People Refusing Astra Zeneca - What Happens?

[Nootkah]

I've seen an increasing number of people on here and on social media saying they'll go to their mass vaccination centre appointment but if it's Astea Zeneca, they'll refuse. I'm curious as to what actually happens next? They've had an appointment, been offered a vaccine that remains approved for their group, and have declined. Are they "ticked off" the list as "offered" or do they stay at the top of the list for upcoming appointments and continue to be invited?

@ThornAmongstRoses that's not how it works in the NHS though. People dont just get to pick the more expensive treatment because they fancy it. Anyone can hang on hoping they'll be offered whatever but it's perfectly possible that when x% of the population are vaccinated the government will lose interest in vaccinating the rest. It's been the levels of severe sickness and death that were problematic, not the fact that some get severely ill and die.

People dont just get to pick the more expensive treatment because they fancy it.

They aren’t ‘picking’ Pfeizer because it’s more expensive and so that’s the one they fancy having though are they?

They want it because they don’t believe the alternative is safe.

I doubt anyone even knows or cares about how expensive each vaccine is so I don’t see what that’s got to do with anything.

If the NHS and Government want to punish people for not wanting to have an injection because they don’t believe it’s safe, then they says a lot about them doesn’t it.

And I say that as someone who works for the NHS.

@ThornAmongstRoses

People dont just get to pick the more expensive treatment because they fancy it.

They aren’t ‘picking’ Pfeizer because it’s more expensive and so that’s the one they fancy having though are they?

They want it because they don’t believe the alternative is safe.

I doubt anyone even knows or cares about how expensive each vaccine is so I don’t see what that’s got to do with anything.

If the NHS and Government want to punish people for not wanting to have an injection because they don’t believe it’s safe, then they says a lot about them doesn’t it.

And I say that as someone who works for the NHS.

‘Punish’ is a very odd take.

Punish’ is a very odd take.

Suggestions that the ‘refusers’ should be sent to the back of the queue or risk not being vaccinated at all is of course a punishment. They’re being made to suffer negative consequences due to the fact they don’t want to be injected with a vaccine that they don’t believe is safe, rather than be given the one they do think is safe.

Backing people into a corner and pressuring them into doing something they don’t want to do because they don’t believe it’s safe it’s very wrong - especially if they are effectively being told it’s this or nothing.

@ThornAmongstRoses

Punish’ is a very odd take.

Suggestions that the ‘refusers’ should be sent to the back of the queue or risk not being vaccinated at all is of course a punishment. They’re being made to suffer negative consequences due to the fact they don’t want to be injected with a vaccine that they don’t believe is safe, rather than be given the one they do think is safe.

Backing people into a corner and pressuring them into doing something they don’t want to do because they don’t believe it’s safe it’s very wrong - especially if they are effectively being told it’s this or nothing.

I understand from a few on here that if your risk is raised the GP will discuss options with you for an alternative.

Otherwise supply is limited.

@ThornAmongstRoses

People have the right to decline an injection that they don’t believe is safe.

They shouldn’t be punished for that and should be allowed to have the Pfizer as soon as is possible.

They really shouldn't though. Because people are deciding for themselves, based on media and social media hysteria, that it isn't safe. Actually the people who have been doing the research have stated who is able and who is not able to have it and that should be, and thankfully is, currently that.

You can't just choose what you want and be given it. You can't do that for most things on the NHS, trust me - you get what you're given and your doctor's decide. I have chronic illnesses and take biologic drugs (immunosuppressants) ... A few years ago the vast majority of these (very expensive) drugs came off patent, meaning that all the other drug companies who have been making copies (biosimilars) could release their drugs. Hospitals then started swapping all their patients, whether they liked it or not (which I didn't !) To the cheaper drug, to save the NHS money. You got no choice. I reacted very very badly to the biosim that I was given and then had to fight for 9 months (whilst still taking the drug I reacted to ) to get it changed back to the original. I was told out of the thousands of people at my hospital I was only the second person they had actually managed to get swapped back.

And this really was life changing for me, the side effects were horrific.. not a 4 in a million chance of a blood clot.... This was very real and every fortnight.

So no...you don't just get to pick what you want I'm afraid you get what you're given, unless it's actually contraindicated. It's been stated who cannot have it, and that is that - if you still don't want it ..well then you can't have anything .

Part of the problem is, the mRNA vaccines (Moderna, Pfizer) are coming out as superior to the adenovirus-vector based vaccines (AZ, J&J) both in terms of efficacy and safety.

Everyone needs to weigh up their own risk-benefit ratio. Neither the government, nor most doctors, have time to do this for you. If you choose to refuse AZ (or Vaxzevria, as it has now been rebranded) that should be based on your own valid concerns. The problem is that the information being provided to us by the UK government / MHRA etc. has been somewhat skewed in order to reassure everyone. This is understandable. Whichever way you look at it, the risk for most people is very small. But it still exists. And risk has to be looked at in context. (Incidentally, comparing it to the risk for the pill is a non-starter because there is a choice of contraception available. We are not being offered a choice of different vaccines.)

Take a look at the statistics given in the press conference. The "one death in a million" made a nice soundbite but it didn't help a younger person work out their own risk because the vast majority of people vaccinated in the UK so far with AZ have been OLDER people. What they should have done is told us, for example, how many thirtysomethings have developed the condition as a percentage of how many had actually been vaccinated with AZ. And remember the risk-benefit graph with coloured splodges representing how many people would die of Covid versus the AZ vaccine? It was divided by age group - but didn't separate out the clinically vulnerable from the healthy. We know that the risk of dying of Covid for a healthy 35-year-old is far smaller than the risk of dying of Covid for a 35-year-old with, for example, diabetes or kidney failure. The 30-39 group still to be vaccinated is the healthy 30-39 group - that's why they are still to be vaccinated. So the risk figures should have been directed specifically at them. Same argument goes for the 40-49 age group, incidentally.

In weighing up risk, you can also take into account whether you have already had Covid. You will likely still have antibodies up to six months afterwards (you could take an antibody test to be sure). However, some new variants can get around natural immunity just as they can get around the vaccines. Overall, most people will STILL be better off getting the vaccine. Should our government have done what other countries have done and NOT placed the responsibility for working out individual risk on the shoulders of individual 30 and 40-somethings? Should it have been more transparent in the information it has released? Should the government have slowed down the lifting of restrictions to get in other vaccines and thereby save the lives of a few healthy young(ish) people? Or should the government not have relied so heavily on one particular vaccine when other countries didn't?

Incidentally, comparing it to the risk for the pill is a non-starter because there is a choice of contraception available.

I was one of the people who mentioned the pill and this was exactly my point - yes, there is a choice of contraception available but many of the people saying they are worried about the clot risk of AZ haven't even considered or aren't even aware of a much higher risk of clotting in medication they have quite happily been taking for years.

Great post Fieldofmemes. Thank you.

Fieldofmemes

Good post, thank you! I'm struggling with the fact that it seems any attempt to learn more about the risks/benefits is labelled as selfish and I feel very stressed that the emphasis is on getting younger people vaccinated ASAP rather than erring on the side of caution and allowing people to make their own decisions.

What I really want to see is a breakdown of the stats so I can see what my risk is as a healthy woman, early 30s. As you say, including young people with underlying health issues means that the risk of Covid looks higher for me than surely it is. I'm getting sick of hearing the the risk is lower than the pill, taking a flight, crossing the road etc etc because I mitigate against all those risks by being sensible and I have a choice in those matters. Am I a terrible person for not wanting to take the tiny risk of a very bad reaction to the vaccine or even the larger risk of feeling really poorly after (I find that my MH falls of a cliff if I can't get out and exercise) when I don't have much of a risk of being ill with Covid and in fact, I suspect I had it early on and felt under the weather for a couple of days? Maybe I am but I don't feel comfortable at all.

I know I've made this point before but I would like to highlight that a lot of people who are worried about the clotting risk have thrombiphilia. We are already mot taking the pill/limiting flight times/taking medication during pregnancy.

Doctors always factor this into treatment/drugs they give me so I hope alternative vaccine provision is made for us.

I know covid can cause clotting too btw, so would love to be vaccinated, just with a suitable vaccine

If I didn't have my issues I would happily take AZ

@RockingMyFiftiesNot

Incidentally, comparing it to the risk for the pill is a non-starter because there is a choice of contraception available.

I was one of the people who mentioned the pill and this was exactly my point - yes, there is a choice of contraception available but many of the people saying they are worried about the clot risk of AZ haven't even considered or aren't even aware of a much higher risk of clotting in medication they have quite happily been taking for years.

What makes you think that? Anyone who takes the pill will have a nurse/doctor talk to them about the blood clot risks and what symptoms to look out for before they take it. They will have regular blood pressure checkups and regular appts with a nurse who asks questions about blood clot risk to determine if it’s still the right medication for you.

Plus if I decide that the pill isn’t worth the risk no one is telling me I’m selfish /stupid because the risk is only x.

I meant to add it would be impossible to be unaware of the risks of the pill. Also it isn’t completely unreasonable to think well if I’m already higher risk from pill why increase the risk further ? It’s like saying wearing sunscreen when you eat lots of red meat is silly because the red meat has a cancer risk too!

I believe its called informed consent. Its quite a big concept in medicine.

No need to be so snippy. Due to all the current publicity you are informed of the vaccine manufacturer, but do you really think that when any drug or vaccine has been given in the past the name of the manufacturer has been routinely given? Consent at the most involves knowing the purpose of the drug/vaccine and a brief description of side effects, together with a check of the clinical status of the patient. When I went for my flu vaccine I had no idea who the manufacturer was, and I don’t feel that I was negligent in not asking.

What makes you think that? Anyone who takes the pill will have a nurse/doctor talk to them about the blood clot risks and what symptoms to look out for before they take it. They will have regular blood pressure checkups and regular appts with a nurse who asks questions about blood clot risk to determine if it’s still the right medication for you.

Whilst I had my blood pressure taken once every 3 months or so, I don't recall EVER being spoken to about clotting risks. But no matter, that wasn't my point, and you are in a way supporting my point: there is a higher risk of clotting from the pill than from the AZ vaccine. Yet some of the people refusing the AZ vaccine continue to take the pill which has a higher clotting risk. Even though you say they are warned about it in one-on-one chats with medical professionals. It doesn't make sense to me to be happy to take a higher risk medication and make a lot of noise about not taking a lower risk medication.

Some scientists are now suggesting that halving the AZ dose might lower the risks:
www.sciencemag.org/news/2021/04/hard-choices-emerge-link-between-astrazeneca-vaccine-and-rare-clotting-disorder-becomes

Interesting point: David Spiegelhalter is quoted in this article as saying that risk of "serious harm" to a 20-29 year old from the vaccine is 1 in 100 000 whereas risk from Covid can be higher or lower depending on risk of exposure (no distinction appears to be made between clinically vulnerable and healthy 20-29 year olds, however).

@Fieldofmemes
I agree with you about the data being skewed in the UK for reassurance purposes (because the vaccine programme is seen as a way out of restrictions)

I found this article today from the New York Times which gave more detail on the cases www.nytimes.com/2021/04/09/health/vaccine-blood-clots-astra-zeneca.html

I wish we had more data and about actual covid risks - I'm almost 50, but a healthy 50 with no underlying issues - and would not hesitate to have a Pfizer vaccine but AZ - umm not sure

The adverse-effects reporting can give you more info - here are the reports compiled by the government -

AZ vaccine

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/977006/COVID-19_vaccine_AstraZeneca_analysis_print.pdf

Pfizer vaccine

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/977005/COVID-19_mRNA_Pfizer-_BioNTech_Vaccine_Analysis_Print.pdf

The media has only highlighted the risk of a rare kind of brain clot but there is much more going on than that which they are NOT talking about. I feel that people are not giving full "informed consent" because the risks have been described as mild and generally resolved in a few days, yet this is not the case for everyone.

It seems to me that many people will suffer much worse from the vaccine than they were likely to do from covid itself. And these are just the short term, immediate problems. None of these vaccines has been in anyone's body for a year yet. They weren't trialled on people with multiple disorders or taking multiple medicines. They all involve novel, genes-based approaches, even the AZ one. In one way or another, they all make your body produce, by itself, the spike protein of the virus by giving you the code for that. It's like downloading a new programme onto your computer without checking first how compatible it is with your operating system and whether you can stop it running if it causes problems with all your other programmes. Once in, a vaccine can't be removed.

@SmallTownSouthernGirl

The adverse-effects reporting can give you more info - here are the reports compiled by the government -

AZ vaccine

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/977006/COVID-19_vaccine_AstraZeneca_analysis_print.pdf

Pfizer vaccine

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/977005/COVID-19_mRNA_Pfizer-_BioNTech_Vaccine_Analysis_Print.pdf

The media has only highlighted the risk of a rare kind of brain clot but there is much more going on than that which they are NOT talking about. I feel that people are not giving full "informed consent" because the risks have been described as mild and generally resolved in a few days, yet this is not the case for everyone.

It seems to me that many people will suffer much worse from the vaccine than they were likely to do from covid itself. And these are just the short term, immediate problems. None of these vaccines has been in anyone's body for a year yet. They weren't trialled on people with multiple disorders or taking multiple medicines. They all involve novel, genes-based approaches, even the AZ one. In one way or another, they all make your body produce, by itself, the spike protein of the virus by giving you the code for that. It's like downloading a new programme onto your computer without checking first how compatible it is with your operating system and whether you can stop it running if it causes problems with all your other programmes. Once in, a vaccine can't be removed.

Do you really think overall we’d suffer more from the vaccines than Covid?

@TroubleUsedToBeMyBusiness it's such a complex picture, isn't it? Personally I don't think it's fair of the government to put people in this position now that the risks are known. It's not like we're talking about a risk of getting, say, shingles. CVST/VIPIT/VITT is a serious and often fatal condition. Even if you don't die, there are presumably risks of long-term disabilities such as brain damage. And we haven't been given any information which helps us work out who is at greater risk of it - it is a complete lottery.

Frankly I think the government/MHRA should give ALL the information, broken down properly for age and whether CEV or in good health. Either that, or offer people a choice of vaccine. How can it be "selfish" for people to be reluctant to take the AZ vaccine? - many of the young and middle-aged people (especially women) who are currently being, or about to be, offered AZ are breadwinners and/or have children to look after. If their risk of serious Covid IS low, why should they take the risk of the vaccine? When other, safer vaccines are (or should be) available?

Of course, if the rates of Covid start rising again, the balance may tip more clearly in favour of the vaccine. I really hope that a simple change like halving the vaccine dose (see article I linked above) could reduce the risk to everyone. I can't see a reason not to try it, frankly, when the half dose increased efficacy in the trial.

CVST/VIPIT/VITT is a serious and often fatal condition
And it's more commonly caused by covid and long covid than the extremely rare cases linked to the vaccine. So if you want to avoid the condition, you'd be advised to have the vaccine.

@Tealightsandd
Have you got a data source backing that up please? The information that I read and will try to post suggested that clots were an issue but these were mainly DVT clots caused (I presume) by inactivity / people already being in ICU

@Fieldofmemes
I agree absolutely and note that the medical professionals were careful to say people who hadn't died had made a 'good recovery' - whatever that might actually mean. I think it is reasonable to offer people a choice frankly - I would be prepared to pay to get Pfizer but that isn't being allowed either

It was widely reported a while back that covid causes abnormal clotting.

www.hriuk.org/health/your-health/lifestyle/people-with-coronavirus-are-at-risk-of-blood-clots-and-strokes

Around one in four coronavirus patients admitted to ICU will develop a pulmonary embolism.

These rates are much higher than we would usually see in patients requiring admission to ICU for reasons other than COVID-19.

Other risks from covid. From the link posted above.

However, higher rates of strokes in patients with COVID-19 is somewhat unusual because it also seems to be happening in people under 50 years of age, with no other risk factors for stroke.