UK COVID-19 Update: Oxford/AstraZeneca Jab Safety Reviews, Moderna Vaccine Arrives in the UK

Peter Russell

April 07, 2021

Editor's note, 7 April 2021: This article was updated with new information from the MHRA and EMA.

These are the UK coronavirus stories you need to know about today.

Oxford/AstraZeneca Jab Safety Reviews

After an ongoing safety review on rare blood clotting side effects, the Medicines and Healthcare products Regulatory Agency (MHRA) said people under 30 should be offered an alternative vaccine to the AstraZeneca/Oxford vaccine.

However, Dr June Raine, MHRA chief executive, told a news conference the side effects were "extremely rare".

The Agency said that by March 31, 20.2 million doses of the AstraZeneca/Oxford vaccine had been given in the UK, with an overall blood clot risk of 4 people in a million who received it.

Dr Raine said: "With the proven effectiveness against the disease, that is still a huge risk to our population, the balance of benefits and known risks of the vaccine is still very favourable for the vast majority of people."

Professor Wei Shen Lim, COVID-19 chair for the Joint Committee on Vaccination and Immunisation (JCVI), said: "Safety remains our number one priority. Based on the available data and evidence, JCVI has advised that it is preferable for adults aged under 30 with no underlying conditions to be offered an alternative to the AstraZeneca vaccine where available. This weighs up the risks of being seriously ill or dying from COVID-19 against the extremely small risk of a serious adverse event."

In a briefing, it was confirmed that up to March 31, the MHRA has received 79 reports of blood clots accompanied by low blood platelet count. All the cases involved people who had received their first dose of the vaccine.

Of those 79, a total of 19 people had died.

The 79 cases occurred in 51 women and 28 men, aged from 18 to 79.

Of the 19 who died, three were under the age of 30, the MHRA said.

Out of those deaths, 14 cases involved cerebral venous sinus thrombosis (CVST).

The remaining 5 cases were other kinds of thrombosis in major veins.

Jonathan Van-Tam, England's deputy chief medical officer, said today's announcement was "a course correction" but that "the NHS is all over this" and he did not anticipate a change to the vaccination rollout timetable.

Updated information has been issued to health professionals and the general public.

Earlier, the European Medicines Agency's (EMA) ongoing safety review of the AstraZeneca/Oxford vaccine concluded that "unusual blood clots with low blood platelets should be listed as very rare side effects". EMA executive director, Emer Cooke, said the review also confirmed that "the benefits of the AstraZeneca vaccine in preventing COVID-19 overall outweigh the risks of side effects".

Moderna Vaccine Rollout Begins

The UK's vaccination programme received a boost today with the first dose of the Moderna vaccine administered in a community setting.

Credit: PA Media

Elle Taylor, from Ammanford in Wales, who is an unpaid carer for her grandmother, said she was "very excited and very happy" to receive the vaccine this morning. The messenger RNA (mRNA) vaccine received regulatory approval in January after phase 3 trial results showed efficacy of 94% against COVID and 100% efficacy against severe disease.

The UK has ordered a total of 17 million doses.

First supplies of the vaccine arrived in Wales on Tuesday, with 5000 doses being sent to the Hywel Dda University Health Board area. 

Ros Jervis, the Board's director of public health, said: "We are incredibly lucky to have a third vaccine in Wales, with a long shelf life and the ability to be easily transported, to help deliver the vaccination programme to small clinics across our rural communities."

Moderna's mRNA-1273 vaccine is given in two doses, 4 to 12 weeks apart.


Neurological and Psychiatric Effects of COVID
 

Around 1 in 3 COVID-19 survivors developed a mental health condition within 6 months of infection with the SARS-CoV-2 virus, an observational study has found.

The research, published in The Lancet Psychiatry journal, estimated that 33.6% of people who recovered from COVID went on to receive a neurological or psychiatric diagnosis within the time frame.

Among the most common conditions, anxiety rates were estimated as affecting 17%, and mood disorders, 14%.

Neurological diagnoses such as stroke and dementia were rarer but not uncommon, the research team led by the University of Oxford reported.

Prof Paul Harrison, who led the study, said: "Although the individual risks for most disorders are small, the effect across the whole population may be substantial for health and social care systems due to the scale of the pandemic and that many of these conditions are chronic.

The study was based on electronic health records of 236,379 COVID-19 patients, mostly from the US.

Commenting on the findings for the Science Media Centre, Prof Sir Simon Wessely, regius chair of psychiatry at King's College London, said: "It confirms beyond any reasonable doubt that COVID-19 affects both brain and mind in equal measure."

Dr Musa Sami, clinical associate professor in psychiatry at the University of Nottingham, said: "This data provides very important information for services and policy makers to estimate the burden of neurological and psychiatric disease from COVID-19."

Trial Setback for Oxford Vaccine

A UK trial testing the AstraZeneca/Oxford vaccine in children and teenagers has been paused pending more data on rare blood clotting issues in adults who received the vaccine.

There were no safety concerns in the paediatric trial, Reuters reported on Tuesday, quoting Oxford University sources.

The university said in February that it planned to enrol 300 volunteers aged 6-17 years, based in the UK, for the trial.

Mapping Pandemic Loneliness

Younger people and those living in areas of high unemployment were more likely to experience loneliness during the pandemic than older people and those living in rural areas, official figures have suggested.

The findings were based on an analysis by the Office for National Statistics which mapped loneliness and wellbeing across Great Britain.

It found that between October 2020 and February this year, around 3.7 million adults, or 7.2% of the adult population, reported feeling lonely. That compared to 2.6 million people, or 5% of the adult population, last spring.

The data also suggested that unmarried people, and those living alone, were more likely to have experienced 'lockdown loneliness' than people who were married or living with others.

'Stigmatising' Effect of Naming Variants by Country

Naming new and emerging variants of COVID-19 after places where they were first identified risked penalising countries for carrying out effective surveillance, health leaders have warned.

Many variants of the SARS-CoV-2 virus have become known for their place of origin, including the 'UK variant', the 'South African variant', and the 'Brazilian variant'.

Experts working with the World Health Organisation (WHO), who are developing new names for variants, stressed the importance of not stigmatising countries who were conducting surveillance of the virus and genomic sequencing.

Dr Maria Van Kerkhove, the WHO's technical lead for COVID-19, told a press briefing: "We hope to be able to announce the nomenclature very soon, because we need to make sure that any of the names that are used do not further stigmatise a person, or a last name, or a location inadvertently."

Current naming for the virus variant first identified in the UK is B.1.1.7, while B.1.351 is the name for the variant first found in South Africa, and P1 for the variant that was first detected in Japan, but is circulating in Brazil.
 

The Rise of the Preprint 

A dramatic increase in the accessing of preprints during the pandemic has helped scientists share important information about COVID-19, a study in the journal PLOS Biology suggested.

The research led by Queen Mary University of London (QMUL), the Leibniz Information Centre for Economics, Germany, and the University of Liverpool, found that around 40% of COVID-19 papers were shared as preprints in the early stages of the pandemic.

While preprints used to be largely ignored by policy makers and the media, the nature of the COVID emergency led to them being frequently referenced, the study found.

"What we hope is that the cultural shifts reported in this paper will remain after the pandemic and the biomedical community will continue to turn to preprint servers for disseminating new studies," said Dr Jonathon Coates from QMUL.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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