April 7 2021

Prof Jonathan Van Tam demonstrated his skill in the use of English when he announced a ‘course correction’ this afternoon in the use of vaccine in the UK while experts continue to assess any link between the OAZ vaccine and the very rare cerebral venous blood clots in association with low platelets. This course correction means that in the 18-29 age band the OAZ will not routinely be used for the time being. The Pfizer, Moderna or another vaccine should be used in preference. Only if there are no other vaccines available should the OAZ vaccine be used regardless of age. He made it clear the roll out of the OAZ vaccine has not been halted by the MHRA, they made it clear that the benefits far outweigh any risks. The pause in the one age group is precautionary and is being done whilst further in-depth analysis of each case is made. As of today. the MHRA are aware of 79 cases of cerebral venous thrombosis occurring in 20 million people after a first dose of the OAZ vaccine. I suspect numbers have risen because of the greatly increased vigilance. All 79 cases reported were after the first dose of OAZ vaccine. 51 were female and 21 were male (rest unknown!). The ages ranged from 18-79. 3 of the 19 deaths were aged under 30.

Dr June Raine, chief of the MHRA said there was ‘evolving evidence that blood clots were a potential side effect’. ‘The evidence is firming up and a review has concluded that while it is a strong possibility, more work is needed to establish beyond all doubt the vaccine has caused these side effects’.

As an additional precaution, vaccine recipients have been given new guidance about symptoms they may have after being immunised. Now you should report any new or persistent headache that persists for more than 4 days, any blurred vision, any shortage of breath, swelling of a leg or legs, chest pain, persistent abdominal pain, pin point spots away from the injection site or unusual bruising.

Everybody still accepts the benefits of the vaccine far outweigh the risks in the elderly but that in young adults the risk is more finely balanced.

Boris Johnson is happy with these changes to the official guidance and does not believe it will delay the roadmap out of the UK lockdown. The trials of the OAZ vaccine in children have also been paused whilst further investigation takes place.The European Medicines Agency has today pointed out that the Covid 19 virus has and still is killing thousands of people every day. This helps to keep it in perspective.

I am sure some of you awaiting your second dose are a bit anxious. Can I point out that every single reaction with this rare condition has occurred after the first jab. So if you survived that without a problem remember it happens only after the first jab and has not been seen after the second. My second dose is due next week and I will certainly be having it.

Predictably Europe and the EU are in a muddle about how to respond. Greece, Italy and Portugal are carrying on as usual with no changes. Denmark and Norway have fully paused using the OAZ vaccine. Germany, France, Netherlands, Sweden and Canada have restricted its use.

In the United States it would seem 44% of all Covid cases are in just 5 states. The worst affected seems to be Michigan, but there are large numbers in New York, Florida, Pennsylvania and New Jersey. They have had 197,500 new cases in the last 24 hours. The predominant variant strains are primarily the UK or Kent variant, B117, with 16,275 identified, then the South African Variant at 386 cases with the B1351 variant and then the P1 variant from Brazil with 356 cases.The report of 3 deaths in Michigan in fully vaccinated individuals is concerning. I think we need much more information on these cases to come to an informed opinion. There are many possible explanations. One I mentioned yesterday is I suspect more common than we realise. I wonder if they were very fat and did not get a proper dose of vaccine.

Back to the UK and today’s statistics. Only 631,846 tests were recorded as being done in the last 24 hours. This may be an odd hiccup from the Easter holiday. We still did more than 5 million in the last week. Positive tests were only 2,763. That is a fall of 36% against the 7 day average. And the rate is only 39 per 100k.New hospital data is available but still several days delay. There were 3,536 in a hospital bed on 1st April. 256 had been admitted on 30th March. As for ventilator beds 469 were occupied on 2nd April.

Deaths were 45, which probably includes some catchup registrations from the holiday period. In the last 7 days only 214 reported, this figure is falling steadily. It will not be too long before we have a day without any. The death rate is now 0.3 per 100k.

We remain on course to follow the PM’s pathway. We all know what to do by now. Do not lose sleep over the course correction with the vaccine programme. Remember it does not happen with the second jab. There are other vaccines in the pipeline that will be very suitable for the 18-29 group and may suit them better. The one dose jab and go will be ready by then.

Plenty to discuss and talk about, stay positive and stay alert, please share your comments and above all stay safe.

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