Expert says there is NO evidence uptake of AstraZeneca jab is slowing
Public health expert says there is NO evidence uptake of AstraZeneca jab is slowing in UK after European countries paused its rollout over blood clot fears
- Professor Linda Bauld said all studies indicated the jab was safe and effective
- Germany has suspended use of the AstraZeneca vaccine for people under 60
- Professor Bauld said reports of blood clots were ‘very rare’ and link is unlikely
Professor Linda Bauld of Edinburgh University said there is no evidence that the uptake of AstraZeneca jab is slowing in the UK
There is no evidence that the uptake of AstraZeneca jab is slowing in the UK despite European countries pausing their rollout of the company’s vaccine, a public health expert has claimed.
Professor Linda Bauld of Edinburgh University said all studies indicated the jab was safe and effective, while the fact different countries were reviewing their position was a sign that the system was working.
Germany has suspended use of the AstraZeneca vaccine for people aged under 60 due to fears of a link with rare blood clots.
On Friday, the Dutch government also said it would temporarily halt AstraZeneca jabs for people under 60, after it received five reports of blood clots with low blood plate counts following vaccinations.
It comes as the MHRA insisted there is no evidence of a link between the AstraZeneca jab and blood clots.
Seven people in Britain have died of a blood clot on the brain after having an AstraZeneca coronavirus vaccines out of 18.1million doses, the regulator revealed.
Speaking to the BBC’s Good Morning Scotland radio programme, Professor Bauld said reports of blood clots were ‘very rare’ and a direct link to the vaccine was very unlikely.
Professor Bauld said: ‘These kinds of pauses and reviews are a sign that the system is working.
‘Because when you see either deaths or unlikely adverse events that you wouldn’t anticipate or you didn’t see in the trials it’s reasonable for regulators to look at this.
‘The MHRA is still consistently saying there’s no cause for concern and that is absolutely the message to people.’
She added: ‘It doesn’t look from the behavioural response, the surveys I’ve seen, that it’s affecting uptake in the UK and that’s really important.’
Professor Bauld said she had recently received her blue letter inviting her for vaccination and she was ‘really looking forward’ to it.
Germany has suspended use of the AstraZeneca vaccine for people aged under 60 due to fears of a link with rare blood clots
It comes as the MHRA revealed just seven people in Britain died of a blood clot on the brain after having an AstraZeneca coronavirus vaccines out of 18.1million doses.
It has also emerged that young people are up to 35 times more likely to die of Covid than to develop the type of brain blood clot that European officials fear could be caused by AstraZeneca’s jab, figures suggest.
German medics have seen one case of CVST — a type of rare brain blood clot that can cause strokes — in every 90,000 people to receive the vaccine, and say that is higher than expected. It is equal to a rate of 0.0012 per cent.
The UK’s MHRA regulator last night announced it has seen 30 cases and similar clots after 18.1million doses – around one in every 600,000 people (0.00017 per cent).
For comparison, Cambridge University academics tracking the Covid outbreak say the risk of dying of Covid for 25 to 44-year-olds is 0.04 per cent — around 33 times higher than even Germany’s incidence of CVST.
CVST, or cerebral venous sinus thrombosis, is a blockage in a vein that carries blood away from the brain and it can lead to strokes or bleeding inside the skull.
And even under-25s, who have a vanishingly small risk of being killed by coronavirus, may be four times more likely to die than to develop the condition after getting the AstraZeneca vaccine.
The UK’s health watchdog said on Thursday night it hadn’t seen CVST cases in people who got the Pfizer jab but there was still no proof the AstraZeneca vaccine is raising the risk.
This may be because different groups of people are getting different vaccines.
Germany this week went against the European regulator’s advice and banned the AstraZeneca jab for under-60s because it fears a link to the condition.
Scientists say the balance of risk is ‘very straightforward’ and clearly in favour of vaccination because of the ‘extreme rarity’ of CVST cases.
The risk of dying from Covid-19 is significantly higher than the rate of CSVT blood clots, which haven’t even been definitively linked to the vaccines (Based on fatality estimates from Cambridge University and CSVT occurrences in Germany)
Officials in Frankfurt recorded 31 cases of the condition among 2.7million people to have been given the AstraZeneca jab and have been alarmed by the number.
But this is a rate of just 0.0012 per cent. By comparison, experts estimate the risk of dying of Covid for 25 to 44-year-olds is 0.04 per cent – 33 times higher.
For 15 to 24-year-olds the Covid death risk is 0.005 per cent, making it four times more likely.
Forty under-20s have died in England, out of 86,351 in total, along with 598 20 to 40-year-olds.
And the main benefit of giving the vaccine to younger people is that it protects elderly members of society, whose risk of death is much higher, and therefore allows ministers to loosen lockdown rules.
Professor Adam Finn, a University of Bristol researcher and government adviser on vaccines, said: ‘The extreme rarity of these events in the context of the many millions of vaccine doses that have been administered means that the risk-benefit decision facing people who are invited to receive Covid vaccines is very straight forward: receiving the vaccine is by far the safest choice in terms of minimising individual risk of serious illness or death.’
Comparing the rates of CVST to coronavirus death is tricky for a number of reasons, including that it’s so rare data aren’t clear, and that more people will get a jab than catch coronavirus.
Regulators also don’t break down the CVST cases by age, although they are thought to be more common among young adult women.
A TIMELINE OF THE ASTRAZENECA BLOOD CLOT SAGA
March 7: Austria suspended the use of one batch of the vaccine after a woman, 49, who had been given it died of a ‘severe coagulation disorder’ and a 35-year-old developed a blood clot in her lung.
March 11: Authorities in Denmark, Norway and Iceland suspended all use of the vaccine following a 60-year-old woman in Denmark died of a blood clot after the reports emerged in Austria. Danish health minister Magnus Heunicke said: ‘It is currently not possible to conclude whether there is a link.’
March 11: European Medicines Agency’s safety committee began an investigation into the cases. It confirms 30 cases of ‘thromboembolic events’ – clots – were reported after five million vaccines in the EEA.
March 12: Thailand suspended the use of the vaccine off the back of European worries. Bulgaria also stops using it.
March 12: The European Medicines Agency, Britain’s Medicines and Healthcare products Regulatory Agency, Health Canada, the World Health Organization and AstraZeneca itself, all spoke out to defend the vaccine and say there is no proof it’s linked to blood clots.
March 13: The Netherlands, Italy and Ireland temporarily stopped using the vaccine as fears about the cases in Austria and Denmark snowballed.
March 14: Germany and France suspended the vaccine.
March 15: Spain, Portugal and Slovenia suspended use of the jab.
March 15: Professor Andrew Pollard, the Oxford expert who ran the clinical trials of the jab, insisted safety data are ‘reassuring’ and said ‘clearly those blood clots still happen’ as often as they would in unvaccinated people.
March 16: World Health Organization officials met to discuss the issue. European Medicines Agency is still investigating.
March 17: Scientists accuse governments of banning the jab on political grouns. AstraZeneca’s vaccine has been a flashpoint in the past.
March 18: European Medicines Agency holds a press conference on its investigation and rules that the vaccine is ‘safe and effective’. It said there wasn’t enough evidence to rule out a link to blood clots, but also not enough to prove one. On balance, it would be safer for countries to keep using the vaccine to stop Covid. The investigation would continue.
March 18: Germany, France and Italy resume use of the jab after the EMA’s conclusion.
March 19: Finland suspends the jab after finding blood clot cases in its own population.
March 19: Bulgaria, Cyprus, Ireland, Latvia, Lithuania, Netherlands and Spain all confirm they will start using the jab again. Scandinavian countries did not follow suit and kept the ban in place.
March 22: A study is published that found public trust in the AstraZeneca vaccine collapsed in Europe at the time of the blood clot saga. A YouGov survey found more than half of people in Germany, France, Italy and Spain believed the jab was unsafe.
March 30: Germany bans the vaccine for people under the age of 60 after officials said they had found 31 cases of CSVT after 2.7million vaccinations.
April 2: UK regulators announce a total of 30 blood clots, 22 in the brain, have now been discovered in Britons vaccinated with the AZ jab.
And the fatality rates for coronavirus, estimated by Cambridge University experts only include people who get the virus.
This means the average person’s actual risk of dying from coronavirus is significantly lower than the estimate because not everyone catches it – although if nobody took the vaccine, the likelihood of them catching it one day is far higher.
Most recent calculations by the Cambridge team suggest the risk of dying of Covid is lowest for toddlers and babies, at 0.00039 per cent, around one in 256,000.
It’s highest for over-75s, at 6.9 per cent, or one in 14. And overall, the risk is around 0.3 per cent, meaning that across the whole population around three in every thousand infected people die.
Another complication is that there is no proof the coronavirus vaccine causes CSVT, meaning the cases that happen may have occurred anyway.
If this is the case, the risk caused by the vaccine is effectively zero and the jab is infinitely safer than being unvaccinated.
But even if a link is established, it will be difficult to know how many cases are triggered by the jab in people who would not otherwise have developed CVST.
And CVST is more often survived than it is fatal. Medics say if it’s spotted in time – before it blocks the vein – it can be simple to treat with blood thinners.
Johns Hopkins University in Baltimore, US, estimates that one in every 200,000 people of all ages develop CVST each year.
The European Medicines Agency said on Wednesday, echoing data from Germany, that the risk appears to be one in 100,000 in under-60s who have had the AstraZeneca vaccine.
But much of the data comes from Germany’s AstraZeneca vaccine patients, who are mostly young female adults, and young female adults are statistically more likely to get CSVT even when there is no vaccine around.
EMA director Emer Cooke said cases in women usually outnumber those in men by 10 to one.
The contraceptive pill and smoking may be risk factors for this – scientists are investigating the links.
So without the large pool of men, elderly people and children to dilute the pool with their low CVST risks, the rate appears unnaturally high in the vaccinated group.
In the wake of EU scare stories over the AstraZeneca jab, which came amid a row over supplies, the MHRA last month said there had only been five cases of CVST among 11million administered doses.
In Thursday’s update, which takes into account all adverse reactions recorded up until March 24, it put the count at 22.
The watchdog also revealed it had eight reports of other serious clotting events associated with low blood platelets.
The MHRA said: ‘Our rigorous review into the UK reports of a rare and specific type of blood clot is ongoing.
‘On the basis of this ongoing review, the benefits of the vaccines against Covid continue to outweigh any risks and you should continue to get your vaccine when invited to do so.’
The tenuous links between the vaccine and CVST are still mired in confusion because experts in Germany and other countries where the jab has been halted claim the condition is most common in women.
But all five of the original cases in the UK were among men.
The MHRA did not offer any more details about the new 25 cases. It is unclear how many died.
Earlier this week, Germany announced it would stop giving AstraZeneca’s jab to under-60s because of the link to CVST.
It said the country had seen 31 cases out of 2.7million people given the jab. This suggests 0.0011 per cent of people who were vaccinated later developed the clot – around one in 90,000 people.
However, other major European countries have also restricted the jab to certain age groups, even though they have seen significantly fewer CVST cases despite vaccinating more people.
If the same rate of CVST in Germany had appeared in the UK, almost 200 people would have been diagnosed with it already because six times as many jabs have been used.
The European regulator the EMA also revealed this week twice as many women had received AstraZeneca’s jab in Europe as men, before adding that the people normally most at risk of CVST are females aged 35 to 45.
Until recently, Germany had banned the AZ jab for over-60s due to initial fears about blood clots.
At least 10 countries in Europe, joined by Germany last night, have put some kind of restriction on the use of AstraZeneca’s jab, mostly opting to give it only to over-60s because the CSVT cases seem to be happening in younger adults
It raises the possibility that the rates of CVST among vaccinated people Germany can be explained by more women who are susceptible to the condition being targeted by German rollout.
AstraZeneca insists there is no proof the jab causes blood clots and that rates are not higher than expected overall.
Experts have said it would be unusual that the vaccine could make one ultra-specific type of blood clot more likely but not blood clots in general.
Spain, France and Italy have recorded, at most, one CVST case per million patients despite using the jab on similar age groups to Germany.
But scientists and regulators insist there’s still no evidence the vaccine is causing blood clots or any other severe side effects and that the risk of Covid is greater.
It was also revealed yesterday that Australia is investigating whether AstraZeneca’s Covid jab is linked to blood clots.
Local media reported a 44-year-old man was admitted to a Melbourne hospital with possible clotting days after receiving the vaccine.
Health chiefs said more details would come to light in the coming days and that there was no proof the jab was to blame.
Although there isn’t any evidence that the blood clots are developing because of vaccinations, some academics have a theory that it is the immune reaction making it happen.
Research teams in Germany and Norway claim the blood clotting issue may be caused by the jab, in very rare cases, making the body attack its own platelets.
Platelets are tiny chunks of cells inside blood that the body uses to build clots to stop bleeding when someone is injured. But they can also make unwanted clots.
This chart shows how Britain is still racing ahead of the EU in vaccinating its population against Covid-19, more than three months after the continent started its jab programme
Where Britain’s vaccine doses are made: AstraZeneca doses (yellow) are mainly produced domestically while Pfizer’s are imported from Europe. Moderna’s will start to be shipped from n Switzerland, which is not an EU member and so not under the EU’s jurisdiction, as well as in Spain
Experts from Oslo and Greifswald University believe the jab could cause the body to produce antibodies – normally used to fight off viruses – which mistake platelets in the blood for foreign invaders and attack them.
WHAT IS CVST?
Cerebral venous sinus thrombosis (CVST) is an extremely rare type of blood clot in the brain.
It occurs when the vein that drains blood from the brain is blocked by a blood clot, resulting in potentially deadly bleeding on the brain.
Symptoms can quickly deteriorate from a headache, blurred vision and faintness to complete loss of control over movement and seizures.
John Hopkins University estimates it affects five in a million people in the US every year, which would suggest 330 patients in Britain suffer from the condition annually.
According to the university, it can affect patients with low blood pressure, cancer, vascular diseases and those prone to blood clotting. Head injuries can also trigger the condition.
Britain’s regulator said CVST is so rare they aren’t even sure how common it is in the general population.
To compensate, the body then overproduces platelets to replace those that are being attacked, causing the blood to thicken and raising the risk of clotting.
They admitted they ‘don’t know why this is happening’.
But the researchers say the phenomenon is similar to one that can occur in heparin-induced thrombocytopenia (HIT), when sufferers take a drug called heparin.
Experts say the condition has not been proven to be caused by the jab and may simply be showing up just because millions of people are being vaccinated and reporting their health conditions.
They added that, if spotted early, it could be diagnosed with a simple blood test and quickly treated with blood-thinners.
It comes after it was revealed last night that UK taxpayers pumped £21million into fitting out a Dutch vaccine factory to make AstraZeneca jabs before the EU threatened to ban their export from the continent.
Health Secretary Matt Hancock approved the multi-million pound investment in the Halix factory in Leiden with the guarantee that doses would be sent to the UK.
Initially, it was hoped that Brussels and London could split the jabs produced.
But a senior EU official has threatened to block all AstraZeneca supplies from entering Britain until the drugmaker ups its deliveries to the bloc – putting the factory at the centre of the row.
Thierry Breton – the EU’s internal market commissioner – said ‘zero’ AstraZeneca jabs made on the continent would be shipped across the Channel until the company fulfilled its commitments to Europe.
He said ‘there is nothing to negotiate’ between the EU and the UK.
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