The benefits and risks of the COVID-19 vaccination

Public Health England has issued guidance, which sets out information on the benefits and risks of the COVID-19 vaccination, addressing concerns between the vaccination and blood clotting. It has also issued Blood clotting information for healthcare professionals and updated its vaccination guide for adults.

The release of the latest Public Health England guidance follows recent reports of a very rare condition involving blood clots and unusual bleeding after vaccination. The document says that these reports are being carefully reviewed, but the risk factors for this condition are not yet clear.

Although this condition remains extremely rare, the guidance explains there appears to be a higher risk in people who have had the first dose of the AstraZeneca (AZ) vaccine. Around four people develop this condition for every million doses of AZ vaccine doses given.

This is seen slightly more often in younger people and tends to occur between four days and two weeks following vaccination.

This condition can also occur naturally, and clotting problems are a common complication of COVID-19 infection. An increased risk has not yet been seen after other COVID-19 vaccines but is being carefully monitored.

Anybody experiencing the following from around four days to four weeks after vaccination are advised seek medical advice urgently:

• A new, severe headache which is not helped by usual painkillers or is getting worse.
• A headache which seems worse when lying down or bending over.
• An unusual headache that may be accompanied by:
  • blurred vision, nausea and vomiting
  • difficulty with your speech
  • weakness, drowsiness or seizures.
• New, unexplained pinprick bruising or bleeding.
• Shortness of breath, chest pain, leg swelling or persistent abdominal pain.

Those who have received their first vaccination dose with AZ vaccine without suffering any serious side effects are advised to have the second dose on time.

All adults aged 18 to 39 should still receive any of the available COVID-19 vaccines, says the guidance. Currently the Joint Committee on Vaccination and Immunisation (JCVI) has advised that it is preferable for people under 30 to have a vaccine other than AZ.

The full benefits and risks of the COVID-19 vaccination guidance document is available here.

COVID-19 vaccination guidance for adults updated

COVID-19 Vaccination: a Guide to Phase 2 of the Programme has been added to the latest advice.

The guidance explains phase 2 of the COVID-19 vaccination programme, who is eligible and who needs to have the vaccine to protect them from coronavirus.

It explains the types of COVID-19 vaccines available in the UK and highlights recent reports of an extremely rare condition involving blood clots and unusual bleeding after vaccination with AstraZeneca (AZ). This is being carefully reviewed, it says, but highlights that the risk factors for this condition are not yet clear. Because of the high risk of complications and death from COVID-19, the MHRA, the World Health Organisation and the European Medicines Agency have concluded that the balance is very much in favour of vaccination.

As the vaccine programme progresses, the Joint Committee on Vaccination and Immunisation (JCVI) will advise on the appropriate vaccine for each age group. The vaccine offered may depend on your age. Currently the JCVI has advised it is preferable for healthy people under 30 to have a vaccine other than AstraZeneca (AZ). The time when it will be offered will be based on the availability of those vaccines. Anybody who was previously eligible for vaccination remains so and should come forward to start or complete their recommended course.

The full guide, which addresses questions in relation to the COVID-19 vaccination programme, can be found here.

Blood clotting information for healthcare professionals

Public health England has also updated information is for healthcare professionals on blood clotting following COVID-19 vaccination.

Areas addressed by this guidance are as follows:

• Risk factors for developing this condition.
• Is this condition only associated with the AZ vaccine?
• How many people have developed the condition.
• How many of those affected die.
• Why isn’t the UK suspending use of the AZ vaccine?
• Can COVID-19 infection cause the same problem?
• Has this condition been reported after both the 1st and 2nd dose of COVID-19 vaccine?
• Is it affecting both men and women?
• Is it affecting any particular community?
• Signs and symptoms.
• What you should do if you suspect a case.
• Contraindications or cautions to receiving the AZ vaccine.
• Should we still give people their second dose?
• If someone has had a cerebral or major blot clot with low levels of platelets following the first dose of AZ vaccine.
• If somebody under 30 years has had AZ for their first dose – should they have the second?
• If a patient refuses the AZ vaccine.
• If a patient under 30 years old wants to have the AZ vaccine.

It is stressed that, as with all COVID-19 programme resources, this publication is subject to extensive and regular revisions.

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