Prof Adrian Newland commented for the Science Media Centre on the JCVI announcement on using an alternate vaccine to O/AZ in the under 40's.
Friday 8th May 2021.
Prof Adrian Newland, Professor of Haematology, Queen Mary University of London, said:
“The vaccination programme against Covid-19 has been enormously successful in the UK, with a marked reduction in infection and transmission, saving many lives. There has, however, been the worry caused by reports of thrombosis affecting the cerebral venous sinus (CVST) associated with reduced platelet levels in some in the post-vaccination period. These were particularly noticed in the younger population and in women, although in the latter this may reflect the populations initially targeted as the gap has become less marked as increasing numbers are vaccinated.
“The numbers remain small and it is clear that the risks of CVST are much greater following infection with Covid-19 and remain similar to those reported in the normal population. However, the proximity to the vaccination with the AZ vaccine remains a worry and as the overall number of infections fall the potential risks and benefits of using the vaccine in the younger population is less clear. It is therefore pragmatic advice from the JCVI to suggest looking at an alternate in the less than 40 population. While CVST has been reported following the other vaccines, the numbers are much less and it is unclear whether the mechanisms are the same, or just reflect what would be expected in the normal population. The mortality rate from CVST has been reported at approximately 20% and this is likely to fall with the increasing awareness of its possibility, and the availability of effective treatment.
“The AZ vaccine remains the ‘workhorse’ of the vaccination campaign, because of its less stringent storage requirements, and in the older population, where the risks from infection are so much greater it can be used freely. Alternate products can be offered to those under 40 and supplies are such that the targets for vaccination campaign will not be missed.
“The risks from the AZ vaccine appear to follow only the first dose and so those that have received this can have the second without worry.
“If an alternate is not available then serious consideration does need to be given to receiving the AZ vaccine as, although the risks remain very low from the vaccine, there is an increasing awareness of the development of the condition known as long-Covid, that may impact on 30% of those infected, and is not only very debilitating but, as the name suggests, can cause prolonged suffering. It may also occur in a third of those in whom the infection was symptomless. It is important, therefore, to continue with the universal vaccination programme without delay.”