Britons are cancelling appointments for the Oxford/AstraZeneca coronavirus vaccine amid fears over its potential link to rare brain clots, GPs warned today.
In what could be a major blow to vaccine uptake, doctors said they had been inundated with patients of all ages requesting to be given an alternative to the British-made jab.
GPs have also been bombarded with people complaining of headaches and ‘requesting brain scans’ after getting their first dose.
The concerns come amid fears that public confidence in the jab has been eroded after regulators suspended its use in healthy under-30s yesterday while it continues to probe its link to blood clots. The clots have been spotted in just 79 out of 20million vaccinated Brits.
Meanwhile, a letter sent by NHS bosses on Wednesday has urged all vaccination sites to cancel appointments for young people who don’t have underlying health conditions, including NHS workers and carers.
These people will have to wait weeks before being given access to either the Pfizer vaccine, which is currently being rationed for second doses, or the Moderna jab which is due to start being rolled out later this month.
Dr David Triska, a GP partner at Witley and Milford Surgeries in Surrey, told MailOnline today that people are now cancelling their AZ jab in favour of another.
He said: ‘We have now been inundated with consultations relating to headaches and people defaulting their AstraZeneca appointment to try and get another vaccine. We are reassuring them the balance of risk is in favour of receiving the vaccine.’
The comments were echoed by the Mail On Sunday’s resident GP, Dr Ellie Cannon, who revealed she’d received lots of ‘requests for brain scans from well people’ who are concerned they may have developed the brain clots.
She said there had been ‘mass panic’ following yesterday’s announcement by British regulators, tweeting: ‘Lots of calls from patients thinking they’ve had a blood clot or wanting to be checked for one…… Have we handled this reporting correctly? Storm for GPs and A&E colleagues…’
Matt Hancock today warned people under the age of 30 that refusing a vaccine because of blood clot fears could ‘ruin your life’ due to the risk of catching the disease and developing ‘debilitating’ long Covid.
The Health Secretary launched a media blitz today as officials scramble to shore up public confidence in the vaccine.
People queue at a Covid-19 vaccination centre at Westfield Stratford in London in February
Under-30s will now be offered an alternative Covid-19 vaccine to the Oxford/AstraZeneca jab
Dr Triska also pointed to a Public Health England and NHS guidance factsheet on the various vaccines which has been prepared to help alleviate patients’ concerns.
It comes as experts working with the Medicines and Healthcare products Regulatory Agency on the clot cases said those affected were presenting to doctors ‘with the worst headache they’ve ever had’ four days after the jab and sometimes later.
Dr David Triska, a GP partner at Witley and Milford Surgeries in Surrey, said people are now cancelling their AZ jab for a different one
The wider UK picture is not yet clear, with the British Medical Association telling MailOnline today that reports of patients cancelling jabs ‘isn’t something we’ve been hearing at this stage’, and the Hospital Consultants and Specialists Association declining to comment.
Today, the Health Secretary said everyone should take a vaccine when their time comes, and the risk of experiencing a brain clot was the same as ‘taking a long-haul flight’.
He warned that turning it down could ‘ruin your life’ because even healthy young people are affected by lingering long Covid symptoms.
During a round of broadcast interviews today, he said: ‘Covid is a horrible disease and long Covid affects people in their 20s, just as much it seems as any other age group and can have debilitating side effects that essentially ruin your life.’
Mr Hancock said the UK has ‘more than enough’ Pfizer and Moderna jabs to cover all of the people in the 18 to 29 age group who are yet to receive a vaccination – approximately 8.5million.
He said ‘all three vaccines that are in use in the UK are safe and they are safe at all ages’ and that there is simply a ‘preference for the under-30s, if they want to have the Pfizer of Moderna jab instead then they can’.
Speaking directly to younger people who may be thinking they do not need a vaccine, Mr Hancock told BBC Breakfast: ‘The vaccines are safe, and if you want to have the Pfizer vaccine or Moderna vaccine instead then that is fine.
He added: ‘The safety system that we have around this vaccine is so sensitive that it can pick up events that are four in a million (the chance of developing a rare brain blood clot) – I’m told this is about the equivalent risk of taking a long-haul flight.’
Mr Hancock said there were almost 10.2million people aged 18 to 29 in the UK, of whom 1.6million have had their first vaccine.
Professor Jeremy Brown, a member of the Joint Committee on Vaccination and Immunisation (JCVI), said that the benefit of vaccinating young people is not just preventing severe disease.
Prime Minister Boris Johnson visits the AstraZeneca site in Macclesfield, Cheshire, on Tuesday
Leaked delivery schedules reveal the Government is expecting AstraZeneca’s vaccine to make up 75 per cent of its Covid jab supplies over the next two months
Risk of blood clots from Covid-19 is ‘much higher’ than from vaccine, experts say
Experts have described the risk of getting severe blood clots from Covid as ‘much higher’ than the ‘extremely small’ chance of doing so after having the Oxford/AstraZeneca vaccine.
Figures suggest the risk of developing such a clot is ‘about four people in a million who receive the vaccine’, the Medicines and Healthcare products Regulatory Agency said on Wednesday.
Up to the end of March, the UK regulator had received 79 reports of blood clots accompanied by low blood platelet count, all in people who had had their first dose of the vaccine, out of around 20 million doses given.
Of these, a total of 19 people have died, although the cause has not been established in every case.
Professor Anthony Harnden, deputy chairman of the Joint Committee on Vaccination and Immunisation, has urged people not to lose confidence in the Oxford/AstraZeneca jab, describing it as ‘a great vaccine’.
Speaking on Good Morning Britain, Prof Harnden said there is a ‘much higher risk of getting severe blood clots from Covid than the extremely small risk from this vaccination’.
Chairman of the Commission on Human Medicines Professor Sir Munir Pirmohamed said recent research has shown that clots on the lungs occur in 7.8 per cent of people who have Covid-19, while clots in the legs – known as deep vein thrombosis (DVT) – happen in 11.2 per cent of Covid-19 sufferers.
He told a briefing today that almost a quarter (23 per cent) of patients who end up in intensive care with Covid-19 ‘will have some form of clot’.
He added that up to 30 per cent of people who develop Covid-19 will get thrombocytopenia (lowering of the platelet count).
‘That puts into context that the risk of clots and lowered platelets is much higher with Covid-19 than these extremely rare events which are occurring with the vaccine,’ he said.
Professor Sir David Spiegelhalter, a statistician from the University of Cambridge, said it is ‘crucially important’ that the risk is set in context, and said the information given this week ‘shows there is a benefit-risk balance’.
He said the risk of a young person dying in an accident is around one in 100,000 each month.
He told Sky News: ‘It actually will prevent them catching Covid, and if they don’t get Covid then the chance of developing so-called long Covid – the symptoms you get which many people get, about 10 per cent, after they’ve had even a very mild infection – that will prevent that.
‘It also allows younger people to visit their relatives who are elderly and more vulnerable to the disease, without the risk of infecting them.
‘Lastly, there are social benefits which have been much discussed over the past few days – travel, for example. I think it’s unlikely that people will be allowed to travel out of the country easily unless they have been vaccinated.’
Meanwhile, Professor Anthony Harnden, deputy chairman of the JCVI, explained that the chance of suffering a clot after a vaccine was much lower than for other medicines or during pregnancy.
‘These are extremely rare events – much, much more rare than, for instance, clots due to common drugs that we prescribe such as the contraceptive pill; much rarer than clots during pregnancy; much, much rarer than clots due to Covid itself,’ he told BBC Breakfast.
‘We still feel this is a safe and effective vaccine where the benefits far outweigh the risks for the majority of people.
‘In many ways, it’s better to know the known than the unknown, so I would encourage anybody who’s been offered either their first dose of the Oxford/AstraZeneca vaccine, and certainly their second dose, when there’s been no cases (of clots) for second doses, to receive it when offered.’
Prof Harnden insisted ‘the vaccination programme is going full steam ahead’ across the UK and ‘everybody should remain confident in it’.
The risks of Covid and severe illness were highest in older age groups, but when you look down to very young people, ‘the risks aren’t quite as high’, he said.
This meant that the risk of dying from Covid or a clot after a vaccine looked like they might be more similar for young people.
Urging anyone who has had one dose of AstraZeneca to have their second, Prof Harnden said ‘we don’t know how long that protection is going to last for, and it could well drop off’.
British health chiefs have restricted AstraZeneca’s vaccine in under-30s because their risk of dying from Covid is so small and there are early signs they may be more prone to blood clots after the jab.
But EU regulators have decided against recommending the vaccine is withheld from any age group because they can’t be sure that young people are definitely most at risk of the extremely rare complication.
The UK’s own medical watchdogs confusingly hold the same opinion but acknowledge cases of rare blood clots from the life-saving jab are occurring slightly more often in younger adults.
For this reason, the JCVI — No10’s vaccine advisory panel — has acted out of extreme caution to restrict the jab to under-30s because its benefits don’t clearly outweigh the risks in younger adults, who face a vanishingly small risk of falling seriously ill or dying from the disease.
EU nations have defied their own regulator’s guidance, with Belgium, Germany and Italy shunning the vaccine for under-60s.
But statistical analysis of the risks — done by Cambridge University academics and used to justify the UK’s ‘course correction’ in the roll-out — show the benefits of the jab are much clearer for over-30s, who face a slightly higher risk from the disease and appear to suffer fewer blood clots.
Scientists have still yet to prove the vaccine causes the blood clots and are struggling to untangle the risk factors because young people are also more at risk of suffering the clots. But experts say the evidence is shifting.
What is the latest data on Covid vaccinations?
A total of 31,812,141 Covid-19 vaccinations took place in England between December 8 and April 7, according to NHS England data, including first and second doses, which is a rise of 431,203 on the previous day.
NHS England said 26,879,123 were the first dose of a vaccine, a rise of 58,962 on the previous day, while 4,933,018 were a second dose, an increase of 372,241.
An estimated 94.3 per cent of people aged 50 and over in England have received their first dose of Covid-19 vaccine.
Regional estimates range from 85.9 per cent for London to 96.6 per cent for south-west England.
The figures, from NHS England, are for first doses of the vaccine up to April 4.
Here are the estimated figures for each region:
- South-west England 96.6%
- Eastern England 95.7%
- South-east England 95.7%
- Midlands 95.1%
- North-east England/Yorkshire 94.8%
- North-west England 94.4%
- London 85.9%
NHS England data shows a total of 3,877,259 jabs were given to people in London between December 8 and April 7, including 3,266,747 first doses and 610,512 second doses.
This compares with 5,228,177 first doses and 852,899 second doses given to people in the Midlands, a total of 6,081,076.
The breakdown for the other regions is:
- East of England: 3,218,455 first doses and 566,556 second doses, making 3,785,011 in total
- North East and Yorkshire: 4,236,697 first and 861,572 second doses (5,098,269)
- North West: 3,426,321 first and 668,012 second doses (4,094,333)
- South East: 4,384,580 first and 809,317 second doses (5,193,897)
- South West: 2,979,362 first and 544,143 second doses (3,523,505)
‘We felt that the benefits outweighed the risk in those above 30 years old. But in those under 30, the benefits and risk look more similar,’ said deputy chair of the JCVI Anthony Harnden.
In total, more fatal blood clots have developed in 30 to 39-year-olds than any other age group and more of them have been found in women than men.
But statistical analysis supporting the UK decision was done by eminent statistician Professor Sir David Spiegelhalter, who found that the clots were more common in even younger people.
Professor Spiegelhalter said data suggested about one in 90,000 people aged 18 to 29 given the AstraZeneca jab will likely suffer the clots compared to one in 500,000 over-60s.
Highlighting how the benefit-risk balance of the AstraZeneca vaccine swings heavily in favour of even middle-aged people, his team’s calculations show people in their 40s are 100 times more likely to be hospitalised with Covid if they refuse jab.
Professor Spiegelhalter said the change in vaccine guidance had been made as precautionary measure because young people were being hit with a ‘double whammy’.
He told MailOnline: ‘There does seem to be extra risk in younger people of getting this combination of quite really odd particular group of symptoms [brain clots and low platelet counts].
‘Younger people are also not benefiting so much from vaccine, so in sense they’re getting a double whammy. They are at a higher risk from the vaccine and lower benefit from the vaccine.’
Regulators in the EU, on the other hand, have decided against restricting the British-made vaccine’s use in any age group, claiming that age is not a risk factor.
Professor Spiegelhalter said he was ‘not sure’ how the European Medicines Agency could have come to such a different finding, reiterating that the ‘data definitely does show there is an age gradient.’
He admitted that Europe needed the AstraZeneca vaccine more than the UK because the continent is in the midst of battling a third wave and is struggling to get its jab rollout up to speed.
But justifying their decision not to restrict the vaccine by age, Dr Sabine Strauss said: ‘Our review has shown that there is a predominance of these rare events of thrombosis combined with thrombocytopenia in certain groups – notably in women and younger women.
‘But it is still rather premature to conclude on a specific group because the background risk of thrombosis may be different in various groups and it may also be the case that more people have received this vaccine in certain groups in different countries. The potential for different risk levels is part of our further evaluations.’
The EMA and its UK equivalent, the MHRA, both say the AstraZeneca is safe for every age group, including the under-30s. The EMA has left it to individual countries to carry out their own risk-benefit analysis and decide whether to suspend the jab’s use, which has led to nations taking different approaches.
Germany has banned its use in under-60s, while France is not recommending it for under-55s. Britain’s JCVI said the benefit versus risk stopped at people aged 30 and below.
Putting the tiny risk of jab-related clots into context, Professor Spiegelhalter said if a cohort of people in their 20s large enough to fill Wembley Stadium was given the UK-made jab, just one person would likely develop clotting.
Professor Spiegelhalter added that he believes the low risk coronavirus directly poses to young people makes their decision to get vaccinated altruistic, because it stops them passing it to vulnerable people, has not been emphasised enough.
It comes after the Joint Committee on Vaccination and Immunisation ruled yesterday that healthy Brits under 30 should be given an alternative to the AstraZeneca vaccine while experts probe the clot links.
Professor Spiegelhalter said the UK had the luxury of being able to pivot because it has plentiful vaccine supplies and low levels of Covid infection, which meant the relative risk of the clots was higher than the threat of the virus.
However, should there be a resurgence of Covid transmission or if the UK is hit with vaccine delivery issues, then the relative importance of the risk of blood clots would decrease.
He continued: ‘We do know that as we come out of lockdown and as cases in Europe rise during a third wave, we may experience a third wave in this country over the next few months.
‘And therefore to be unprotected would be to leave yourself at risk of developing Covid, and of course all the complications that come with Covid, including I might say quite severe blood clots, much higher risk of getting severe blood clots from Covid than the extremely small risk from this vaccination.’
Professor Andrew Pollard, director of the Oxford Vaccine Group, said he had woken up on Thursday worrying about the pandemic and how many people are still dying.
He told BBC Radio 4’s Today programme: ‘What I did wake up this morning worrying about is the pandemic.
‘It’s not over, it really does continue to threaten the whole of humanity – today about 12,000 people around the world will be confirmed dead as a result of coronavirus.
‘And those numbers are getting worse – in Europe, in our immediate neighbours, in South Asia, in Latin America – and so this really is not the time to waver.
‘We just need to put our confidence in the hands of the system which I think really has had a big boost by their ability to pick up an incredibly rare event through the monitoring that’s going on, and that really gives me confidence that we can continue with the programme.’
Meanwhile, Professor Beverley Hunt, an expert in thrombosis and haemostasis at King’s College London, who has been working with the Medicines and Healthcare products Regulatory Agency (MHRA) on the clot cases, said those affected had been presenting to doctors ‘with the worst headache they’ve ever had’ four days after vaccination and sometimes later, though prompt treatment could save lives.
Yesterday, the MHRA said the benefits of the vaccine still outweigh the risks overall.
While it has not concluded that the vaccine causes rare brain clots, it says the link is getting firmer.
Up to March 31, the MHRA in the UK has received 79 reports of blood clots accompanied by low blood platelet count, all in people who had their first dose of the vaccine, out of around 20 million doses given.
Of these 79, a total of 19 people have died, with three under the age of 30.
NHS England said today that a further 34 people who tested positive for coronavirus have died in hospital in England, bringing the total number of confirmed deaths reported in hospitals to 86,510.
Patients were aged between 54 and 95 and all had known underlying health conditions.
The deaths occurred between December 26 and April 7. There were 19 other deaths reported with no positive Covid-19 test result.