Under-30s in UK offered alternative to AstraZeneca jab – BBC News

based on the currently available data the commissioner who medicine is advising the following first our pregnant women should continue to discuss with the healthcare professional whether the benefits of having the vaccine outweigh the risks for them number two people with a history of blood disorders that increase the risk of clotting should only have the covet 19 vaccinations when the benefits outweigh any potential risks number three anyone who experienced cerebral or other major blood clots occurring together with low levels of platelets after the first vaccine of courage 19 astrazeneca should not have the second dose we will be continually monitoring uh further reports as they come in uh continuing monitoring other aspects to identify risk factors um so that we can refine the advice that we give at present the data on people who've had two doses of the covered 19 astrozenica vaccine are limited because these events are rare and comparatively small number of second doses have been given therefore it is not possible to draw a conclusion about how frequently blood clots with a low platelet count happen following a second dose of the vaccine but this will be monitored closely by the mhra and by the chm as part of the ongoing review so just to put into context these events are extremely rare as june has already mentioned and i want to put into context in relation to covet 19 itself it is important to remember the covet 19 itself causes clotting and it causes lowered platelets and i've got a few figures from a paper which is recently published pulmonary embolus clots on the lungs occurring 7.8 percent of people who have curved 19 dvt deep venous thrombosis clots in the legs occurring 11.2 percent uh who've had uh covert 19.

And um of those people who've been infected with sars curvy 2 getting curved 19 and ending up in itu 23 will have some form of clot covered 19 also causes strokes in about 1.6 percent and up to 30 percent of people who develop covert 19 i will get thrombocytopenia which is lowering of the platelet count and that puts into context that the risk of clots and lowered platelet is much higher with covered 19 than these extremely rare events which are occurring with a vaccine so to finish off the chm has advised that the link between the vaccine and blood clots in the cerebral and other veins occurring together with lowered platelets is getting firmer but absolute proof of the link between the vaccine and adverse events will need extensive scientific work based on the currently available evidence and the benefit risks remains favorable for the vast majority people but as june said is more finely balanced for the younger people and we are advising that this evolving evidence should be taken into account when considering the use of the vaccine i'll hand back to professor van tan thank you professor serbaneer thank you professor brain you've now heard from the regulatory experts and in a moment i will turn to the new advice from the jcvi with professor lim but before we do that i'd like to put into context in a visual way what the data are telling us in terms of uh benefits and risks so if i could have the first slide please so this slide and i'll go through the first one slowly shows you in blue type to the left of the slide the potential benefits from vaccination and on the orange part to the right the potential harms and you can see that as you go down the slide from top to bottom those benefits and potential harms are arrayed by age band starting at 20 to 29 young adults through to 60 to 69 relatively old adults and the way these data have been arrayed are in terms of intensive care admissions prevented via vaccine on the left and serious harms potentially due to the vaccine on the right and i thank colleagues at the winton center for um risk risk and evidence communication at cambridge university for help with getting this slide together and this first slide is set as you can see from the title in a scenario of low exposure and in actual fact the rates of disease assumed in this scenario are lower than those we currently have in the uk at the moment and you can see that if you look at the 20 to 29 age band then the potential benefits um amount to 0.8 icu admissions averted compared with serious harms of potentially 1.1 but as you go up through the age groups the amount of serious harm declines but the amount of benefit in terms of averted icu admissions becomes much more pronounced and these are arrayed over a 16 week period now we don't expect vaccine to last for 16 weeks we very confidently expect that it is going to be many many months of protection from a vaccine and the reason for using 16 weeks is is because that is a typical pandemic wave that's the duration of it but you can see that um at a very low exposure risk lower than we have in the uk at the moment the risk benefit is relatively finely balanced in those younger age groups but it becomes very overwhelming uh in favor of vaccine as you go down the up the ages if we go on to the next slide please this is now a medium risk scenario and it is um set at 60 cases per 100 000.

That is marginally l higher than the uk average at the moment but it is lower than some of the remaining hot spots in the uk and you can see that when you when the disease is around us more when there's more exposure then the benefits the potential benefits start to stack up but the potential serious harms remain static of course and this is still over a 16 week period and you can see that the data become more overwhelming in terms of vaccine benefit finally let's move to a high exposure risk and this one next slide please is set typically at where we get to in terms of a pandemic wave this is set at the height of the second pandemic wave that we went through in the last few months and i think is reflective of the kind of scenario we want to avoid in the forthcoming autumn and winter if we possibly can but here when there's a lot of covid19 circulating in the population you can see that even in the 20 to 29 group the potential benefits in terms of intensive care admissions averted is very much higher than the serious harms due to vaccine and and that's why the regulators have concluded as they have about risk benefit for the astrazeneca vaccine so i hope that's placed it all into a bit of context for everybody so that i recognize it's been a detailed scientific discussion so far but hopefully those figures bring it to life and at this point i'm going to hand over to um professor lim to um give us the jcvi advice thank you thank you jonathan jcbi has been meeting over the last two weeks and we have carefully and independently reviewed the safety evidence and the benefit evidence given to us from mhra and public health england and that includes some of the kinds of data that you've seen earlier on the slide we are well aware of the high level of protection that covet 19 vaccines provide particularly against serious disease that is hospitalization i2 admission and from dying from corbett 19 disease against that must be balanced the uncertain occurrence of an extremely rare adverse events that may be associated with vaccination acting really in the interest of safety and for public benefit jcvi feel that there are three points of advice that we would like to put across the first is that information given to individuals who are being offered vaccination and information given to health professionals should be appropriately updated to reflect the latest considerations and deliberations by jcvi and by mhra the second point is that those who have received their first dose of astrazeneca vaccine should continue to be offered the second dose of estrogenical vaccine according to the set schedule and the final bit of advice is that adults who are aged 18 to 29 years old who do not have an underlying health condition that puts them at higher risk from serious coveting disease should be offered an alternative coveting vaccine in preference to the astrozenica vaccine where such an alternative vaccine is available and perhaps it's useful to state what is not advised as well we are not advising a stop to any vaccination for any individual in any age group we are advising a preference for one vaccine over another vaccine for a particular age group really out of the utmost caution rather than because we have any serious safety concerns

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