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The AZ issue is a headache for everyone

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It goes without saying that every case where someone has suffered a blood clot after having the AZ vaccine is awful. But I really fear that the way the Government’s new advice around the vaccine has been presented is to the benefit of no one.

Copperfield makes the point that a little bit of knowledge for patients is dangerous, and any GP who has competed with Dr Google would agree. 

I fear that this blood clotting issue could be the first major hindrance in what has so far been an exceptional vaccination programme. GPs are rightly warning about ‘causing panic’ among patients of all ages, and the workload implications of people with headaches turning up to general practice (and we have a useful guide here).

And I feel that the health authorities – even the calming Professor Jonathan Van-Tam – have handled this wrong. The slides demonstrating the risks were themselves harmful in the first place: first, they stripped out all potential outcomes of not having the vaccine other than ICU admissions – which ignores the risk of Long Covid, for example; second, those over the age of 30 won’t be comparing the risks of having the AZ vaccine with the risks of not having any vaccine – they will be comparing the risks of having the AZ vaccine with having Pfizer or Moderna, and they may well demand this; and third, the risks were presented at an individual level, when the real benefit of under-30s getting the vaccine is at a population level (as an aside, let’s reject any idea that the younger generations have been selfish during the pandemic – but presenting info like this will cause even the most altruistic to be concerned).

This is without even mentioning the psychological factors around the ‘definite’ risks of actively having the vaccine v the ‘theoretical’ risks of catching Covid, or the autonomy patients have when they decide to start taking the contraceptive pill, for example, against the pressure being placed on them to have the Covid vaccine.

But following this up with advice that under-30s should not be given AZ simply caused unnecessary fear. As many have pointed out, the risks are lower than for many other medications (though I would say pointing out the risks of other medication don’t help – my wife, also a healthcare journalist, is currently writing a piece about how women’s health groups are worried the constant comparisons with the contraception pill are beginning to affect their uptake).

This might not be fashionable to say, but a paternalistic approach might have been best in this case: no pause on the vaccines; telling patients there are risks associated with every medication, but the risks of not taking medication are higher, regardless of the age; anyone who has risk factors should be given a different vaccine; the red flags should be spelt out clearly, with NHS 111 for example ready to deal with this.

Or, in other words, deal with it in exactly the same way you deal with less high profile medication.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at


Charilaos Minas 17 April, 2021 12:14 pm

Needles in a (scared, skeptical,….insert your own adjective here) haystack: unrealistic optimism (“If I didn’t get Covid until now I’ll be fine without the vaccine”) versus unwarranted vaccine skepticism (4 cases per 1,000,000 AZ doses: but what if it’s me?). Reconciling the irreconcilable: my risk of getting covid without a vaccine is much higher than the risk of side effects due to immune system response to AZ vaccine but the first might be perceived as “fate” whereas the latter is “a choice”. The weird and wonderful working ways of the reptilian part of the human brain, in all its glory…