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.

It would seem intuitively obvious that people with moderate asthma are more at risk from Covid, so that’s what people assumed at first but as I understand it several million cases later there’s no substantial evidence that this is in fact the case

Yup, this is what my GP told me - I take a middling dose (two puffs twice a day) of the steroid inhaler - so I rarely need Ventolin, for example - but my GP said that C-19 isn't just or mainly a lung thing, as they first thought - it's more neurological and that the fact that I'm medicated for hypertension was actually more of a risk factor.

Doesn't make me any less concerned about the effects of COVID though.

The data doesn’t show that the risk is that high compared to other groups who are much higher risk. Even with an additional health need, you may still be low risk.

steroid inhaler plus reliever is categorised as mild asthma

Bear in mind that if the government were going to prioritise people according to their detailed level of risk then they’d need to be putting men in different priority groups to women which would be a whole can of worms.

Yes absolutely scotland, you'll be classed as needing it.

Originally the people with asthma on combo steroid and reliever inhalers were classed as moderate risk, (eg Fostair, setitide) more so than "just" being on the brown and an occasional blue.

Asthma U.K. seem to have also re done all this categorisation though nhs haven't.

I personally worry a lot about long Covid after having mild chronic fatigue in the past.

I wonder if doctors will know and be able to help patients on guidance on who will receive it for ppl who aren't sure if they fit the criteria?

So it's possible that I started off as CEV (shielding notification), moved down to CV when they changed it to "AND steroids" four weeks later, and may end up in the general population with no raised risk based on the newest table (which I appreciate is for vaccines at the moment). All of which would be great news if my risk has reduced a lot, but the only way I know that is through my own research as I am still getting shielding emails and letters, up to last week when my letter arrived.

@scotlandg

I wonder if doctors will know and be able to help patients on guidance on who will receive it for ppl who aren't sure if they fit the criteria?

Not at the moment, they might be able to give you more info in a couple of months or so I imagine.

@dustyknickers very sorry to hear your plight sounds awful hope you feel better soon 💐

@LearnedResponse

Bear in mind that if the government were going to prioritise people according to their detailed level of risk then they’d need to be putting men in different priority groups to women which would be a whole can of worms.

Not necessarily. Men might be at increased risk of death, but women are at greater risk of Long Covid - a potential long-term debilitating disability. Both fates are worth avoiding.

I'm seeing lots of clinically vulnerable asthmatics posting today on here and on other sites about how they think they will be getting the vaccine due to being in group 6. The fact they have been taken off this list and so are no longer on any priority list for the vaccine has not been well communicated at all!

Some asthmatics are ecv and remain in category 6. As you say, op, there are others who have dropped out from under the heading of being clinically vulnerable. But the information around asthma has been so badly communicated that I thought I'd just state the obvious for clarity.

I don't feel it's been communicated at all for the whole incident. I only found out I didn't need to shield by luck in May.

@NothingInterestingToDeclare Thank you, it's a very slow recovery from covid pneumonitis. I have a long road ahead of me.

@denfit

I'm seeing lots of clinically vulnerable asthmatics posting today on here and on other sites about how they think they will be getting the vaccine due to being in group 6. The fact they have been taken off this list and so are no longer on any priority list for the vaccine has not been well communicated at all!

@denfit As it's a new disease, we're learning more everyday.

Recent research has indicated that people with asthma might in fact be at less risk.

Why asthma might surprisingly protect against poor outcomes in COVID-19

erj.ersjournals.com/content/early/2020/10/29/13993003.03045-2020#:~:text=Asthma%20may%20protect%20against%20poor,shielding%20and%2For%20mucus%20hypersecretion.

Am I looking at the wrong versions? Because the mist serious asthma is still on the CEV/shielding list (as of November) and the glossary for today's priority list includes for CV priority 6

'Individuals with a severe lung condition, including those with asthma that requires continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission'

I haven’t read all the thread but I was under the impression that this is phase 1 of vaccinations and the higher risk would be those with severe asthma, however with phase 2 the mild asthmatics would be prioritised before the non asthmatics. So those with mild asthma might not be high priority in this phase, but will be high priority in the second phase as it is still an underlying health condition even if mild.

That’s quite a tenuous study though, the control group were significantly older (age being the biggest risk factor) and there were more males. It’s retrospective, not a random sample. You wouldn’t expect the same percentage of asthmatics as in the general population, it’s unlikely you’ve got any age matched controls in the hospitalised patients, they will be made up of older people or those with other conditions, which make up a larger percentage of the population. Which is indicated by the control group being significantly older. They’ve also pointed out that asthmatics were asked to shield or reduce contact.

Some of the other data has shown asthmatics were admitted in greater numbers, I’m just not convinced there’s robust evidence at the moment. I think asthmatics are at least risk than some other conditions but certainly not all
Of the ones still eligible

Oh yes definitely still early days, but its certainly interesting. The fact that asthma medications are being trialled as potential Covid treatments also suggests the risk (to asthmatics) is lower than initially thought. Covid is not the flu. There are different vulnerabilities.

Budesonide trial:
GPs in participating practices will trial the medication, which is often prescribed for asthma and COPD, from today (27 November)
www.pulsetoday.co.uk/news/coronavirus/gps-to-test-inhaled-corticosteroids-in-major-covid-treatment-study/

I am on Symbicort and am morbidly obese. I work in an acute hospital, sometimes with Covid patients. 6 of my team have had Covid this year, one of whom I share a small office with. I have not missed a day off work and have stayed well and Covid free. I will however be vaccinated, possibly next week because I am frontline. The evidence has been that asthmatics have not fared too badly.

While I'm aware there are definitely many many higher priority people than me (and rightly so), I too am worried about being dropped off the list completely (for now). I'm 43, on the highest possible dosage of symbicort and take montelucast and currently on day 10 of oral steroids for a flare up. I'm not on the ECV list and therefore not classed as having severe asthma so no longer in category 6 where I thought I'd be with 'moderate asthma'.
I know there are studies which suggest that asthma may not be as great a risk as originally thought but I do feel vulnerable at the moment.

I understand the anxiety but isn't it good news that asthma night not be such high risk afterall? Even better, the medication potentially gives protection against severe Covid.

Covid isn't the same as the flu.

It's as much, if not more, a vascular and inflammatory disease than a respiratory one.

Thank you for trying to reassure me @SheepandCow. Unfortunately just bad timing for me to read about this - already anxious about generally worsening asthma.