Alternatives to AstraZeneca vaccine for under 40s “could be considered” amid rise in blood clots

[Whichjab]

www.standard.co.uk/news/uk/astrazeneca-vaccine-side-effects-blood-clots-under-40-b931498.html

This is concerning, especially as there is limited research into combining vaccinations. I feel that the trust in vaccination is being eroded. I have always been pro vacc but feeling much less so atm.
I'm not sure I will get my second jab now.

Appointment is booked for Tuesday when it will be 11 weeks. Suppose I could get away with putting it back an extra week or 2?

I believe the German study was done precisely to establish the risk ratio per jabs given in women vs men as opposed to absolute numbers. And it concluded that women are more at risk even when you remove the fact that more women have been vaccinated.

@whataballbag

Appointment is booked for Tuesday when it will be 11 weeks. Suppose I could get away with putting it back an extra week or 2?

You can put it back by as long as you like Our Gp surgery rang my dh again to ask ( very politely and I felt so sorry for the receptionist) if despite declining the Jax twice would he like to receive it now. ( I wondered if people had been quite rude to her, no need for it as she was actually apologising to him for ringing up)

He just said no thank you and she assured him it was there if he wanted it.

So yes feel free to say no

My dear friend, the one who felt like someone was stabbing her in the heart just a few hours after her first Jax told me the other day that she isn’t having the second one.

@whataballbag

Appointment is booked for Tuesday when it will be 11 weeks. Suppose I could get away with putting it back an extra week or 2?

To be honest I personally would go for it rather than spending the next few weeks worrying more. However I am not you. What I will say is don't push it back longer than another 2 weeks. Though antibodies won't drop off like on a cliff edge. We actually don't know how quickly they can drop without that second dose to help with longevity. Some research says if you have had covid before you may not need the second dose. However that is not a definite thing recommended. I think more research in underway.

@Schulte

I believe the German study was done precisely to establish the risk ratio per jabs given in women vs men as opposed to absolute numbers. And it concluded that women are more at risk even when you remove the fact that more women have been vaccinated.

Nope

Nope what?

@TruelyWonder just realised you're on the good news thread too

[quote whataballbag]@TruelyWonder just realised you're on the good news thread too [/quote]
And about every other coronvirus thread too😳

Been off work unwell for months now. Seems like these boards have kept me going. Good distraction from painkillers and hospitals. Plus no point wasting my work skills doing nothing. I like helping people 😊

I have done some quick and dirty number crunching.
Same caveats as when I did this last week:

1. NHS England publishes data on how many jabs, by age and sex, but it doesnt tell you what vaccine was given to whom. All we know is roughly 67% of all vaccine this month is AZ, but that is likely to be skewed in different directions to different age groups (less for over 65, more for under).
2. MHRA data now gives us a break down by sex, but it doesnt break that down by age
3. We dont know the time lag between these clots being reported in the yellow card data and people receiving the jab, this means we cannot be certain what the correct denominator is for reporting a clot rate - for eg some clots might relate to jabs that happened months ago.

These caveats are important. I wish the MHRA would do this analysis for us, so unreliable people like me dont have to try to do it instead.

I have looked at the increase in cases between this week's yellow card report and last week's. Those 2 reports give cases to April 21st and April 28th respectively.

To compare those to the number of jabs received, I have looked at NHS England data showing the number of extra jabs given between April 11th and April 18th. This time period is partly pragmatic (not like the NHS England data has been presented in a way designed to help this analysis) but also to give a window of 10 days between the jab and MHRA report. It's not perfect. I dont know what a reasonable lag would be. I'm far from an expert.

I have looked at both first and second jabs, as there are now 6 cases of these clots within 2nd jabs.

The results are worrying. On sex first, it suggests that in the week between April 11-18th, 1.27m men received a jab (1st and 2nd combined) and 1.55m women. If it is correct to compare those jab numbers to the increase in AZ clot reports between April 21 and April 28th, then we have 1 clotting case for every 116k men being jabbed, and 1 case for every 74k women. This suggests to me the higher incidence amongst women is not due to more women receiving the jab. As the MHRA now seem to be saying: the sex skew is real.
Note that I have not adjusted these numbers for the fact that not all jabs received will have been AZ. All we can know on that is that roughly 67% of the jabs occurring this month have been AZ. So those ratios could be a bit worse, but I'm not going to adjust for that as frankly it's worrying enough as it is (plus, remember that if some of the extra clot cases reported this week relate to jabs before April 11th, then that would mean the rate wasnt as bad as it looks here, so basically it seems safer to not adjust in either direction).

On age:

Doing the same thing, and looking at the number of vaccine doses given by age group in the week between April 11 and 18th, and comparing that to the increased case numbers, gives some very worrying figures, particularly for the 50-59 group. Again these are for both 1st and 2nd doses.

Extra blood clotting cases reported between April 21-28th compared to extra doses of vaccine given between April 11-18th:

49 and under: 1 case per 68,870 doses
50-59: 1 case per 28,490 doses
60-69: 1 case per 71,430 doses
70-79: 1 case per 216,280 doses
80: none

@Carefulvulvadriver, I can perhaps help you out with number of first AZ jabs given in each week, as I've been keeping a record of those from the last few yellow card reports.

In the week of 7-14 April, 1.2 million first AZ jabs were given.
In the week 14-21 April, 0.8 million first AZ jabs were given.
In the week 21-28 April, 0.6 million first AZ jabs were given.

I don't have older data and of course this doesn't tell you who they were given to, but I'm afraid they make the numbers you've so kindly calculated look even worse.

Assuming the incidents are reported in a fairly timely manner, then at the moment, each day, on average at least one person dies from a blood clot after having the AZ vaccine. How can this just be ignored by the regulators?

And just to close the matter with Truely, although I’m not entirely sure what you were noping, the report found that the clotting incidence rate (not absolute numbers) was a factor 3 higher in women vs men.

From the report: The incidence rate ratio was 9.68 (3.46 to 34.98) for ChAdOx1 compared to mRNA-based vaccines and 3.14 (1.22 to 10.65) for women compared to non-women after adjusting for age group.

Der Spiegel did a good job of translating the study findings into plain language if you read German: www.google.co.uk/amp/s/www.spiegel.de/wissenschaft/medizin/astrazeneca-impfstoff-neurologen-beobachten-seltenes-hirnthrombose-risiko-auch-bei-aelteren-frauen-a-55183f23-d673-4ee4-927a-2e85c5f7b501-amp

The report author was actually saying the German regulator should review its recommendations for women over 60.

@whataballbag it’s so hard to know what to do isn’t it especially without all the facts. I’m not sure if you’ve come across this but in Ireland they have extended the gap between first and second doses for under 60s without any known risk factors to 16 weeks and I’ve read before that we know the first dose protects for at least 16 weeks. My feeling is that a lot could change during that timeframe. Here is the link to the Ireland data

www2.hse.ie/screening-and-vaccinations/covid-19-vaccine/astrazeneca/immunity/

I’m 5.5 weeks away from my second and in my 30s but plan to delay a bit further unless the data seems clearer. It’s so hard isn’t it. I just want to be fully vaccinated but not to feel like I’m playing Russian Roulette.

Thanks for that @Carefulvulvadriver. That 50-59 age band is looking quite anomalous. What would happen to the numbers if you compared with the week starting the 1st of April? I'm thinking two weeks for the clot to occur and up to a week for the yellow card report to occur.

[quote Rainbowsandstorms]@whataballbag it’s so hard to know what to do isn’t it especially without all the facts. I’m not sure if you’ve come across this but in Ireland they have extended the gap between first and second doses for under 60s without any known risk factors to 16 weeks and I’ve read before that we know the first dose protects for at least 16 weeks. My feeling is that a lot could change during that timeframe. Here is the link to the Ireland data

www2.hse.ie/screening-and-vaccinations/covid-19-vaccine/astrazeneca/immunity/

I’m 5.5 weeks away from my second and in my 30s but plan to delay a bit further unless the data seems clearer. It’s so hard isn’t it. I just want to be fully vaccinated but not to feel like I’m playing Russian Roulette.[/quote]
Definitely. It does seem that the instances are lower for second vaccines.

Part of me just wants to get it over and done with and the other part is like 'oh fuck'

@Carefulvulvadriver thank you for that. The 50 years group is especially concerning given they have acknowledged that the risk increases as age decreases. It makes me think that some of the numbers reported in the small samples in some countries who took prompt action to suspend AZ for younger people were indeed reflective of the actual case rate.

@whataballbag I know exactly what you mean. I’ve spent the last year so worried about covid and was so excited about the prospect of being vaccinated. I had mine just as there had been some concern raised about AZ but it seemed to be a rare event so I went ahead but felt quite apprehensive and then a few days after I’d had mine Germany suspended it and it became big news so I’ve never had that yay I’m vaccinated moment as I’ve been worried about clots then worried about what to do about the second dose. I am however relieved to have the protection afforded by the first dose but am really concerned about the current situation and feel it’s being brushed over in the press. I’m really not sure that in my age group the risks still outweigh the benefits on an individual level I understand that they possibly do society wide without access to alternative vaccinations.

[quote Rainbowsandstorms]@whataballbag I know exactly what you mean. I’ve spent the last year so worried about covid and was so excited about the prospect of being vaccinated. I had mine just as there had been some concern raised about AZ but it seemed to be a rare event so I went ahead but felt quite apprehensive and then a few days after I’d had mine Germany suspended it and it became big news so I’ve never had that yay I’m vaccinated moment as I’ve been worried about clots then worried about what to do about the second dose. I am however relieved to have the protection afforded by the first dose but am really concerned about the current situation and feel it’s being brushed over in the press. I’m really not sure that in my age group the risks still outweigh the benefits on an individual level I understand that they possibly do society wide without access to alternative vaccinations.[/quote]
That's the thing isn't it. I'm just bloody glad I've already had the first dose and got through the 4 weeks.

Can't imagine how the 30+ year olds who haven't received anything yet are feeling to be facing the prospect of a first

The rise in the cases in the 50s age group ties in with the timing of when they've been vaccinated so we'll probably see a rise in the 40s age group too.

I've got a plan in place for getting Pfizer or Moderna when my turn comes (hopefully soon as I'm 38). Thanks to many threads on here it sounds like those of us determined to avoid AZ can work out a strategy to book at the right place for the alternatives... Maybe not 100% certain but at least a good chance of not getting AZ that way.

@whataballbag absolutely I’m hugely grateful to have had my first and to be ok. The four week wait was really tough, as I struggle with health anxiety but the risk appeared lower then. I’d be really struggling with weighing up getting my first at present. Though lots of people seem really relaxed about it all. I wish as a previous poster said that there was an element of choice for people that there was the option of choosing to wait for a different vaccination for those who feel concerned while allowing those who are comfortable with the risks and keen to get vaccinated asap to get theirs. It’s all such a personal decision and I’m very grateful to live in a country that has access to vaccinations and have done brilliantly with the roll out but I do feel while rates are low it’s a hard balance.

Hi @QueenStromba, thanks for the suggestion.

If I understand you right, you were suggesting looking at a wider window of vaccinations and comparing those to the MHRA age break down, to allow for time delays between having the jab and getting and reporting the symptoms. (Sadly we cannot look at age break downs on the clots prior to April 21st as the MHRA only started giving age them last week).

Looking at a wider jab window obviously reduces the rate of occurrence. It also changes some of the relative differences between the age groups in a way that is interesting, although doesnt change the order of which groups face the higher absolute risk. Interested in thoughts on this though as the relativities do change a bit (eg comparing the relative risk between the under 50s and the 50-59 group).

Here's the data comparing the clots reported between April 21st to 28th to the age break down of TOTAL (not just AZ) vaccine doses (1st and 2nd) for the period April 4th to 18th (best I could figure out with the way the data iss reported)

49 and under: 115k doses per case, or 0.9 cases per 100k jabs (
50-59 58k doses per case, or 1.7 cases per 100k jabs
60-69 118k doses per case, or 0.9 cases per 100k jabs
70-79 387k doses per case, or 0.3 cases per 100k jabs
80 plus no cases

For comparison, the narrower window of jab data (april 11-18) gave the following rate per 100k jabs:
49 and under: 1.5 per 100k
50-59: 3.5 per 100k
60-69: 1.4 per 100k
70-79: 0.5 per 100k

@Schulte thank you for that. The problem however is that the MHRA havent given us the age breakdown by AZ jabs! It's so annoying as it seems very likely that they do have it

I also looked at the sex break down on the wider window. Comparing the extra cases reported between April 21st to 28th to all jabs between April 4th to 18th results in one man with a clot for every 209k jabbed and one woman with a clot for every 140k jabbed.

Women looked 1.6 X more at risk than men on the narrower jabbing window, and 1.5 X more at risk on this wider window, so not a huge difference.

Obvs important to stress this the data on vaccinations is not broken down by vaccine type, so we cannot know for sure how many AZ vaccines for each age group and sex.

@nordica I would love to hear the strategy! I’ve not been able to do it here I called the helpline and was told they don’t know who is giving what where so can’t help me at all make an informed decision. I know where I have booked is AZ I don’t want it! Not sure how to find out or go about getting an alternative

Just saw this in the independent:

www.google.co.uk/amp/s/www.independent.co.uk/news/health/covid-vaccine-astrazeneca-blood-clots-cases-latest-b1842455.html%3famp

Looks like there is to be a change in policy.

Seems germany have changed their advice on az again