UK Covid: Van-Tam says AstraZeneca vaccine’s risk v benefit is finely balanced for younger people – as it happened

• Healthy adults under 30 should be offered an alternative vaccine to the Oxford/AstraZeneca jab if there is one available in their area and they are not at high risk of Covid, following concerns over rare blood clots, the UK government’s vaccination advisory body has said. The new advice was issued after the Medicines and Healthcare products Regulatory Agency published new figures showing that there have been 79 cases of extremely rare types of blood clotting incidents, including 19 deaths, following the use of 20m doses of the Oxford/AstraZeneca vaccine. (See 5.18pm.) Previously the MHRA said any link between these cases and the vaccine was unproven, but today it said the evidence for this was “stronger” than it had been before and that a connection was now “reasonably plausible”. At a news conference with the MHRA and the JCBI, Prof Jonathan Van-Tam, the deputy chief medical officer for England, presented figures showing that, for older people, the benefits of having the vaccine clearly outweighed the risks. (See 4.42pm.) But he went on:

But you can see that at a very low exposure risk ... the risk-benefit is relatively finely balanced in those younger age groups.

That is why the government is offering the under-30s the option of getting an alternative vaccine. Van-Tam said that some people might have to wait a bit longer for a jab, but that the overall effect on the vaccine rollout programme would be “negligible”. (See 3.48pm.) For weeks the UK authorities have been insisting that the AstraZeneca vaccine is safe, and downplaying the reports linking it to rare blood clots that have led to some EU regulators restricting its use to older people, or suspending its use altogether. But the UK authorities are now taking a more precautionary approach than the European Medicines Agency, which announced its own AstraZeneca update at the same time as the MHRA and the JCVI. The EMA proposed that the rare blood clots would be listed formally as a side-effect of the vaccine, but it did not propose any restrictions on its use.

• Matt Hancock, the health secretary, has announced that more than one adult in 10 in the UK has now had both doses of vaccine.

• Almost one in 14 people aged 16 or over in Great Britain say they are lonely, up 40% since last spring, according to the Office for National Statistics.

• A comedy club has said it suffered “significant damage” to its reputation after being wrongly linked to the government’s proposal for coronavirus health certificates.

• Northern Ireland’s justice minister has said the government’s “dishonesty” over the consequences of hard Brexit has contributed to the anger felt by loyalists, as police counted the cost of 41 officers injured during violence on the streets over four nights.

• Alex Salmond has been accused of being an apologist for Vladimir Putin’s Russian regime after he refused to say whether Moscow was to blame for the Salisbury poisonings in 2018.

That’s all from me for today. But our coronavirus coverage continues on our global live blog. It’s here.

The UK has recorded 45 further coronavirus deaths and 2,763 new cases, according to the latest update to the government’s dashboard.

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And here are details from the MHRA news release of the 79 extremely rare blood clotting incidents, including 19 deaths, that occurred after 20.2m doses of the Oxford/AstraZeneca vaccine were administered in the UK.

Up to and including 31 March 2021, the MHRA had received 79 UK reports of blood clotting cases alongside low levels of platelets following the use of the Covid-19 vaccine AstraZeneca:

44 of the 79 cases were of CVST with thrombocytopenia.

35 of the 79 cases were of thrombosis in other major veins with thrombocytopenia.

79 cases occurred in 51 women and 28 men, aged from 18 to 79 years. It should be noted that more women have been vaccinated with Covid-19 Vaccine AstraZeneca than men.

Sadly, 19 people have died out of the 79 cases – 13 females and 6 males. 11 out of the 19 people who died were under the age of 50, 3 of whom were under 30. 14 of these 19 cases were of CVST with thrombocytopenia and 5 were of thrombosis with thrombocytopenia.

All 79 cases occurred after a first dose of the vaccine.

Here is the news release from the MHRA about today’s announcement.

And here is a page on the MHRA’s website with detailed briefing notes for healthcare professionals and vaccine recipients.

7 Apr 202111.52 EDT

Libby Brooks

Scottish Conservative leader Douglas Ross has warned that smaller pro-union parties will only benefit the Scottish National party in next month’s Holyrood election.

Speaking to the Scottish Parliamentary Journalists’ Association after George Galloway launched his manifesto for the pro-union Alliance for Unity earlier today (see 2.45pm), Ross said:

It’s very clear that they are only going to harm the pro-UK side, they are not going to benefit the case for Scotland remaining in the UK, they’re going to take away the strong opposition that the Scottish Conservatives have been, and other pro-UK parties, rather than damaging the nationalist cause.

Ross added that voters should appreciate this is a “crucial” election in Scotland. He said: “The future of our country is at stake if the nationalists get another majority.”

Although polling earlier today (see 1.17pm) suggested that Scottish Labour is making gains on his party, threatening them for second place against the SNP, he insisted: “We can stop that obsession with independence and get back to the issue that really matters to people, which is our recovery from Covid-19.”

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Here are the three slides presented by Prof Jonathan Van-Tam during the briefing. They seek to present, in numerical terms, the risk-benefit balance, by age group.

They compare the number of people who would avoid ending up in intensive care as a result of the use of the Oxford/AstraZeneca vaccine against the number that might suffer a serious harm from the use of the vaccine.

The first slide covers the benefits and harms with a low rate of coronavirus in circulation – defined as 2 cases per 10,000, or about the rate it was in the UK in March. On the basis of these figures, it would be safer for under-30s not to take the AstraZeneca vaccine – although, as Van-Tam said, the figures do not take into account the risk of developing long Covid, or the fact that the benefit of the vaccine should last for longer than 16 weeks.

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But with a medium rate of coronavirus in circulation – defined as 6 cases per 10,000, or about the rate it was in February – even for the under-30s the balance of risk tips in favour of the vaccine.

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And with a high rate of coronavirus – defined as 20 cases per 10,000, or the situation at the peak – the vaccine benefits are even clearer.

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This is from Nadhim Zahawi, the vaccine deployment minister.

Van-Tam is summing up.

He says he hopes people will feel they have seen authentic experts doing their best to keep people safe.

And that’s it.

I will post a summary shortly.

Q: Are there any reasons women are at more risk than men?

Pirmohamed says of the 79 cases, 51 were in women.

Of the 79 cases, 51 were in women, and 28 were in men.

The numbers are quite small, and that may reflect actually who is getting the vaccine, because many of the healthcare workers for example are women.

But if you actually look at the incidence rate according to the number of vaccines administered, there is actually no difference between men and women.

Q: Are there things that could be done to mitigate this risk?

Pirmohamed says an immune response seems to be targeting platlets. It is not clear why. When they understand this, they might be able to prevent it in individuals with risk factors, or they might be able to adapt the vaccine, he says.