Under-40s to be offered alternatives to AstraZeneca vaccine – unless there are shortages

the Astrazeneca jab  © LOIC VENANCE/AFP via Getty Images the Astrazeneca jab 

People under the age of 40 will be advised to have an alternative jab to AstraZeneca, unless shortages cause delays in the vaccine rollout, the Government’s advisers have said. 

The Joint Committee on Vaccination and Immunisation (JCVI) says those in their 30s should be offered Pfizer or Moderna, because of concerns about “extremely rare” blood clots linked to AstraZeneca

The same advice has already been given to those below the age of 30.

Currently the programme is inviting anyone who will turn 40 by July 1 to come forward, with invitations expected to be issued soon to those in their 30s. 

Following the change in the advice, those below the age of 40 will book their jabs in the same way, and be given an appointment without the type of vaccine being specified.

Officials said that while the intention is to administer Pfizer or Moderna, it was possible that some of those in younger groups might be offered AstraZeneca on the day, in the event of any delays in supplies. 

In the new guidance, the JVCI said that adults aged 30 to 39 without underlying health conditions should be offered an alternative to the Oxford-AstraZeneca vaccine.

But amid concern that this could slow the rollout of the vaccine programme, advisers said this should be the case “only where this is available and only if this does not cause any substantial delays in being vaccinated".

Health officials insisted that despite the change, the Government will still hit its target to offer first doses to all adults by the end of July.

The committee said they had reviewed the latest available evidence, including the current Covid infection rate, the scale and pace of the vaccine programme, and modelling of the timing and size of any third wave.

The chances of a younger person being seriously ill with Covid have become smaller as infection rates increasingly come under control in the UK.

This was considered alongside the latest advice from the Medicines and Healthcare products Regulatory Agency (MHRA) on extremely rare cases of concurrent thrombosis (blood clots) and thrombocytopenia (low platelet count) following the first dose of the Oxford-AstraZeneca vaccine.

The MHRA stressed that for the vast majority of people, the benefits of AstraZeneca outweigh any risks.

The safety regulator still backs the vaccine, but the advice on rollout from the JCVI has changed. 

Professor Wei Shen Lim, Covid-19 Chairman for JCVI, said: “Safety remains our number one priority. We have continued to assess the benefit-risk balance of Covid-19 vaccines in light of UK infection rates and the latest information from the MHRA on the extremely rare event of blood clots and low platelet counts following vaccination.

“As Covid-19 rates continue to come under control, we are advising that adults aged 18-39 years with no underlying health conditions are offered an alternative to the Oxford-AstraZeneca vaccine, if available and if it does not cause delays in having the vaccine. The advice is specific to circumstances in the UK at this time and maximises use of the wide portfolio of vaccines available.

“The Covid-19 vaccines have already saved thousands of lives and the benefit for the majority of the population is clear – if you are offered the vaccine, you should take it.”

Dr June Raine, MHRA chief executive said: “Public safety is always at the forefront of our minds and we take every report seriously.

“Our position remains that the benefits of the AstraZeneca vaccine against Covid-19, with its associated risk of hospitalisation and death, continues to outweigh the risks for the vast majority of people. The balance of benefits and risks is very favourable for older people but is more finely balanced for younger people and we advise that this evolving evidence should be taken into account when considering the use of the vaccine, as JVCI has done."

Up to April 28, the MHRA had received 242 reports of blood clotting cases in people who also had low levels of platelets in the UK, following the use of the Oxford-AstraZeneca vaccine.

Over the same period, 28 million people were given a jab, meaning rates of 10.5 per million doses.

Health officials stressed that everybody who has already had a first dose of the Oxford-AstraZeneca vaccine should receive a second dose of the same jab, irrespective of age, except for the very small number of people who experienced blood clots with low platelet counts from their first vaccination.

As a precautionary measure, anyone who has the following symptoms from around four days to four weeks after vaccination is advised to seek prompt medical advice:

  • a severe headache that is not relieved with painkillers or is getting worse;
  • a headache that feels worse when you lie down or bend over;
  • a headache that is unusual for you and occurs with blurred vision, feeling or being sick, problems speaking, weakness, drowsiness or seizures;
  • a rash that looks like small bruises or bleeding under the skin;
  • shortness of breath, chest pain, leg swelling or persistent abdominal pain.

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Under-40s to be offered alternatives to AstraZeneca vaccine – unless there are shortages