-65s-to-account-for-over-half-of-employment-growth-in-next-10-years

My asthma is out of control and I'm on the shielding list. I'm also a carer. Would I be in cat 4 or 6 or neither? I'm 35.

@scotlandg

My asthma is out of control and I'm on the shielding list. I'm also a carer. Would I be in cat 4 or 6 or neither? I'm 35.

If your on the shielding list your CEV and will be in the higher group for vaccines

My letter said I remain on nhs shielding list but advice is due to virus reduction ppl don't need to shield at this time. Is a flag on all my notes that says - high risk from covid. So does that means shielding even thought they not saying ppl need to at this point? It's was a generic letter.