Covid-19: Under 40s should get choice of vaccine, say UK officials

British officials said on Friday people under 40 should be offered an alternative to Oxford/AstraZeneca’s Covid-19 vaccine where possible due to a small risk of blood clots, given the low number of cases and the availability of other shots.

AstraZeneca’s Covid-19 shot, developed by Oxford University, has resulted in reports of rare blood clots with low platelet levels that occur more commonly in younger adults. Some countries have advised the shot be given only to older people.

Officials emphasised the benign domestic conditions that provided the context for the decision, on the same day that Germany went the other direction and made the shot available to all adults who might want it.

The UK's Joint Committee on Vaccination and Immunisation (JCVI)said the advice reflected low levels of Covid-19 infection in Britain and the availability of other vaccines made by Pfizer and Moderna.

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Officials said Britain would still offer a first dose of Covid-19 vaccine to all adults by the end of July, and emphasised it was better for people in the age group to receive AstraZeneca’s shot if no other one was available.

"As Covid-19 rates continue to come under control, we are advising that adults aged 18 - 39 years with no underlying health conditions are offered an alternative to the Oxford/AstraZeneca vaccine, if available and if it does not cause delays in having the vaccine," said Wei Shen Lim, COVID-19 Chair for JCVI.

“The advice is specific to circumstances in the UK at this time and maximises use of the wide portfolio of vaccines available.”

Previously, advice was only for people under 30 to be offered an alternative vaccine.

The British MHRA medicine regulator has found an incidence of 17.4 clots per million doses of the vaccine among 30 to 39 year olds, compared with 10.5 clots per million doses overall.

There have been 4.5 deaths per million doses for the 30 to 39 year olds, compared to 2.1 deaths from the clots per million doses reported overall.

June Raine, MHRA chief executive, said the benefits of the AstraZeneca vaccine “continue to outweigh the risks for the vast majority of people”.

“The balance of benefits and risks is very favourable for older people, but is more finely balanced for younger people.”

German decision

On Thursday, Germany's health minister Jens Spahn said it would allow AstraZeneca's Covid-19 vaccine to be administered to adults of all ages and aims to offer 12-18 year olds a vaccine by the end of August as it seeks to speed up its rollout.

The country’s 16 regional health ministers have agreed with Mr Spahn to reverse a previous decision to restrict the AstraZeneca shot to people over the age of 60. He also said that the 12-week gap between first and second doses of AstraZeneca vaccinations could be shortened.

“Both these measures serve to further accelerate our vaccination campaign overall,” said Mr Spahn. Initial supply shortages and bureaucratic hurdles meant Germany, which has Europe’s biggest economy, got off to a slow start with its inoculation strategy.

The move, already adopted in several German states, would be on a voluntary basis and family doctors would decide how best to administer the vaccine, Mr Spahn said.

Mr Spahn also said Germany aimed to offer 12-18 year olds a vaccine by the end of August, provided European regulators give approval for the BioNTech/Pfizer shot for that age group.

So far, 30.6 per cent of Germany's population of about 83 million has received a first dose and 8.6 per cent are fully vaccinated, Robert Koch Institute data shows.

Germany is due to ease restrictions this weekend on people who are fully vaccinated or who have recovered from Covid-19. They will be exempt from a night-time curfew and will no longer need to provide a negative test to go shopping.

Germany has been hit by a third wave of the pandemic but the number of new cases is easing off. The 7-day incidence fell to 129 per 100,000 on Thursday, Robert Koch Institute data showed.

State of emergency

Meanwhile, Japan's government is set to extend on Friday a state of emergency in Tokyo and three other areas by about three weeks until the end of May to curb a surge in novel coronavirus cases just months before the start of the Tokyo Olympics.

The government had hoped a "short and powerful" state of emergency would contain a fourth wave of infection, but new cases in Tokyo and Osaka prefecture are still at high levels, said economy minister Yasutoshi Nishimura, who is also in charge of pandemic measures.

Extending the state of emergency to May 31st from May 11th will leave a margin of fewer than two months before the July 23rd start of the Games, which were postponed by a year due to the pandemic.

“Osaka particularly is in quite a dangerous situation with its medical system,” Mr Nishimura said on Friday at the start of a meeting with a panel of medical and economic experts, noting that variant strains are spreading rapidly.

“We have a strong sense of danger that Tokyo could soon be turning into the same situation as Osaka.”

The panel later approved the extension plan, Mr Nishimura said. Formal government approval is set for later in the day, with prime minister Yoshihide Suga giving a news conference at 7pm (11am Irish time).

All hospital beds for critical patients in Osaka prefecture are occupied, public broadcaster NHK reported on Friday, and Nishimura said the medical situation in neighbouring Hyogo prefecture, where the city of Kobe is located, was also poor.

In Tokyo, there were 907 new cases of novel coronavirus infection on Friday.

Nationwide, Japan has recorded 618,197 cases of infection and about 10,585 deaths from Covid-19, government figures showed.– Reuters