April 13 2021

Do not forget you can now have a free Covid test on request now, even if you have no symptoms. You can actually have two a week so if not yet immunised this may be a useful check for you if you have to commute to work or work in conditions where distancing is not easy to maintain.

All the programme to immunise the over 50s was finished 3 days early. The next phase has now started. If you are aged 45-49 you can either apply or wait to be called for your first jab.

It is quite likely that if you are just having your first jab you will be offered the new Moderna vaccine which has been rolled out across the UK ready to start immunising. There are 17 million doses in the first batch which is enough to treat 8.5 million people with 2 doses. This vaccine is similar to the Pfizer vaccine and uses mRNA technology to manufacture it. No actual viruses are used in manufacture, this makes it quicker to produce in bulk. The efficacy is quoted as 94.1% in preventing the disease and 100% in preventing serious disease.

The side effects of Moderna are the same as and no worse than the other vaccines, you can expect fatigue, muscle pains or myalgia, joint pains or arthralgia, headaches, pain at the injection site and local redness where injected. They should be gone within a week and will respond to paracetamol. Should you not be happy please seek advice.

The Johnson and Johnson vaccine which is being used now in the USA works in a similar way to the OAZ vaccine. The USA have now identified 6 cases of blood clots on the brain with low platelets in the 6.8 million jabs that they have given using the J and J vaccine. They have paused using it pending the ongoing investigations in both the USA and the EU.

Pfizer have been heavily criticised for increasing the cost of each dose of its vaccine by about 60% for all future orders from the EU. The cost has risen from $12 to $19.5 for delivery in 2022-23. The costs are predicted to rise even further.

The Prime Minister has today stressed that the reduction in Covid infections, hospitalisations and deaths has been due to the lockdown restrictions rather than the vaccination rate. I think this may be more political than medical in origin, as I believe they are both playing a major part. We certainly would not be where we are today if we just relied on immunisations. The immunisations are an essential part of our exit strategy. With this latest relaxation of the Covid restrictions we can expect to see a slight to moderate rise again in the number of new cases, subsequent hospitalisations and perhaps deaths.

Progressing our immunisation programme should mitigate against this and contribute to the figures dropping again to keep us on target.

Apparently there have been problems in Wales providing the data which has only just been released some 2 hours late. In England there are no updates on the vaccination numbers but I anticipate they have steadily increased as usual.

Yesterday 874,399 Covid tests were done and 2,472 were positive. This is a fall of 15% over the last 7 days and is a rate of 27.7/100k of the population.

Deaths number 23. Again, most encouraging. Tuesday is often the highest day of the week. It is a further 17.9% drop over the last 7 days.

There were 2,537 people in hospital beds on 11th April . The last daily admission figure is the 7th April when it was 230. Those treated on a ventilator now are only 377.

I always enjoy a good detective story and if it has a medical theme even better. I have recently read about the amazing work of Dr Maria Scully, a haematologist at University College London. It was her who found the link with the Covid vaccination and blood clots with low platelets. She was treating a patient with low platelets and blood clots in the brain. She had seen this before and knew the various causes but this patient did not have any of the usual causes. As is usual these days she called an MDT meeting. For those not used to hospitals this brings all available experts and other together to go through the case with a fine-tooth comb known as a Multi-Disciplinary Team meeting.

The consensus of the meeting was that this looked like HIT or heparin induced Thrombocytopaenia. That was strange because this patient had not been given heparin. Heparin is a drug commonly used to prevent clots not to cause them. There is a blood test that can be use to diagnose HIT known as the P4 Antibody test. A large batch of further tests had been ordered to try and puzzle this out and Dr Scully decided to add the P4 antibody test to the list. To their amazement this was positive. A few weeks later a similar patient with low platelets and blood clots on the brain also came through the department, they immediately did the P4 antibody test and this came back positive as well. The two patients’ histories were compared in great detail. The only similarity any one could find was they had both recently had the OAZ vaccine.

A week or so later Dr Scully became aware of another patient in a hospital in Birmingham with the same set of symptoms. She persuaded the clinicians there to do a PC4 test and low and behold that was positive as well. She had also recently had the OAZ vaccine. Problem solved! They had also found a test for it. Why it happens is another story waiting to be solved.There is now a whatsapp group of over 500 consultant haematologists across the world sharing information on cases and how they should be managed.

Remember the bigger picture at worst, there is only a 1 in 250,000 chance of getting this reaction. We continue to do well. We may yet have a bumpy ride. Our priorities are to get vaccines done so if it’s your turn, go now. Then we must still continue the reduced lockdown rules, particularly the use of distance and masks.

We can stay safe and we must.

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