PEOPLE aged 30 to 39 in the UK are to be offered an alternative to the AstraZeneca vaccine as a precaution due to a very small risk of rare blood clots. 

The Joint Committee for Vaccination and Immunisation is not banning the use of the vaccine in this age group, but said where the Pfizer or Moderna vaccines were available they should be used preferentially as long as this does not cause any substantial delays to the vaccination programme.

The JCVI also said that current modelling indicates that a possible third wave of the virus is likely to be smaller than previously expected. 

However, they stressed that this could change if there were a slowdown in the rate of the vaccine rollout or a dip in uptake, and urged young people to get vaccinated. 

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The UK still remains on track to give all adults a first vaccine dose by the end of July, according to England's deputy chief medical officer Professor Jonathan Van Tam. 

The change follows a previous change in guidance which said that people under-30 should be offered an alternative to the Oxford-AstraZeneca vaccine. 

The change partly reflects the continued decline in rates of coronavirus in the community, which means the risk of being exposed to the virus is now much less than at earlier phases of the immunisation rollout.

As a result, for younger people with no underlying health conditions - whose risk from Covid is very small - the benefit of vaccination in terms of preventing severe illness begins to be outweighed by the possibility of developing a blood clot, even though the risk of that is also very slight. 

This is not the case for older age groups whose risk of serious disease from Covid is statistically higher. 

Where there is no alternative, under-40s should still be offered the AstraZeneca vaccine as this was preferable in public health terms to any slowdown in vaccination - particularly amid growing evidence that the vaccines reduce transmission, and the risk of unvaccinated young people being able to spread the virus as the economy reopens.

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However, there are thought to be no supply issues with offering the vast majority of younger people alternatives to AstraZeneca.

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 to 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."

Up to April 28, the Medicines and Healthcare Regulatory Agency (MHRA) said it had received 242 reports of blood clots accompanied by low blood platelet count in the UK, all in people who had the AstraZeneca vaccine, out of around 28.5 million doses given.

These clots occurred in 141 women and 100 men aged from 18 to 93, with 49 deaths.

Six cases have been reported after a second dose.

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A particular type of brain blood clot - cerebral venous sinus thrombosis (CVST) - was reported in 93 cases (with an average age of 47), and 149 had other major thromboembolic events (average age 55) accompanied by low blood platelet count.

The overall incidence of blood clots with low platelets after a first dose is put at 10.5 per million doses, and about one in a million for a second dose.

For those aged 40 to 49 the incidence is 10.1 per million doses, and 17.4 per million for those aged 30 to 39.

Overall, the death rate per million doses is 2.1, but is 4.5 for those aged 30 to 39.
MHRA chief executive Dr June Raine 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 Covid-19 vaccine AstraZeneca 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."

Anyone who had a first dose of AstraZeneca without developing a blood clot, regardless of age, is urged to take up their second dose as planned. 

The regulator said people should seek medical attention if they experience any of the following symptoms four days to four weeks after vaccination: a severe headache which is not relieved with painkillers or is getting worse; a headache that feels worse when a person lies down or bends over; a headache that is unusual 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; or shortness of breath, chest pain, leg swelling or persistent abdominal pain.