Alternatives to AstraZeneca vaccine for under 40s “could be considered” amid rise in blood clots 2

[Whichjab]

Just starting another thread as so much information still coming out. Interesting that Germany have just allowed AZ for all that want it.

Note, this is not an Anti-Vaccs thread. It is just a discussion about alternatives.

In fact, UK did a great job with Pfizer.

• UK placed its order back in July (!) 2020. It was initially for 30million vaccines but the quantity was increased to 40 million in October 2020.
• We were the first country to approve Pfizer in December 2020.
• We received our first delivery (5.8 million doses) last year which gave a heads up with vaccinations.
• Throughout 2021 when other countries experienced delays with their vaccines, our Pfizer supplies kept running like a clock every single week. Our contract must have been water tight.
• We have now upsized our order to 100 million. I am guessing some of these doses will be used as boosters for people who previously received AZ. A combination of adenovirus and mRNA vaccines is expected to further increase vaccine efficacy.

re: those charts - there was an interesting Twitter thread from someone who had looked into the numbers.

The charts we first saw on the 7th April press conference were always wrong because they had counted vaccinations and clots up to the same date. In reality there is a lag of about 2-5 weeks because the clots don't happen instantly and then it takes time for them to get reported. So if you count the VITT incidences up to today's date, ideally you should only count AZ jabs given until early April or so to have a more accurate ratio of clots to jabs given. If they had done this on 7th April they would have needed to make the policy change for under 40s at that time, not wait until today.

@Schulte - we know that jabbing anyone with AZ will result in more clot deaths, not just for younger people. We also know that some people will continue to die from covid and with covid and that those numbers will go up as society opens up more and people start to travel, particularly if the vaccination programme stalls. We do know that stopping using the AZ vaccine altogether on all age groups does carry a risk, that isn’t speculation, especially given the number of weeks required post vaccination (and the need for two doses) to gain best protection. So some people need to take the risk, regardless. Given the fact no vaccine provides instant immunity at date of first jab, deciding which course of action carries least risk to specific individuals and to society as a whole will always involve some speculation, whatever decision is made by whoever makes it.

@Walkaround maybe , but as someone with mental health issues, group 6 for 3 underlying causes. In 40s and due second az in a few days. This hasn't filled me with confidence. In fact I was hesitant about the first dose due to lower efficacy and variants to start. Even if I take the second jab, I'm still going to be vulnerable to variants.

@Dementedswan - you’re vulnerable regardless, that’s presumably why you agreed to be vaccinated at all. I personally think you have a considerably greater risk from being only half vaccinated than from being fully vaccinated, and the AZ vaccine is effective against the dominant variants in the UK at the moment.

Agreed @Walkaround, it’s a fine balance whichever way you look at it. I’m not saying that AZ shouldn’t be used at all. My view is that the age limit for being offered a choice should be higher and that we’re being shown flawed stats to justify a decision that is questionable. There are plenty of people in all age groups still more than happy to have AZ, those who are not however should be able to get access to an alternative. Even if it means a slight delay.

@Schulte - you see, this is what I don’t understand. When has the Government or anyone ever actually said you must have your vaccine now or we will refuse ever to vaccinate you at all, ever? All I’ve heard is calls for over 50s, etc, etc, to come forward and have their vaccine if they haven’t already, not that that window has now closed and only people under 50 are now allowed to be vaccinated. You’re perfectly free to delay til the cows come home, or you get covid, or the country runs out of vaccines.

@Walkaround that's true, I need to focus on that.

Also, @Schulte, people over 40 are not banned from receiving a different vaccine from AZ, and lots of over 40s have received alternatives, it’s just the country is not wallowing in so many vaccines that it can offer everyone a genuine choice. I mean, honestly, if we all had genuine choice, as in you turn up on the day and are asked do you want vaccine A or vaccine B, where vaccine A is slightly less effective and has slightly more vaccine-associated risks, what do you think almost everyone would choose? There is a lack of choice because there is genuinely a lack of choice. Trying to fiddle it, so that some people get a choice and others are too slow off the mark isn’t really more fair or efficient, it’s just a tool to use to try to get people to keep presenting themselves for vaccination sooner rather than later whilst simultaneously trying to ensure the vaccination programme doesn’t grind to a halt due to lack of availability of the favoured vaccine (which might happen if too many people are offered a “choice.”).

I'm 43 and have been delaying due to concerns. The fact that they've now raised the cut off age worries me even more. Our local vaccination site I know to be AZ. I'd rather be vaccinated than not, but I'd also rather something other than AZ.

@nordica can you post the link to that Twitter thread please?

I hope this link works:
twitter.com/mimifontaine/status/1390621771045429256?s=19

She has also raised some further points for example that men are at higher risk of covid complications and how that would impact the risk vs benefit calculation.

Much more detailed explanation of my pp. Very clear twitter thread. Thanks Nordica and others. Definitely helps to know it is not just me seeing it and taking a sharp intake of breath.

@Schulte

No one can know if not using AZ on people under 50 from say 1 April and perhaps delaying / prolonging the rollout by 3 weeks or so would really have resulted in more COVID deaths. It’s just speculation.

It's not speculation that being vaccinated reduces transmission and that the high proportion of people vaccinated in the UK is part of the reason cases have dropped. It's not speculation that cases in the UK are now considerably lower than most of the countries that you say have "rightly put the safety of the people" first and did not use the AZ vaccine even if it meant slowing their vaccination rollout. If cases were five times higher at the moment your risk of severe covid would be five times higher.

@nordica

I hope this link works: twitter.com/mimifontaine/status/1390621771045429256?s=19

She has also raised some further points for example that men are at higher risk of covid complications and how that would impact the risk vs benefit calculation.

Balances out, doesn't it? Women seem to be at higher risk of long Covid. I think also post menopause women's risk of serious illness or death is pretty similar to men's?

Men are more at risk of death at all ages. The only reason it balances out in terms of total deaths by the oldest age group is because women outnumber men as a cohort by this point. ONS stats have an explainer.

No idea about long Covid split other than to say the stats are all based on self reported perceptions at this point. Of the dozens and dozens of people I know from 30s-70s the men have all had worse symptoms and slower recovery. Again just my personal experience but no less robust than any other anecdata at this point. Also suggest Long Covid and life altering / fatal side effect risks are not comparable.

Many, but not all long Covid has been self reported. Some patients have had access to scans (which have shown heart, lung, and other damage).

Studies into the risks are ongoing but indicate long Covid is an increased risk for women:
www.bmj.com/content/372/bmj.n829#:~:text=Middle%20aged%20women%20have%20a,unpublished%20studies%20available%20as%20preprints.

The UK has been too dependent on AZ.

Well that’s a pretty easy statement to make at this stage of the proceedings - if only we could travel back in time to take advantage of your superior knowledge.

Back end of last year, these threads were full of posters shouting about the mRNA vaccines being untested technology and no way would they be treated as guinea pigs. How times change!

And with regard to boosters, a number of posters on other threads have mentioned that having more than two doses of adenovirus vaccines is inadvisable as the efficacy is reduced to an unacceptable level (apologies if I am over-simplifying this). In which case, presumably those who have had AZ will be offered mRNA boosters?

The new charts say 40-49 have equal risk from vaccine clots and Covid. So as risk of Covid increases in higher age and risk of clots increases by younger age... what’s the rush for a 40, 41, 42 year old?

@MrsFezziwig

The UK has been too dependent on AZ.

Well that’s a pretty easy statement to make at this stage of the proceedings - if only we could travel back in time to take advantage of your superior knowledge.

Back end of last year, these threads were full of posters shouting about the mRNA vaccines being untested technology and no way would they be treated as guinea pigs. How times change!

And we haven't been too dependent on AZ. The vaccine procurement portfolio has been incredibly diverse and give us many options, unlike say Australia.

@wintertravel1980

QueenStromba

This study produces very large confidence intervals (given its relatively small size).

It is also based on a sub-optimal interval between the two doses (under 35 days). AZ is much more effective when the gap is extended.

Real-life evidence (an outbreak in Lambeth care home) suggests that AZ is still effective (especially against severe outcomes) even though its efficacy is reduced.

Are you talking about the care home where a total of six residents caught the SA variant after having the AZ vaccination? And you're complaining about a study of a couple of thousand people being small? Have you got shares in AstraZeneca or something?

Oh, and you're not going to get to above 50% efficacy (the point where is generally accepted that a vaccine is useful) from 10% efficacy by playing around with the dosage interval.

[quote Walkaround]@QueenStromba - have you read the entire article you linked? Your sweeping statement is not justified scientifically, it’s patently just your personal opinion based on extremely minimal data that the AZ vaccine is worse than nothing. The article you linked also doesn’t justify waiting around for the likes of Novavax.
The S African variant is a variant of concern with respect to all current vaccines and I don’t think you are proposing we all wait until there are vaccines against the current variants of concern before we have any vaccination at all, are you?[/quote]
Point me to the part of the paper which refutes my claim please.

My point is that there are probably millions of people who've had the AZ vaccine and who aren't on the list to receive boosters in the autumn. Many of these people have been given AZ because they're at risk enough from covid that the government claim it's worth some of them dying due to the vaccination rather than wait for stock of a different vaccine. This is with Novavax apparently being due for approval any day now.

@TheRogueApostrophe

I'm 43 and have been delaying due to concerns. The fact that they've now raised the cut off age worries me even more. Our local vaccination site I know to be AZ. I'd rather be vaccinated than not, but I'd also rather something other than AZ.

Exactly the same here - am only just 41 and have had covid (mildly, but did have annoying symptoms months later eg covid toe, and sense of smell is not 100% back yet). I've young DC as well and just not willing to risk AZ - but am desperate to get the vaccine!