UK COVID-19 Update: Immune Thrombocytopenic Purpura Oxford Jab Risk, Lack of Test Kit Evidence

Tim Locke

June 09, 2021

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

Immune Thrombocytopenic Purpura Oxford Jab Risk

Scottish data from 2.53 million adults just published in Nature Medicine found a small increased risk of immune thrombocytopenic purpura (1.13 cases per 100,000) after a first dose of the Oxford/AstraZeneca vaccine.

The analysis also found very small increased risks of other arterial blood clot and bleeding events up to 27 days after vaccination. There were insufficient data on any association with cerebral venous sinus thrombosis.

The authors say the findings need to be understood within the context of the very clear benefits of the Oxford vaccine, and the risk of developing a serious adverse vaccine-related event is far lower than the risk of serious illness or death caused by SARS-CoV-2, particularly for elderly and other vulnerable populations.

They say further research is needed as relatively few people aged 40 or under were included in this study due to the vaccination programme targeting older adults first.

The data was from December to April and responses to second doses also need to be assessed.

Professor Aziz Sheikh, University of Edinburgh, and study lead, said: "This very small risk is important, but needs to be seen within the context of the very clear benefits of the vaccines and potentially higher risks of these outcomes in those who develop COVID-19."

Delta Measures

Ten percent of England's population is under new measures to try to stop the spread of the delta variant. There's military support, extra testing, extra vaccination campaigning, and people are urged to minimise travel.

After website problems eased yesterday, NHS England reported 490,000 vaccination appointments booked by 25-29 year olds. NHS England Chief Executive Sir Simon Stevens called it an "encouraging Glastonbury-style rush".

Chris Hopson, NHS Providers' chief executive, told Times Radio that hospitals in COVID hotspots are currently coping with infection rates.

"What chief executives are consistently telling us is that it is a much younger population that is coming in, they are less clinically vulnerable, they are less in need of critical care and therefore they’re seeing what they believe is a significantly lower mortality rate."

Professor Neil Ferguson, Imperial College London, told a Science Media Centre briefing that modelling suggests "there is a risk of a substantial third wave". 

He said the doubling time for the delta variant is just under 7 days but from a low level.

Antibody Levels Rising

Latest Office for National Statistics (ONS) blood test data for the week beginning 17 May show "a clear pattern" between vaccination and testing positive for SARS-CoV-2 antibodies.

In England, Wales, and Northern Ireland, an estimated 8 in 10 adults would have tested positive for antibodies. In Scotland the figure was 7 in 10.

Kara Steel from ONS commented: "Antibody levels across the UK have continued to go up, with over three quarters of the adult population now having some level of antibody protection against COVID-19.

"This shows the clear impact of the vaccination programme, including second doses which have increased the numbers testing positive for antibodies.

"Today’s results highlight the  importance of monitoring antibodies as infection levels change and we move into summer."

Separate ONS data found 6% of adults reporting vaccine hesitancy. This was higher in 16 to 29-year-olds, Black or Black British adults and in deprived areas.

Reasons for negative attitudes towards having a jab included women being concerned over fertility, and clinically extremely vulnerable adults and people with disabilities having concerns over effects on an existing health condition.

Jabs Reducing Infections

First doses of the Oxford/AstraZeneca or Pfizer/BioNTech vaccines reduced UK new SARS-CoV-2 infections incidence by 61% and 66%, rising to 79% and 80% after the second dose, according to a study using ONS data published in Nature Medicine.

The study covered the period from December to May, including alpha variant cases, and vaccination was most effective at reducing symptomatic infections, and those with a greater viral burden.

Lack of Test Kit Evidence

The Royal Statistical Society said more work is needed to evaluate COVID-19 tests, which it said have come to market without evidence to support their accuracy for use in many current settings.

Professor Deborah Ashby, co-chair of the RSS Working Group on Diagnostic Tests, said: "Testing has been a key focus of many government’s strategies in fighting COVID, but the lack of statistical standards has caused issues, with tests coming to market without enough known on their effectiveness.

"We urge regulators to take on board our recommendations, to allow for more scrutiny of diagnostics more generally and for future pandemics."

The MHRA said it was considering changes to the diagnostics regulation framework.

Kids' Respiratory Infections

GPs in England are being asked to consider seeing under-5s face-to-face if they have respiratory symptoms.

The new guidance says: "COVID-19 tends to be a mild, self-limiting illness in children. Prolonged illness and/or severe symptoms should not be attributed to COVID-19 and should be evaluated as usual."

More News

  • The Royal College of Nursing warned against people without registered nurse qualifications being employed for registered nursing roles. "Filling registered nurse vacancies with those who are not registered nurses is not filling those vacancies," said RCN Acting General Secretary & Chief Executive Pat Cullen.

  • Reports said former Downing Street adviser Dominic Cummings has not yet provided evidence to back up claims he made about the Government's pandemic response to a Commons committee last month. 

  • GP trainees reported a significant reduction in burnout after undertaking mindfulness training, according to a small Warwick Medical School study published in BMC Medical Education . Lead author Dr Manuel Villarreal, said: "The pandemic has entailed doing lots of telephone consultations and GP trainees are now having to make different decisions in new scenarios. That comes with additional stress."

  • People who were more concerned about catching COVID-19 were more disapproving of the wrong-doings of others, according to Cambridge research involving US participants published in Evolutionary Psychology. "There is no rational reason to be more judgemental of others because you are worrying about getting sick during the pandemic," said senior author, Professor Simone Schnall.

  • UCL research published in the Clinical Journal of the American Society of Nephrology found COVID-19 infection risks were higher for dialysis patients with diabetes, those who lived in local communities with higher COVID-19 rates, and received dialysis at clinics that served a larger number of patients. Lead author, Dr Ben Caplin, said the work "suggests that in addition to isolation of confirmed cases, addressing factors that might reduce transmission from patients without suspected or confirmed disease might provide an additional opportunity to further modify the impact of COVID-19 in this population".

  • Lockdown boosted time spent online with adults spending an average of 3 hours 37 minutes a day online, according to Ofcom. Half of UK adults visited an online adult site or app in 2020. Ofcom's Yih-Choung Teh said: "In an unprecedented year, we’ve seen a real acceleration in our migration to online services – which, for many people, have provided a lifeline in lockdown."

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

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