12 burning questions about AstraZeneca’s jab and links to rare blood clots answered

THE possible link between the AstraZeneca jab and rare blood clots has left Brits with more questions.

Regulators have said there is a plausible link to the handful of cases among millions of people who have received a dose of the jab. 

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Because there is an early signal young people are more at risk, people under the age of 30 in the UK will be offered a different vaccine.

But regardless of the connection, officials have reminded people the benefit of getting a potentially life-saving Covid vaccine still far outweighs any side effect.

England’s deputy chief medical officer Professor Jonathan Van-Tam said blood clots - which have caused 19 deaths in the UK - are “vanishingly rare”. 

He reassured it was “quite normal” and “business as usual” for a change in how medicines and drugs are used in patients.

The family of one of the Brits who died of a blood clot less than three weeks after taking the AZ jab have also urged people to "keep saving lives" by taking the jab.

Dr Alison Astles said her brother, Neil Astles, 59, was “extremely unlucky”.

Here we answer your main questions about the vaccine:

1. Should I get my second dose?

Millions of Brits will wondering if they should get their second dose of the AstraZeneca vaccine, and experts have reassured they should.

People who will be invited for their second dose will be those most vulnerable to Covid - the elderly, NHS workers and those with underlying health conditions.

Prof Adam Finn, a member of the Joint Committee on Vaccination and Immunisation (JCVI), said for these people, “the risks of Covid-19 are real”, and by taking the vaccine “your chances of remaining alive and well will go up”.

Prof Van-Tam said: "It remains vitally important that people who are called back for their second dose come for it, and all adults in the UK come forward for vaccination when they are offered it."

Getting the second dose of your vaccine ensures you have optimal protection against Covid. 

Professor Anthony Harnden, deputy chair of the JCVI, said his “strong advice” is for people to get their second one, because it is not known how long protection from a first dose will last.

2. Can I mix and match and have a different jab for my second dose?

The safest option right now is to have the same vaccine for both doses, Prof Harnden said.

There are ongoing studies to see whether two separate vaccines - which use different technologies - work well together.

But at the moment, it is “an evidence-free zone”, Prof Harnden told Good Morning Britain, adding: “We just don’t have that data and we don’t have the safety data on doing that.

“So by far the safest option at the moment would be to receive the same vaccine type. People should not lose confidence in this Oxford/AstraZeneca vaccine, it’s a great vaccine.”

3. What is the risk in numbers?

The risk of getting a blood clot after the AZ jab is miniscule - and is, in fact, less than you would expect in the normal course of events.

The MHRA said the risk of an unusual blood clot in relation to the AZ jab is four in a million.

This is based on the 79 reports of such cases in 20 million people who have received a first dose of the AstraZeneca vaccine.

The Health Secretary Matt Hancock said the risk was the same as getting a blood clot from a long-haul flight.

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Thrombosis UK has also said taking the contraceptive pill makes you two or three times more likely to develop a clot - but this is considered perfectly safe.

Of the 79 cases in the UK, 19 resulted in death. It means the risk of death is roughly one in a million. 

Meanwhile, if you avoid the jab and then catch Covid, you are two per cent more likely to develop a clot, statistics suggest.

People who get Covid have died of blood clots. 

Sir Munir Pirmohamed, chairman of the Committee on Human Medicines, said at the MHRA briefing that some 7.8 per cent of people with Covid suffer blood clots on the lungs, while 11.2 per cent will suffer deep vein thrombosis (DVT).

4. If the risks are so small, why can young people not have the vaccine?

Officials had to work out whether the risk of the side effect was worth younger people taking the vaccine.

The younger someone is, the lower their risk of dying from Covid. But the data on blood clots after the AZ jab has suggested that younger people appear to be more affected. 

On the balance of risk, the MHRA decided younger people should be offered a different coronavirus vaccine.

Professor Wei Shen, chairman of the Joint Committee on Vaccination and Immunisation said the recommendation was “out of the utmost caution” rather than because of “any serious safety concerns”.

JVT showed an in-depth explanation of the risks of the vaccine, compared with the risk of ending up in intensive care with Covid, for each age group.

Slides revealed that for people in their 20s, 2.2 ICU admissions per 100,000 people would be prevented by vaccines in a 16-week period - the lowest of any age group given that younger people are not as at risk of severe Covid. 

This is when there is 60 cases of Covid per 100,000 people - just above the average in the UK now.

The risk of “serious harms” due to the vaccine, however,  is 1.1 per 100,000 in a 16-week period, which is the highest of any age group.

The MHRA has concluded that the balance of risk for the vaccine is “very favourable for older people” but more finely balanced for younger groups.

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5. Why is it still offered to people in their 30s and 40s?

Other European countries have said anyone under the age of 50 to 70 should not receive the AstraZeneca vaccine as a precaution.

So why is the UK still recommending it for those in their 30s and 40s? 

JCVI chair Professor Wei Shen said every country makes their own decisions when taking into account the risk of a next wave, the amount of vaccine supplies, and the values of its own people - which varies greatly between nations.

Europe is in a very different place to the UK right now - it is experiencing a third wave and its vaccine rollout has been poor.

And it was only a few weeks ago that some countries were ONLY giving the jabs to younger people, claiming it was ineffective in the elderly.

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Asked why the UK was taking a different approach to some EU nations, Mr Hancock told the Today programme: “I think we are taking the right approach, to be as safe as possible, but not to lose out on the benefits that vaccinations bring."

He said the benefits of use of all vaccines among 40 year olds “spectacularly” outweighs the risks. .

Prof Shen recommended those who are just over the age threshold should make their own decision - but insisted taking the jab is the safer option.

He told the briefing: “For somebody who is 31 or 32 I think they have to make their own decision as to what they want to do about vaccination.

“We would still say that the balance is in favour of being vaccinated because of the risk from Covid-19 and the protection the vaccine offers.”

6. Why vaccinate young people at all?

Young people have a considerably lower risk of Covid death, but Mr Hancock urged the under-30s to take a vaccine from Moderna and Pfizer when offered.

He said this would help protect their own family and society at large.

But also, it will prevent a young person from catching Covid and then suffering long-term persistent symptoms.

Mr Hancock said: "Covid is a horrible disease and long Covid affects people in their 20s just as much it seems as any other age group and can have debilitating side effects that essentially ruin your life."

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Professor Jeremy Brown, a member of the Joint Committee on Vaccination and Immunisation (JCVI), said “the benefit of vaccinating young people is not just preventing severe disease”. 

Talking to Sky News, he said: “It actually will prevent them catching Covid, and if they don’t get Covid then the chance of developing so-called long Covid – the symptoms you get which many people get, about 10 per cent, after they’ve had even a very mild infection – that will prevent that.”

He added: “It also allows younger people to visit their relatives who are elderly and more vulnerable to the disease, without the risk of infecting them. It will reduce the chance that a young person can infect their elderly relatives with this disease, which is a benefit.

“Lastly, there are social benefits which have been much discussed over the past few days – travel, for example. I think it’s unlikely that people will be allowed to travel out of the country easily unless they have been vaccinated.”

Prof Van-Tam said vaccines “continue to be the way out for the UK” and for Brits to “get our lives and the economy back to normal”. 

7. What are the alternatives for under-30s?

The roughly 10.2 million healthy people aged 18 to 29 years old won’t be offered a vaccine for a few weeks yet.

But when they are, it will be the Pfizer or Moderna vaccines.

Mr Hancock said today there were “more than enough” supplies of the Moderna and Pfizer doses for this age range.

Both use different technology than the Oxford-AstraZeneca jab called “messenger RNA (mRNA)”. 

Conventional vaccines are produced using weakened forms of the virus, but mRNAs use only the virus’s genetic code, meaning no actual virus is needed to create an mRNA vaccine.

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8. Will the rollout still hit targets?

Mr Hancock said the UK is still “on track” to hit its target of offering all adults the shot by the end of July and “we are in good shape” on future supply of doses.

Prof Harnden also said he is “pretty confident” there will be enough vaccine to reach the target of offering a first dose to all adults in the UK by the end of July.

At the MHRA briefing, Prof Van-Tam said after speaking to colleagues in the NHS, the “effect on our timing of our programme should be zero or negligible”. 

9. What are the symptoms of the rare blood clots?

Brits should seek medical attention if they have "rare side effects" for more than four days after inoculation, experts today urged.

These are:

• A persistent headache: a severe headache that is sudden or progressive.
• Vision blurring: or other neurological issues such as face, arm or leg weakness, disturbance of speech, confusion, drowsiness or seizures.
• Shortness of breath: when you are gasping or struggling to take in enough air.
• Chest pain.
• Leg swelling.
• Abdominal pain.
• Bruising: That can’t be explained by anything else, or pinpoint round spots beyond the injection site.

10. Should you get the vaccine if you’ve previously had a blood clot?

It goes without saying that if someone suffered a blood clot after they had an AZ vaccine, they should not get the second dose.

But what about people who have had a blood clot in the past, or are at risk of one?

The MHRA previously said there is no evidence that the AZ jab increases the risk of blood clots generally - such as DVT - and it is a rare combination of blood clotting events with low blood platelets that have been under the microscope. 

But the agency advises “careful consideration be given to people who are at higher risk of specific types of blood clots because of their medical condition”.

It said this was precautionary. 

The agency added that the benefits still outweigh the risks and that “everyone should continue to get their vaccination when asked to do so unless specifically advised otherwise”.

Pregnancy predisposes to blood clotting, and so women should discuss with their GP whether the benefits of having the vaccine outweigh the risks for them.

11. Can I reduce risk of a blood clot by taking aspirin before jab?

Experts say this advice circulating on social media is a myth and may be harmful. 

Aspirin will not tackle the type of blood clot being investigated and may cause bleeding.

12. What else causes blood clots?

There are several risk factors for blood clots in general, including sitting for long periods of time, smoking and drinking alcohol.

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They affect people of all ages, and can go unnoticed if the patient doesn’t know the signs. 

Experts have said it could even be that the patients who had blood clotting actually caught Covid-19 before their jab had time to kick in.