UK advises under-30s to take offer of alternative to AstraZeneca vaccine

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

The new guidance from the body that advises the UK government on vaccinations came as the European Medicines Agency said there was 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 vaccine, saying its benefits still outweighed the risks. But the UK’s Joint Committee on Vaccination and Immunisation said people under the age of 30 should preferably be offered either the BioNTech/Pfizer or the Moderna jab as an alternative. It has not advised against use of 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: “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.”

Downing Street played down the significance of the announcement, insisting that the UK vaccination programme was “on track” and that it was confident of its vaccine supplies, including Moderna and Pfizer jabs.

The UK government is not planning any special new campaign to reassure people following Wednesday’s move.

Conservative party officials stressed people under 30 could still choose to receive the Oxford/AstraZeneca jab if it was the only one available, rather than wait for an alternative.

Authorities have for several weeks investigated 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.

The EMA said at least 62 cases had been established among people who had taken the jab.

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 countries continue to have age restrictions in place.

In the UK, 79 cases of the rare blood clots have been identified among people who had been given the AstraZeneca vaccine, with 19 having died. Three of the deaths were people under 30. Of the total suffering from rare blood clots, 51 were women and 28 were men.

The UK’s Medicines and Healthcare products Regulatory Agency said pregnant women and those with a history of blood disorders should discuss their vaccine options with a doctor.

Sir Munir Pirmohamed, chair of the UK Committee of Human Medicines, a government advisory body, said the “incidence rate” of rare blood clots showed no difference between men and women.

“At the moment we do not have any evidence to say either men or women are more likely to get this,” he added.

The committee also found no evidence that taking the contraceptive pill caused higher risk of blood clots among those who have taken the AstraZeneca vaccine, said UK officials.

Men and women under 30 who had already had a first shot of the AstraZeneca vaccine should have the second dose, added the officials.

Emer Cooke, head of the EMA, said unusual blood clottings “should be listed as possible side effects of the [AstraZeneca] vaccine”. But the EU regulator also said it had not found evidence that women were more likely to be affected.

Van-Tam insisted the revised guidance would not change the timeline for the UK’s vaccine rollout so long as supplies of jabs from pharmaceutical companies came through as scheduled. “The effect on the timing of our programme should be zero or negligible,” he said. Nadhim Zahawi, UK vaccine minister, said the government was “confident” it would meet its targets.

The UK government’s main goal is to offer all adults a first dose of a vaccine by the end of July.

Britain has ordered 17m doses of the Moderna vaccine, which was first administered in Wales on Tuesday. Its introduction should ease pressure on the supply of vaccines for the under-50s, whose inoculations have been delayed.

AstraZeneca acknowledged the findings and said it had been collaborating with the authorities on their investigations into the blood clots. It was “already working to understand the individual cases, epidemiology and possible mechanisms that could explain these extremely rare events”.

The World Health Organization said a causal relationship between the vaccine and blood clots was “plausible” but “not confirmed”, adding that it would continue to investigate.

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