NHS England has cancelled all appointments it has made for patients aged under 30 to have their first Oxford/AstraZeneca Covid jab and advised them to discuss their vaccination with their GP.
GP-led sites have also been asked to cancel all appointments made for under-30s to have the vaccine, pending discussion between patients and their GP.
Clinics scheduled for today must ensure to have regulated healthcare professionals on site to discuss the risks of the vaccination with patients.
Second doses should go ahead except in very specific circumstances, NHS England added.
New advice from NHS England in light of yesterday’s updated guidance regarding the AstraZeneca Covid vaccine and blood clots refers to those aged under 30 who are in cohorts 1-9.
This includes health and social care workers, patients with underlying health conditions which puts them at higher risk from Covid and unpaid carers – as well as the recently added household members of the immunosuppressed.
- For those who have a first dose appointment at a vaccination centre or community pharmacy on or after 9 April, booked through the National Booking Service, these appointments will be cancelled centrally.
- For those booked via a local booking system, these appointments must be cancelled locally. Individuals will be asked to contact their GP team to discuss the benefit and risks to them of receiving the AstraZeneca or another vaccine.
It added that anyone who chooses to go ahead with the AZ vaccination following a discussion with a clinician should be offered one, while arrangements should be made for those who opt for an alternative vaccine.
The guidance said: ‘PCN-led Local Vaccination Services, working with system partners including hospital hubs, should rebook this individual in a clinic offering the Pfizer BioNTech vaccine over the coming four weeks. Guidance on how to access additional Pfizer BioNTech vaccine will follow shortly.’
As it is too late to cancel appointments made for today, ‘all sites should prepare to have individual conversations about the risks and benefits of receiving the AstraZeneca vaccine should individuals arrive for their appointment’, NHS England said.
‘This means all vaccination sites will need to put immediate measures in place to ensure that regulated healthcare professionals are available to support these conversations, using the materials provided by PHE.’
The vast majority of second dose appointments should still go ahead, the guidance added.
However, patients with a history of cerebral venous sinus thrombosis, acquired or hereditary thrombophilia, heparin-induced thrombocytopenia or antiphospholipid syndrome ‘should only be considered’ for the AZ vaccine ‘when the potential benefit outweighs any potential risks’.
And patients ‘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 Covid-19 Vaccine AstraZeneca’.
It comes as the MHRA yesterday said GPs should weigh up the benefits and risks of anyone at a higher risk of developing blood clots before administering the AZ jab.
Meanwhile, ‘anyone who has symptoms four days or more after vaccination is advised to seek prompt medical advice’, the MHRA said. These include:
- a new onset of severe or persistent headache, blurred vision, confusion or seizures
- develop shortness of breath, chest pain, leg swelling or persistent abdominal pain,
- unusual skin bruising or pinpoint round spots beyond the injection site
All of these measures come out of an abundance of caution, the MHRA stressed yesterday, as its review into vaccine-related thrombosis continues. They stressed any blood clots are extremely rare.