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.

@SheepandCow

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.

The budesonide trial in older adults has literally only just started recruiting though. The dose is also higher than your average asthmatic would be on. Although the suggestion was made that inhaled steroids were protective some time ago there’s no evidence. Yes it’s interesting and I’m sure everyone would be over the moon with proof that they’re less vulnerable. I just think the evidence should be there before a change to policy, especially as the WHO still categorise asthma as vulnerable, as do our own guidelines.

I understand. It's hard not to worry especially with any underlying condition.
And it's still so new so we don't know everything about it. I hope it at least helps to even just slightly ease your concerns.

It's good news too that we're ready to go with the vaccines. It won't happen for everybody overnight but we're getting there.

@OrangeDino

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.

Can you ask for a referral to the respiratory team?

Agree. It's still very early days - but it's potential good news.

I think there's also evidence from hospitalisation and death data (worldwide, including from countries with no shielding) that asthma isn't as high risk as initially feared.

In any case, severe asthma is still on the priority list, to receive the vaccine before the rest of the general public.

Age remains the biggest risk factor.

The people most vulnerable (if restrictions are lifted once the initial priority groups are done) are those aged between 40-50, who have undiagnosed hypertension or diabetes.

These are two of the conditions with the highest Covid death rates. They're also known as silent killers because both are often symptomless (or have easily overlooked symptoms) until later stages.

They commonly develop once somebody hits their 40s.

Diabetes yes but I thought there was evidence both ways for hypertension? www.uclh.nhs.uk/News/Pages/HighbloodpressureanditsdrugtreatmentunlikelytoincreaseentryofCOVID-19virusintocells.aspx

@BungleandGeorge - yes, asthma nurse suggested this today actually - although apparently they aren't seeing anyone at the moment so we shall see!

We still have so much to learn don't we.
Under the circumstances, taking into account the vascular effects of Covid and the hypertension death rates, it's probably best to err on the side of caution and include on the priority list people over 40 who have hypertension.

[quote OrangeDino]@BungleandGeorge - yes, asthma nurse suggested this today actually - although apparently they aren't seeing anyone at the moment so we shall see![/quote]
Sounds like you definitely need a bit more input. They’re still doing remote consultations, and X-rays etc if needed

@Iremembertheelderlykoreanlady

This came as a bit of a blow for me. I'm on sybicort and have been holding onto the fact that I'll be in group 6.

I still will be, just means I've got to phone my GP and have an embarrassing conversation about my BMI which is over 40 but not according to their records as I haven't been weighed there for years 😅

Your GP practice have failed you considering your weight should of been mentioned during your annual asthma check.

@OrangeDino I think you should be referred to check there isn't anything else going on that might mean you do get access to the vaccine in the first wave. A friend has a bad infection in jan (not Covid) and an X-ray showed some narrowing of airways and has been told to be extremely careful by her consultant, with any infection. (3 kids though...!) Now on fancy better inhalers. This time last year she was on bog standard clenil.

Although, they wondered if they had in in March (consultant doesn't think so but her son had temperatures for over a week) and she barely had anything.

That article is fascinating sheep.

(Currently having a mild asthma mucous exacerbation! But I think it's, as that article says, as I'm fighting of the mildest of infections.)

I also believe the non allergic type of asthma is more common in women, and older women.

I just have these extremely over dramatic reaction to viruses in my lungs, (cold air, fumes and smoke can too) but from that article, that's acting as type of barrier in the case of Covid? Or is that too simplistic?