Can someone clarify the asthma situation?

[Iremembertheelderlykoreanlady]

At first people with asthma were in group 6

Then they weren't

Now apparently people who use a brown preventer inhaler are back in group 6.

I used to use a brown inhaler but was using my blue one too much (asthma was not controlled) so they moved me to symbicort which is a combined inhaler.

So am I on the list for group 6 or not, as I don't use a brown inhaler anymore.

Does anyone know or could link to the guidance?

@StillDumDeDumming I'm not entirely sure I've ever had 3 lots of steroids in 3 months. It's possible, my asthma wasn't particularly well controlled for a period in my late teens early 20s but never to the point of needing a nebuliser. It may be some surgeries are saving themselves time by just pushing through all the yearly flu jab brigade.

Some people where I am locally who got invited and booked for tomorrow under the “vulnerable” category because of Asthma have tonight had their appointment (for tomorrow) cancelled! People are outraged, quite rightly!

@Waterdropsdown

Some people where I am locally who got invited and booked for tomorrow under the “vulnerable” category because of Asthma have tonight had their appointment (for tomorrow) cancelled! People are outraged, quite rightly!

I would be absolutely fuming if that were me!

I'm miffed enough about being told I was in group 6 back in December and being removed from group 6 shortly before they started vaccinating group 6.

I can't imagine how disappointed I would be if my appointment were cancelled.

I've just had another inhaler added in, so I'm now on a combination inhaler, montelukast and spivriva respimat. I have needed nebs in the past but was never actually admitted and I don't think I have ever had 3 lots of oral steroids in 3 months.

Are they really saying I'm at less risk than someone who was admitted when they were a child but now gets by on a brown a blue inhaler?

@Waterdropsdown

Some people where I am locally who got invited and booked for tomorrow under the “vulnerable” category because of Asthma have tonight had their appointment (for tomorrow) cancelled! People are outraged, quite rightly!

Jeez this is my worst nightmare. I think I just scrapped through into group 6 (received text a couple of days ago)

I spent a week in high dependency unit for asthma. It was 18 years ago though, I'm hoping this meets the new criteria for group 6.

Before now the JVCI said it was a hospital admission within 12 months. If asthma uk are correct then this has changed. So has the original criteria for steroids, this was 4 courses in 6 months and they now are saying it's three in three months however far back.

Slight changes that will means many more get vaccinated.

I agree it's a huge miscommunicated mess of a epic size.

For anyone interested, I spotted this posted by Asthma UK on Facebook, buried in the comments. This is the basis of the decision we are not at increased risk of death www.bmj.com/content/371/bmj.m3731?fbclid=IwAR2jRSty76ov0vzv29qn367WHuQq2zfuP3aM_gXUhc80gqQ8Q5TPo6jcxjQ

I believe these %s show where the statement that we do not have an increased risk of death but a slightly increased risk of hospitalisation comes from (1st column is number and % in sample, 2nd covid deaths and 3rd covid hospitalisation)

My first thought is that 13% being asthmatic is too high. Asthma UK say 8% of adults are currently receiving treatment, though BLF say over 12% have ever been diagnosed. So I suspect anyone who has ever had an asthma diagnosis is included in that analysis, not only the flu jab asthmatics which might mask the level of risk? Though I would have thought someone cleverer than me would already have thought of that in the analysis, so maybe I am misinterpreting it

@Eccle80 that's a huge paper.

Interesting that the BMJ definition of severe asthma and the JCVI definition do not seem to match.

Also controlled Asthma will put you into the moderately at risk group using the BMJ definition.

No two groups seem to agree.

@purplebagladylovesgin yes it is, I admit I only scanned through it!
As you say, everything seems very inconsistent between groups though

A lot of people get diagnosed at children and then grow out of it but tend to have ventolin for occasional use. Whether they get full reviews though I'm not sure. Or whether the marker for asthma gets taken off.

As peak flow declines as we age, around 45, it could remain on Gp files? As particularly women, could find it worsening again.

A male teacher friend wfh the first time round "due to asthma" but when I discussed it with him he wasn't on a steroid inhaler. I couldn't really work out why he had the ventolin either, he did say it wasn't really a thing any more. 🤷🏻‍♀️

My elderly fil has a ventolin for "bronchitis" in the winter which I've queried a few times as tbh he sounds a tad asthmatic to me. (They moved near us and go to the same Gp surgery now who are v good and I know he had a few appt about it all recently. I'm hoping they at least gave him a spacer!)

@PutneyHill mine too. Having got my appointment I'd be so disappointed for it to be cancelled.

@PutneyHill
Is that your location? It’s the Essex house vaccination centre that’s cancelling

I wonder if this could change again. Haven't we seen changes in occupations being eligible such as nursery and staff at SEN schools? And now police and teachers. My ds says he has had 3 lots of steroids in 3 months but I think he's misremembering the year he had 9 courses of antibiotics in a year. The thing is if you are confident it means your risk isn't so great, it would actually be good news. Sadly, it doesn't feel that way.

The update by Asthma uk says it was direct from the JCVI so it's unlikely to change.

They also said they have issued guidance as to how GP's can identify these people. But it will mean a lot of going through notes.

My hospital admission was 18 years ago so I will be contacting the doctor so they know which year to look into.

The update also said it would be a big task. No kidding, they have something like 8 million to get through. My worry is they have left it so late to clarify that group 6 will be over by the time the have identified the asthmatics who are vulnerable.

All hospital admissions should have been coded, ditto steroid courses etc. It’s not difficult to search for those and get a list of people. I suspect most GPs will be pragmatic, surgeries are too busy vaccinating to start going into numerous medical records. Quite a number of asthmatics will be excluded though because they’ve already had the vaccine on other grounds

Yes...my wishful thinking.

Medical records are easily lost though, especially if you have changed surgeries a lot (I've been a patient at at least 11 surgeries and have info missing from my records).

My husband was told last month that his medical record doesn't go back beyond 2009. He was born in 1987 so the GP doesn't know anything he was diagnosed with in his first 22 years of life.

I expect there will be people who were hospitalised years ago and it won't be on their record.

@CaffiSaliMali

Medical records are easily lost though, especially if you have changed surgeries a lot (I've been a patient at at least 11 surgeries and have info missing from my records).

My husband was told last month that his medical record doesn't go back beyond 2009. He was born in 1987 so the GP doesn't know anything he was diagnosed with in his first 22 years of life.

I expect there will be people who were hospitalised years ago and it won't be on their record.

Do you think anyone is going to have time to look back at paper notes? I’m not sure if there has been any official word, I wouldn’t be too surprised if they are advocating something totally impossible to achieve. The risk seems to be uncontrolled asthma rather than anything else so it’s not that relevant what happened to you as a child. If you have regular reviews they should have asked if you’ve ever had a hospital admission and a yes would show up on your records

@BungleandGeorge @CaffiSaliMali this is my concern and I'll be contacting the surgery tomorrow. I've changed surgeries twice and when I had my asthma hospital admission they were still using paper records. It's very unlikely that my notes of 18 years ago have been transferred to digital codes.

I'm mid-20s, have mild asthma with a brown & blue inhaler, and I was invited for my vaccine this week. In a rural area so guessing they've just got through the list quicker

Have you ever been in hospital or had 3 courses of steroids @Pawsin?

@WarriorN

Have you ever been in hospital or had 3 courses of steroids *@Pawsin*?

No, I have a steroid inhaler but not tablet steroids. I did check to make sure it was correct, and they said yes, so I'm guessing it's just location dependant and whether they've met the targets

It does seem to vary a lot between which asthmatics have a surgery which invites them to attend and which asthmatics don't.

My DH told me he has seen people on our local Facebook group with asthma (but not shielding) say they've been offered a vaccine. There are two surgeries in our area and I don't know if these people are at my surgery or the other one.

I keep jumping every time I get a text in case it's an offer of the vaccine. Realistically I know it won't be as I've never been admitted or had that many steroid tablets in such a short time frame.

However, I keep hearing so many people with milder asthma treatment than mine (Fostair, Montelukast and Ventolin) have been offered theirs so I can't help but hope my GP surgery does offer me a vaccine.

They barely have any records for me because I haven’t lived here very long.

I hope you get a vaccine @CaffiSaliMali!

So on that basis my husband (very occasional ventolin) will be vaccinated, but not me (fostair and becotide twice a day).

He was hospitalised with asthma as a child but grew out of it.

I have been hospitalised with pneumonia 3 times in the last 10 years, but although it was the asthma that agrevated it, it’s pneumonia on the record.