Possible serious side effects from the Astra Zeneca vaccine discussion

[bimble]

Do we know yet if it stops the brazilian kind?

 

[Oula]

This post gives me some comfort, in that it confirms that i've not suddenly turned into an irrational hypocrite - I'm a mid 40s woman with a recent positive antibody test and i've not yet clicked to book my 1st jab, though it has been available to do since yesterday.
But also, I hadn't thought about the (obvious) fact that the people in this country who would have been most at risk - from a hesitant me - have already been vaccinated. So as you say, that does seem to reduce the urgency somewhat, I'm just thinking to hover over that booking button for another couple of weeks maybe see what changes. Feels pretty uncomfortable though, like i'm being silly, or selfish.

I hovered over the booking button for a couple of days, then when I went to do it they told me my invitation had been withdrawn due to lack of availability, not to contact my GP and they'd be in touch. I got the text again a few weeks later and jumped on it quicker that time.

 

[littlebabyjesus]

Even if the benefits are marginal, you are making yourself safer for others by being vaccinated (even if they've been vaccinated) and adding that little bit to the protection that might stop a further wave.

I think that's the strongest argument to still go ahead and do it.

 

[elbows]

It's a fair point. You only know there's a surge after it's well under way. That's why I'm also in favour on balance of the mass testing programme.

I remain optimistic, though. We and certain other places like Portugal have already had the wave that is currently hitting places like Turkey. It will probably take a new mutation to cause another major outbreak here. And of course that could well happen, but it's not a certainty.

I hope you do know that one of the reasons I've sometimes gone mad at you about some specific things in this pandemic is because I know you are more than capable of understanding lots of the detail of this pandemic and the dynamics, so I got frustrated on occasions where I couldnt really understand how you reached certain conclusions at times.

I mention this now not because I want to repeat any of those arguments, I really dont, and especially not on this thread. But that history means I sometimes think of you when I read certain modelling exercises or see certain data. And there have been some recently where I've thought ooh, I wonder if littlebabyjesus has seen this. Here are the recent examples of stuf where I have thought of you:

The modelling exercises some universities did that SAGE took a look at, in regards this unlocking phase, the vaccination programme and the third wave. ie the picture they expect in the event of no mutation complications in the coming months:

University of Warwick: Road Map Scenarios and Sensitivity, 29 March 2021
LSHTM: Interim roadmap assessment: prior to Step 2, 31 March 2021
Imperial College London: Evaluating England’s Roadmap out of Lockdown, 30 March 2021
SPI-M-O: Summary of further modelling of easing restrictions – Roadmap Step 2, 31 March 2021

And the other stuff I thought may be of interest involves immunity, since these days they seem to have two different sorts of antibody tests when analysing blood donor samples in order to estimate levels of population immunity. One sort (N) tells them about naturally acquired immunity, the other (S) covers both natural and vaccine-induced immunity. Data from these is part of the weekly surveillance report. I'm only going to include some of the graphs here, there is a bunch of text on the subject too if it isnt clear from my description what these are showing. Page 66 onwards of: https://assets.publishing.service.g...977003/Weekly_Flu_and_COVID-19_report_w14.pdf



I bring all of these up now because they obviously have a relationship to expectations of what may be in store for us, even in the vaccination era and even in the absence of problematic mutations taking hold.

 

[Bahnhof Strasse]

Denmark's just suspended the use of it outright. More for everyone else then.

 

[Teaboy]

Denmark's just suspended the use of it outright. More for everyone else then.

Yeah, it seems a pretty easy decision for them given their small population and confirmed supplies. I think they are predicting just a 2 week delay to the overall program.

 

[Limejuice]

Denmark's just suspended the use of it outright. More for everyone else then.

Czechia: Waste not, want not.

AstraZeneca vaccine: Denmark stops rollout completely

It is the first European country to fully withdraw the jab over possible links to rare blood clots.

www.bbc.co.uk

"Meanwhile the Czech Deputy Prime Minister Jan Hamacek said he had instructed the Czech ambassador in Denmark to try to buy the 2.4 million AstraZeneca vaccines doses that the Danes would no longer be using."

 

[two sheds]

Presumably good to mop up all the second AZ vaccinations of people who've had first AZ one with no problems (as I've had my second one today), try to use other vaccines for younger people.

 

[elbows]

Both vaccines are based on a new technology using adenoviruses, which cause the common cold, that have been modified to essentially render them harmless. The viruses are employed as vectors to ferry instructions for human cells to make proteins found on the surface of the coronavirus, priming the immune system to make antibodies that fight off the actual virus.

Scientists are working to find the potential mechanism that would explain the blood clots. A leading hypothesis appears to be that the vaccines are triggering a rare immune response that could be related to these viral vectors, FDA officials said at a briefing on Tuesday.

U.S. FDA to scrutinize vaccine design behind COVID-19 shots linked to blood clots

With two COVID-19 vaccines now under scrutiny for possible links to very rare cases of blood clots in the brain, U.S. government scientists are focusing on whether the specific technology behind the shots may be contributing to the risk.

www.reuters.com

And how that angle was discussed in the article someone already linked to a little earlier in the thread ( AZ COVID Vaccine: Causal Link to Severe Thrombosis Established )

Greinacher noted that there have been discussions on the possibility that the rogue antibody is produced by the immune response to the virus spike protein in the vaccine (the wanted protective immune reaction of the vaccine), as the structure of part of the spike protein resembles part of the PF4 molecule. But evidence thus far suggests that this is not a cross-reacting antibody.

"That is fantastic news for the vaccine program as it would have meant that all vaccines would have been affected," he commented.

On whether the reaction could be caused by the adenoviral vector used in the AstraZeneca vaccine, Greinacher says it is "too early for a reasonable scientific argument to be drawn on a direct link. We know that adenovirus interacts with platelets, so in theory that could make sense. But if this was the mechanism, I would have expected many more patients to have had these problems."

In the NEJM paper, Greinacher et al add: "The amount of adenovirus in a 500 microliter vaccine injection administered 1 or 2 weeks earlier would seem unlikely to contribute to subsequent platelet activation observed in these patients."

 

[bimble]

Just booked myself in, feel better already.

 

[elbows]

They are moving the bar to under 40's instead of under 30's.

Under 40s to be offered alternative to AZ vaccine

Link to rare blood clots leads to shift in vaccination programme for younger age groups.

www.bbc.co.uk

I'm not surprised, since such decisions are a combination of various judgements about risk, prevalance levels of the virus, supply issues and vaccination programme timetables. Its also possible that they have less rosy data about vaccine hesitancy in certain age groups than they have acknowledged, and are trying to adjust things to cope with that.

 

[bimble]

I don't know if anyone can help with this, just a question.
My friend who had a stroke 3 years ago, he's due to get 2nd jab of AZ on Tuesday this coming week.

On 7th April, the MRHA was saying this .


I can't find anything more recent and seems to be absent from the nhs website that advice now.

Maybe they have changed their view on this in the past month, it looks like it.
Should he at least speak to his gp at least first? he's 41.

 

[two sheds]

Definite talk to gp I'd say. Is there a specialized coronavirus phone helpline?

 

[LDC]

I don't know if anyone can help with this, just a question.
My friend who had a stroke 3 years ago, he's due to get 2nd jab of AZ on Tuesday this coming week.

On 7th April, the MRHA was saying this .View attachment 267275


I can't find anything more recent and seems to be absent from the nhs website that advice now.

Maybe they have changed their view on this in the past month, it looks like it.
Should he at least speak to his gp at least first? he's 41.

They should check with their GP/at the vaccination centre, but my understanding is in that position if they've had their first dose then they go ahead with their second.

And as I've said before, not all strokes are clots anyway.

But please get them to check rather than relying on the above.

 

[bimble]

Will annoy him until he promises to just check with a doc.

 

[LDC]

Just got this through work email bimble

Questions re: previous blood clot with AstraZeneca

There has been some confusion regarding the rationale for asking whether an individual has had a previous blood clot when screening for the AstraZeneca vaccine. This is to rule out whether the individual has a history of heparin-induced thrombocytopenia and thrombosis (HITT or HIT type 2) or has experienced major venous and/or arterial thrombosis occurring with thrombocytopenia following vaccination with any COVID-19 vaccine. As the majority of patients would not necessarily know they had thrombocytopenia we ask whether they have had a clot and if they say yes it should be followed up with do you know the cause?

If the patient indicates something unrelated to the 2 indications above such as a long haul flight or a fall then it is ok to administer. If in doubt check with the clinical lead. There is no evidence that those with a prior history of thrombosis or known risk factors for thrombosis are more at risk of developing the reported serious thromboembolic events with concurrent thrombocytopenia after the COVID-19 Vaccine AstraZeneca. For most of these individuals, the risk of recurrent thrombosis due to COVID-19 infection remains far greater than the risk of this syndrome.

 

[bimble]

thank you will send that on to him. Still not clear (to me), in that he didn't have a fall or a flight was just sat in his flat when it happened.

 

[Riklet]

I wonder if "us younguns" will be getting Moderna or Pfizer then? Not sure which they have more left of at the moment...

Tbh id probably have AZ no bother, but having a posh/expensive one is a bit of a bonus I wonder whether it'll be massively inconvenient tho... no way do I want to travel to a different town or city for a jab right now.

 

[Teaboy]

I wonder if "us younguns" will be getting Moderna or Pfizer then? Not sure which they have more left of at the moment...

Tbh id probably have AZ no bother, but having a posh/expensive one is a bit of a bonus I wonder whether it'll be massively inconvenient tho... no way do I want to travel to a different town or city for a jab right now.

I'm going to be in danger of sounding like a naggy parent and appreciate not everyone has access to a car but at a time when vast swathes of the global population don't have any access to a vaccine you've not only got access to one but are being given a choice of vaccine. It seems a bit millennial to be bothered that you might be inconvenienced by having to travel a bit.

 

[Riklet]

I'm going to be in danger of sounding like a naggy parent and appreciate not everyone has access to a car but at a time when vast swathes of the global population don't have any access to a vaccine you've not only got access to one but are being given a choice of vaccine. It seems a bit millennial to be bothered that you might be inconvenienced by having to travel a bit.

Well tbf you dont know my circumstances. Not only do I not have a car I can barely walk 10 mins down the road. And yes there is always someone worse off, that's the nature of life sadly.

Frankly id rather have AZ than get sent off on a car trip to somewhere 45 mins away.

 

[Teaboy]

Well tbf you dont know my circumstances. Not only do I not have a car I can barely walk 10 mins down the road. And yes there is always someone worse off, that's the nature of life sadly.

Frankly id rather have AZ than get sent off on a car trip to somewhere 45 mins away.

Yeah, sorry I've got a bit of a grump on this morning.

I don't know how things will work when a choice of vaccine becomes available but up till now everyone I've spoken to has managed to get an appointment at a nearby centre. The key seems to be if a local one isn't available then just look again the next day and keep looking daily until it shows up. There seems to be a quirk of the booking service that it doesn't always show every centre every time.

A friend of mine who lives in Oxford was initially only offered an appointment at Stoke Mandeville or Heathrow. After a few days of looking he got an appointment at the Oxford Utd stadium.

 

[8ball]

Frankly id rather have AZ than get sent off on a car trip to somewhere 45 mins away.

I have nothing terribly intelligent to add, but just to mention, I had the second AZ jab yesterday. The side effects are about 20% what they were with the first one (the first one was just “a bit meh for most of a day”).

Seems to gel with the general experience.

 

[William of Walworth]

A friend of mine who lives in Oxford was initially only offered an appointment at Stoke Mandeville or Heathrow. After a few days of looking he got an appointment at the Oxford Utd** stadium

That (my! ) team are now in the League One playoffs, unexpectedly .... less surprisingly, the vaccine squad are scoring a fair few goals too

 

[Aladdin]

Just got this through work email bimble

Questions re: previous blood clot with AstraZeneca

There has been some confusion regarding the rationale for asking whether an individual has had a previous blood clot when screening for the AstraZeneca vaccine. This is to rule out whether the individual has a history of heparin-induced thrombocytopenia and thrombosis (HITT or HIT type 2) or has experienced major venous and/or arterial thrombosis occurring with thrombocytopenia following vaccination with any COVID-19 vaccine. As the majority of patients would not necessarily know they had thrombocytopenia we ask whether they have had a clot and if they say yes it should be followed up with do you know the cause?

If the patient indicates something unrelated to the 2 indications above such as a long haul flight or a fall then it is ok to administer. If in doubt check with the clinical lead. There is no evidence that those with a prior history of thrombosis or known risk factors for thrombosis are more at risk of developing the reported serious thromboembolic events with concurrent thrombocytopenia after the COVID-19 Vaccine AstraZeneca. For most of these individuals, the risk of recurrent thrombosis due to COVID-19 infection remains far greater than the risk of this syndrome.

What happens if the blood clot the patient had WAS after AZ? What advice do ye get? Does the patient get offered a different vaccine like ..pfizer?

 

[LDC]

The paragraph says this, it is talking about thrombus post-vaccine, but it's only ones with HITTS 1 or 2 that are concerning, not just any clots which are common.

"This is to rule out whether the individual has a history of heparin-induced thrombocytopenia and thrombosis (HITT or HIT type 2) or has experienced major venous and/or arterial thrombosis occurring with thrombocytopenia following vaccination with any COVID-19 vaccine."

AFAIK if you've had a clot with any thrombocytopenia post first dose of AZ then you don't get a second dose of AZ, but I have no idea what people are getting (if anything) as I've not come across it and it wouldn't be something I would, nor would I deal with making the decision.

The other condition that makes it not possible to get any AZ vaccine is Antiphospholipid syndrome (APS)

E2A now I've had a coffee; that decision would also be made by someone knowing all the other factors involved; risk factors for clots, other medications they were on, medical conditions they had, their actual physical state at the time, age, etc.

 

[William of Walworth]

The paragraph says this, it is talking about thrombus post-vaccine, but it's only ones with HITTS 1 or 2 that are concerning, not just any clots which are common.

"This is to rule out whether the individual has a history of heparin-induced thrombocytopenia and thrombosis (HITT or HIT type 2) or has experienced major venous and/or arterial thrombosis occurring with thrombocytopenia following vaccination with any COVID-19 vaccine."

AFAIK if you've had a clot with HITT post first dose of AZ then you don't get a second dose of AZ, but I have no idea what people are getting (if anything) as I've not come across it and it wouldn't be something I would, nor would I deal with making the decision.

The other condition that makes it not possible to get any AZ vaccine is Antiphospholipid syndrome (APS)

Is it known how rare (or not?) are the above conditions?

 

[LDC]

Is it known how rare (or not?) are the above conditions?

Clots generally?
Clots post AZ vaccine?
Clots post vaccine with thrombocytopenia?
Thrombocytopenia?
Anti-phospholipid syndrome?

 

[William of Walworth]

Apologies for being unclear, and in a pre-work hurry.

I was trying to ask about the two particular conditions you specified in your previous post.

I suppose that comparing the general rarity and the post vaccination rarity of them might? be interesting too.

 

[bimble]

LynnDoyleCooper friend did chat to GP and i feel reassured, they said his stroke was not related to thrombocytopenia (whatever that may be) and so he should go ahead with 2nd dose of AZ.

 

[LDC]

Apologies for being unclear, and in a pre-work hurry.

I was trying to ask about the two particular conditions you specified in your previous post.

I suppose that comparing the general rarity and the post vaccination rarity of them might? be interesting too.

No worries, I'm rushing too! No idea of the incidence of thrombocytopenia or anti-phospholipid syndrome, seen and heard of the first, never heard of the second and when it came up recently at work no doctor had ever come across anyone that had had it, so fairly uncommon generally I expect.

All that comparison is done and it's what's given them the data to be cautious with the AZ vaccine.