13 April 2021
All appointments made for patients aged under 30 to have their first Oxford/AstraZeneca (AZ) Covid-19 vaccine have been cancelled by NHS England; patients have been advised to discuss their vaccination with their GP.
GP-led sites have also been asked to cancel all vaccination appointments made for under-30s, pending discussion between patients and their GP. NHS England said second doses should go ahead except in very specific circumstances.
This follows new Joint Committee on Vaccination and Immunisation (JCVI) recommendations that under-30s who are in phase 1 of the vaccine rollout, and remain unvaccinated, should be offered an alternative Covid-19 vaccine to the AZ vaccine if it is available after establishing an “extremely rare” blood clot risk.
NHS England’s new advice regarding the AZ vaccine, here, refers to people aged under 30 who are in cohorts 1 to 9, including health and social care workers, patients with underlying health conditions that put them at higher risk from Covid-19, and unpaid carers as well as household members of the immunosuppressed.
It advises that, 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, their appointments will be cancelled centrally.
For those booked through a local booking system, their appointments need to be cancelled locally. Individuals will be asked to contact their GP team to discuss the benefit and risks to them of receiving the AZ or another vaccine.
Anyone who chooses to go ahead with the AZ vaccination after a discussion with a clinician should be offered one, while arrangements should be made for those who opt for an alternative vaccine.
The guidance added that the majority of second dose appointments are still to go ahead. 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”.
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 Medicines and Healthcare products Regulatory Agency (MHRA) said GPs should weigh up the benefits and risks of anyone at a higher risk of developing blood clots before administering the AZ jab. It also said “anyone who has symptoms four days or more after vaccination is advised to seek prompt medical advice”.
GPs have warned of unintended consequences from the Government’s latest AZ Covid-19 vaccine advice, including creating “panic” among patients and adding to the workload of already pressured practices.