UK recommends under-30s use alternative vaccine to AstraZeneca

The UK has abruptly changed its guidance over the Oxford/AstraZeneca vaccine, saying that people aged 18-29 should be offered alternative jabs, in a move that could complicate Britain’s vaccination programme.

The new guidance from the body that advises the UK government on vaccinations came as the European Medicines Agency announced a link between rare blood clots in the brain and the AstraZeneca jab.

The EMA did not change its guidance for who should take the jab, saying the benefits still outweighed the risks. But the UK’s joint committee on vaccination and immunisation said people under the age of 30 should be offered either the BioNTech/Pfizer or the Moderna vaccine. It has not restricted the AstraZeneca vaccine for any other age groups.

“It’s a course correction to the UK [vaccination] programme, there’s no question about that. But in medicine that’s normal,” said Jonathan Van-Tam, England’s deputy chief medical officer.

Boris Johnson, UK prime minister, said on Twitter: “We will follow today’s updated advice, which should allow people of all ages to continue to have full confidence in vaccines, helping us save lives and cautiously return towards normality.”

Authorities have for several weeks been investigating links between the AstraZeneca vaccine, which has already been given to millions of people across Europe, and cases involving rare but serious blood clots in the brain.

At least 16 European countries halted or limited use of the AstraZeneca vaccine last month, with most resuming its use after the EMA said the benefits outweighed risks. A number of European nations continue to have age restrictions in place for the jab.

In the UK, 79 cases of the rare blood clots have been identified among people who have had the AstraZeneca vaccine, and at least 19 deaths. Three of the deaths were among people under 30; of the total, 51 were women and 28 were men.

The UK’s Medicines and Healthcare products Regulatory Agency, the UK regulator, said pregnant women and those with a history of blood disorders should discuss their vaccine options with a doctor. Those under 30 who have already received the first shot of the vaccine should come forward and have their second dose, officials said.

The regulator added that it had not found evidence that the contraceptive pill caused higher risk of rare blood clotting. 

Sir Munir Pirmohamed, chair of the Committee of Human Medicines, which has been working with the MHRA, said the blood clot link was “getting firmer”, but that absolute proof would only come after extensive scientific work.

Van-Tam said the changes would not affect the timeline for the UK’s vaccine rollout. “The effect on the timing of our programme should be zero or negligible,” he said. Nadhim Zahawi, UK vaccine minister, also said the government was “confident” in meeting its targets.

Emer Cooke, head of the EMA, said “unusual blood clotting following vaccination should be listed as possible side effects of the [AstraZeneca] vaccine”. She added that recommendations could change as more data become available.

At least 62 cases of blood clotting among people who had taken the jab were recorded by April 4, the EMA said.

Sabine Straus, head of the EMA’s safety committee, said the watchdog’s job was to determine the risk and benefits of each vaccine and that it was up to individual countries to determine how to use the jabs available.

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