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MHRA may change advice for young people receiving AZ vaccine

837 replies

IloveSooty424 · 05/04/2021 22:18

I just saw this news story on Channel 4 news tonight.

www.channel4.com/news/uk-medicines-regulator-considers-issuing-new-advice-over-oxford-astrazeneca-jab

It seems the MHRA may follow other European countries and Canada and advise that younger people should not receive the AZ vaccine. It seems the decision will be made imminently in the coming days.

I’m due to book my vaccine this week and don’t know whether to wait and see how this plays out. I’m 42. I’m also concerned that if younger people will only be offered the Pfizer vaccine it will slow down the vaccine programme substantially.

Any thoughts?

OP posts:
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5
terribleg · 07/04/2021 16:09

Will am alternative option even be available at a later date or will we be left as covid cannon fodder?

I'm reluctant to get a different 2nd one as that won't have testing for that yet.

EasterIssland · 07/04/2021 16:10

@anyoldtime

Well apparently you will still be offered your 2nd dose I don’t see the logic in this. It’s under 55 in Europe. The UK say under 30? The EMA said today there is not enough data to mix vaccines. Is the UK proceeding to offer to under 55s as otherwise their vaccine rollout has to be reset?
it's not under 55 in europe, ema hasn't stopped it for any age or sex and many people below 55 have had this vaccine (at least in spain)
BuggerBognor · 07/04/2021 16:10

This reply has been withdrawn

Message from MNHQ: This post has been withdrawn

TabbyStar · 07/04/2021 16:10

what if you've already had covid and haven't suffered from long covid or even anything more than mild symptoms?

This is the position my 18 yo DD is in, due to have AZ on Friday - or at least she was, not sure what will happen now.

terribleg · 07/04/2021 16:11

Like, what do we do? Do we just wait and see what happens? Get checked over? Ignore it all?

I read about a link to low blood platelets? not sure that's still the case. If it is is it easy to check?

CovidCorvid · 07/04/2021 16:11

@oldegg123. Thanks.

I get what you’re saying about picking me up on saying “not safe “. I suppose it’s a bit subjective. I understand the risk of clots are low. But then so is the risk of covid for an under 30.

And covid doesn’t feel safe. I wouldn’t feel safe if I was under 30 and someone offered to infect me with covid. As the risks for under 30s are about equal between AZ /clot and covid then AZ doesn’t feel very safe currently.

I’ll certainly get Dd to talk to the GP though I worry they’re not going to have much more info.

cathyandclare · 07/04/2021 16:11

The increased risk of COVID with increasing age is independent of other conditions, however the MHRA will be looking at populations not individuals.

MarshaBradyo · 07/04/2021 16:12

@BuggerBognor

the experts are saying someone in their 40s are more at risk of covid itself than from the vaccine, yet the poster recommends not to have the vaccine and wait for another one,

The risk reduces to zero (as far as we know) with an alternative vaccine so I think the post you are referring to is totally reasonable and did not deserve the nasty remark. If AZ was the only game in town it would be different - it isn’t.

When would another be available?

You’d have to factor in waiting

littlepeas · 07/04/2021 16:12

@terribleg

JVT saying the risk/benefits are clear. In the 40 to 49 age group, not using the AZ vaccine would avert 0.5 harms per 100,000 people. But it could risk an extra 51.5 ICU admissions. He says it would have been “absurd” to stop using the vaccine on people in that age group in those circumstance

But is the covid risk in that group higher depending upon general health already, i.e is a healthy 40 at the same risk as an overweight one. Statistically the older you get the more likely to be overweight, health problems etc but individually not necessarily the case.

Yes. And also men are at a greater risk of Covid, whereas it appears to be women who are more at risk of adverse effects from the vaccine....
BuggerBognor · 07/04/2021 16:13

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cathyandclare · 07/04/2021 16:13

Although it's not totally clear @littlepeas

Pirmohamed says of the 79 cases, 51 were in women. But that may be because more women have been getting the vaccine, he says. He says if you make allowance for the number of vaccines administered by gender, there is no difference, he says

BuggerBognor · 07/04/2021 16:14

This reply has been withdrawn

Message from MNHQ: This post has been withdrawn

MarshaBradyo · 07/04/2021 16:14

Yes. And also men are at a greater risk of Covid, whereas it appears to be women who are more at risk of adverse effects from the vaccine....

I still reckon my risk from Covid is greater as slim female late 40

Be interested to see difference

terribleg · 07/04/2021 16:15

Did they say how many under 50s had had AZ?

CuriousaboutSamphire · 07/04/2021 16:15

It helps to remember that the increased RR in younger people isn't statistically large, it's just that at that age the balance tips a little and so, as there are other vaccines available, they are taking that additional precaution.

Had there been no other vaccine the advice would be for that age group to take the AZ vaccine like everyone else.

The evidence of causality is getting stronger, the incidence rate isn't growing, it is unlikely to in older age groups and, as there is an alternative, they are moving to reduce the 'vanishingly rare' risk in the appropriate age group.

So it is a preference, not a hard rule that 18-29 year olds should be offered an alternative vaccine if one is available to them.

Tealightsandd · 07/04/2021 16:15

@littlepeas That's not exactly correct. Men are slightly more at risk of dying from covid (although post menopause, women's risk nearly catches up). However, women under 55 are highest risk for long covid.

Long covid has been associated with clotting. Someone on here posted a link to a recent BBC article about a young woman in her late 20s/early 30s who developed clots in her lungs with long covid.

littlepeas · 07/04/2021 16:16

But they don’t appear to be allowing for that when it comes to the ages of people vaccinated. Many more people over 50 have been vaccinated than people under 50.

I think it must be very difficult to unpick the data at the moment. It doesn’t fill me with confidence.

littlepeas · 07/04/2021 16:17

Do we know whether the link to blood clots when unwell with Covid is directly linked to the virus, or is it because of inactivity?

Tealightsandd · 07/04/2021 16:19

Well anyway there isn't enough supply of AZ for the next two months.

Today's announcement is under 30s, who weren't going to get the vaccine because there isn't enough of it, won't be getting the vaccine.

CuriousaboutSamphire · 07/04/2021 16:19

@littlepeas

But they don’t appear to be allowing for that when it comes to the ages of people vaccinated. Many more people over 50 have been vaccinated than people under 50.

I think it must be very difficult to unpick the data at the moment. It doesn’t fill me with confidence.

The charts included that data. JVT said that it had all been taken into consideration. It's really complex, lots of nuances and confounding factors.

That and more older people have been vaccinated, so data is not smooth between age groups, nor is the data.

Comefromaway · 07/04/2021 16:20

@Tealightsandd

Well anyway there isn't enough supply of AZ for the next two months.

Today's announcement is under 30s, who weren't going to get the vaccine because there isn't enough of it, won't be getting the vaccine.

Which doesn't re-assure the many under 30's who are due their 2nd dose shortly.
SophieB100 · 07/04/2021 16:20

Here is a copy and paste from Guardian live feed, for those who missed it, hope it is useful. Read it from the bottom up, if you see what I mean.
Sophie

Q: Are there any reasons women are at more risk than men?

Pirmohamed says of the 79 cases, 51 were in women. But that may be because more women have been getting the vaccine, he says. He says if you make allowance for the number of vaccines administered by gender, there is no difference, he says.

16:08
Q: Are there things that could be done to mitigate this risk?

Pirmohamed says an immune response seems to be targeting platlets. It is not clear why. When they understand this, they might be able to prevent it in individuals with risk factors, or they might be able to adapt the vaccine, he says.

16:06
Q: Does this mean young people could get the one-shot Janssen vaccine, and be able to go on holiday more quickly?

Van-Tam says the alternatifve now is the Pfizer vaccine.

The Moderna one will be available from mid-April in England.

The Janssen vaccine could become available over the summer, he says, but he says they do not know for certain when it will be available.

He says the UK’s plan was always to have “multiple horses in the race”.

He says it would have been impossible to pick this up without having deployed millions of doses of vaccine.

He says they do not know if other vaccines will present similar problems. They won’t know till the use them, he says.

16:04
Raine says the link between the vaccine and the blood clotting condition is “reasonably plausible”. But more work needs to be done on it, he says.

16:02
Q: Why can’t older people be given an alternative vaccine too? Some countries are not giving the AZ vaccine to the under-55s or the under-60s. Are they being too cautious?

Lim says every country has to make their own decisions. They take into account factors like the amount of Covid they have, the vaccines they have, and the amount of risk people will accept.

In some countries life expectancy will be much lower than in the UK. That means their assessment of risk will be different, he says.

He says, for the UK, they decided it was best to set the threshold at around the age of 30.

He says they do not know yet if this rare condition is related to one vaccine, or to several. And he says it may be linked to Covid, and not to the vaccine at all.

Van-Tam says the JCVI was free to make its own recommendation. It was free to decide what it wanted.

He says in the 40 to 49 age group, not using the AZ vaccine would avert 0.5 harms per 100,000 people. But it could risk an extra 51.5 ICU admissions. He says it would have been “absurd” to stop using the vaccine on people in that age group in those circumstances.

15:56
Van-Tam says many vaccine manufacturers are working on a vaccine for children. So the AZ vaccine is “not the only show in town”, he says.

15:55
Pirmohamed says there is a slightly higher risk of the rare clotting condition in younger people than in older people.

He says it is not clear why yet. More work needs to be done on this, he says.

He says the trial of the vaccine on children was paused out of an abundance of caution.

15:51
Q: Are the risks significantly higher for the under-30s?

Lim says it is not just the risk to an individual. There is a slightly higher risk to younger people compared with older people. But the key points is that the risk/benefit balance changes, because older people are at so much greater risk from coronavirus.

That is why the under-30s are being offered an alternative.

Van-Tam says his slides did not make allowance for the risk to young people of getting long Covid after an infection. The slides just focused on the risk of ending up in ICU.

28m ago
15:48
Van-Tam says some people might have to wait longer for a jab, but impact on overall programme timetable 'negligible'
Van-Tam says the impact of this on the overall timetable for the rollout of vaccines should be “zero, or negligible”.

He admits this is a course correction.

But he says this is normal in a vaccine programme.

The programme is a massive beast. If you sail a massive liner across the Atlantic, you are going to have to make at least one course correction.

He says the NHS will get the right vaccine to people.

But there might be a “small delay” for some people, and some people might have to travel a “slightly greater distance” to get their jab.

15:45
JCVI confirms under-30s to be offered alternative to AZ jab
Prof Wei Shen Lim is now giving the JCVI’s advice.

The information given to people getting the vaccine should be updated, he says.

People should get the AZ vaccine according to schedule, he says.

But he says people aged 18 to 29 who do not have an underlying health condition that puts them at greater risk from Covid should be offered an alternative to the AZ vaccine if one is available.

15:42
Van-Tam then show an alternative chart with the risk/benefit balance with a higher exposure risk (ie, if there were a high level of coronavirus in Britain). In those circumstances, even for younger people, the benefits are much stronger.

15:39
Van-Tam says risk/benefit balance for AZ vaccine for younger people could be finely balanced
Van-Tam says we have now heard from the regulators.

He is now presenting slides what illustrate the potential benefits and the potential risks.

He says the figures behind this slide assume that Covid cases are at a lower rate than they are now.

He says the figures also assume the vaccine benefit lasts for 16 weeks. But in practice the vaccines are expected to offer protection beyond that.

He says the chart shows that, in younger age groups, the risk/benefit balance is finely balanced. For older people, it is very clear, he says.

EasterIssland · 07/04/2021 16:21

@BuggerBognor

the experts are saying someone in their 40s are more at risk of covid itself than from the vaccine, yet the poster recommends not to have the vaccine and wait for another one,

The risk reduces to zero (as far as we know) with an alternative vaccine so I think the post you are referring to is totally reasonable and did not deserve the nasty remark. If AZ was the only game in town it would be different - it isn’t.

Will you be offered pfizer tho ? Mhra hasn’t recommended it. And you’re refusing a vaccine that is recommended for your age. Why someone age 22 who hasn’t received their vaccine yet should have to now wait longer cuz loads of 30+ people will be refusing it and want another vaccine. Do you know when will people get the vaccine they want ? Cuz they might not get it for a while and in the meantime they’ll be risking catching the virus. If mhra is recommend it I hope it’s followed what mhra says and not what the pp I reply to hopes happens.
LeeMiller · 07/04/2021 16:21

it’s not under 55 in europe, ema hasn't stopped it for any age or sex and many people below 55 have had this vaccine (at least in spain)

Every EU regulator makes it own recommendations. EU health ministers are meeting later this afternoon and apparently want a unified response as they really need to try to rebuild public trust. I don’t think regulators in EU states will update their rules until after that.

NannyGythaOgg · 07/04/2021 16:21

@Beebityboo

Great. Mum is 59. She's really not going to want to get the second, and then what happens? What a bloody mess!
'Young' in terms of the AZ vaccine is under 30 so your mum doesn't fall into that category.

I think it should be an informed choice and no one should be forced to have the vaccine but this risk certainly shouldn't be a factor in the decision for any but those young enough to have an even lower risk from having CV19. Out of a total of 30million people having the AZ vaccine, 18 have had clots - that's 1 in 600,000 which are pretty good odds against it being a problem.

The very slight increase in blood clots has all been in women under 55 - and nobody is totally sure it is caused by the vaccine though it seems likely that some are.