UK’s Joint Committee on Vaccination and Immunisation is now advising healthy adults younger than 40 “to receive an alternative to the Oxford/AstraZeneca vaccine – where available and only if this does not cause substantial delays in being vaccinated”.
This is based on the fact that “the chances of a younger person becoming seriously ill with #COVID19 get smaller as infection rates increasingly come under control in the UK”. @GretchenVogel1 and explored these trade-offs in risk and benefit here:
@GretchenVogel1 UK's regulator, the MHRA:
"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” gov.uk/government/new…
@GretchenVogel1 Emerging evidence suggests that second dose of AZ is not associated with the same amount of clotting disorders haematologist Beverly Hunt said just now in @SMC_London briefing. Some similar cases, but apparently not a single one with anti-PF4 antibodies so far.
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“I know that this is not a politically easy thing to do. So I very much appreciate the leadership of the United States", says @DrTedros at @WHO presser on #covid19 about US support for #TRIPSwaiver “We urge other countries to follow their example.”
@DrTedros@WHO "We are in an unprecedented crisis that requires unprecedented action”, says @drtedros.
“The World Trade Organization provisions for IP waivers were designed precisely for a situation like this.
If we don't use them now, then when?"
@DrTedros@WHO This is important news:
"This afternoon, WHO gave emergency use listing to Sinopharm Beijing's #COVID19 vaccine, making it the sixth vaccine to receive WHO validation for safety, efficacy and quality."
So where are we on the rare clotting disorder linked to AZ and J&J shots? What do we know? How do risks and benefits compare? What does it mean long-term and around the world? @GretchenVogel1 and I tried to answer some questions, thread to come in a bit.
First off:
This is complex and I‘m tired of people pretending it‘s all obvious.
So a few general points about the decisions that have to be made here:
They are
- local, but with global implications
- based on imperfect data in an evolving pandemic
- about individual decisions as well as population-level effects (and these two things can point in opposite directions)
In the US the Advisory Committee on Immunization Practices (ACIP) is meeting at the moment to discuss data on the rare clotting disorders seen after immunization with J&J’s #covid19 vaccine and to make recommendations on future use of the vaccine.
I’ll tweet along a bit.
Outcomes from the rare clotting disorders are likely to improve from "recognition among physicians also recognition in the public that if you develop a severe headache, severe abdominal pain that you really need to see your doctor", says @mstreif1.
@mstreif1 As of 21 April, 15 confirmed cases of the rare clotting disorder (here called TTS, Thrombosis with Thrombocytopenia Syndrome) after about 8 million vaccinations with J&J’s #covid19 vaccine, says @CDCgov's Tom Shimabukuro
“We have now heard of 8 cases of these very rare side effects as part of the rollout in the US, where the vaccine has been given to over 7 million vaccinees”, says EMA head Emer Cooke at press briefing on the safety review of J&J's #covid19 vaccine.
“This is a very rare effect but it also makes it very important for doctors and patients to be aware of the signs so that they can spot any concerns and seek specialist help as soon as possible”, says Cooke. "Early intervention by specialists can change the outcome."
"The scientific assessment that PRAC has concluded on today will allow vaccination programs in member states to take decisions on how to roll out this vaccine based on their national situation” (infections, hospitalizations, ICU admissions, vaccine availability), says Cooke.
Getting a bit annoyed at everyone using numbers from yesterday’s Oxford pre-print to compare how often CVST occurs after mRNA vaccines and AstraZeneca vaccine.
We cannot directly compare these numbers because they came about in completely different ways.
The authors say so themselves IN the preprint:
"we cannot directly compare the risks of CVT associated with ChAdOx1 nCoV-19 with any of the other vaccines, or with COVID-19, since we are using data collected by the EMA monitoring system, not from the electronic health records..."
And yes, @UniofOxford press release does exactly that anyway:
"Compared to the AZ-Oxford vaccine, the risk of a CVT from COVID-19 is about 8 times greater."
This is one reason (of many) why we need science journalists and not just press releases.