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08th April 2021

AstraZeneca COVID-19 Vaccine Update (Last update: 08.04.21)

Following the remarkable COVID-19 vaccination programme, which has so far resulted in over 30 million people receiving their first dose of the vaccine, there have been some reports of an extremely rare adverse event of concurrent thrombosis (blood clots) and thrombocytopenia (low platelet count) following vaccination of the first dose of AstraZeneca ChAdOx1 nCoV-19 vaccine (AZD1222). To date, there are no reports of adverse events following the second dose of this vaccine.

There hasn’t been any indication for thrombosis/thrombocytopenia following the injection of other COVID-19 vaccines approved for use in the UK, currently Pfizer-BioNTech and Moderna, which is encouraging.

Following the update on 7 April 2021 from the Medicines and Healthcare product Regulatory Agency (MHRA) and the independent Joint Committee on Vaccination and Immunisation (JCVI), revised guidance has been published about the safety and use of the AstraZeneca COVID-19 vaccine in younger adult age groups.

NHS England has also issued a letter announcing the key points, next steps and what Practices should do.

Second Dose:

Who should have the AstraZeneca COVID-19 vaccine?

  • People who have received a first dose of the AstraZeneca vaccine should continue to be offered a second dose of the AstraZeneca vaccine, irrespective of age
  • For people in cohorts 1-9 who have received the first dose of AstraZeneca and are due to receive their second dose, no further action is required and these appointments should continue

Who should not have the AstraZeneca vaccine?

  • People who have experienced major venous and arterial thrombosis occurring with thrombocytopenia following vaccination with any COVID-19 vaccine should not receive a second dose of the COVID-19 Vaccine AstraZeneca
  • People with a history of the following should only be considered when the potential benefit outweighs any potential risks:
    1. Cerebral venous sinus thrombosis
    2. Acquired or hereditary thrombophilia
    3. Heparin-induced thrombocytopenia
    4. Antiphospholipid syndrome

First Dose:

People in cohorts 1-9 aged 30 years and above who are scheduled to receive a first dose of AstraZeneca, vaccination should continue with consent obtained in line with the recommendations set out in the Green Book.

Adults under 30 without underlying health conditions

People in cohorts 1-9 aged under 30without an underlying health condition, who have yet to receive a COVID-19 vaccination and are scheduled to receive a first dose of AstraZeneca on or after the 9 April:

  • Will have their appointment cancelled centrally if they are due to have their first dose at a vaccination centre or community pharmacy which was booked through the National Booking Service
  • Will have their appointment cancelled locally if it was booked through a local booking system
  • Will be advised to contact their GP Practice to discuss the benefit and risks to them of receiving the AstraZeneca or another vaccine
  • Will be offered the AstraZeneca vaccine if, following a conversation with a clinician, they choose to go ahead and have the AstraZeneca vaccine
  • Will be offered the Pfizer BioNTech vaccine, over the next four weeks, if they choose not to have the AstraZeneca vaccine

People who have contraindications or conditions that require special precautions for use of the AstraZeneca vaccine

People in this category attending a booked appointment:

  • Will be asked by a clinician about additional risk factors, using the materials provided. If they are at increased risk, they should have a discussion about the benefit and risks to them of receiving the AstraZeneca or other vaccine
  • Will be offered the AstraZeneca vaccine if, following a conversation with a clinician, they choose to go ahead and have the AstraZeneca vaccine
  • Will be rebooked and offered the Pfizer BioNTech vaccine, over the next four weeks, if they choose not to have the AstraZeneca vaccine

All vaccination sites should be prepared to discuss the risks and benefits of receiving the AstraZeneca vaccine during a booked appointment, which will mean having regulated healthcare professionals available to support these conversations, using the materials provided by PHE.

MHRA and JCVI have emphasised the balance of risk is still very much in favour of vaccination. Therefore it’s critical that the vaccination programme is delivered in a similarly balanced and operationally robust manner.

*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

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