A decision to offer people under 30 an alternative vaccine to the AstraZeneca jab has prompted concern that some could shun the injection over fears about its safety.
Iain Duncan Smith, the former Conservative leader, warned that the decision by the Medicine and Healthcare products Regulatory Agency to advise an alternative jab for the under-30s could disrupt the UK’s vaccine programme and play into the hands of anti-vaccination campaigners.
“It will, I’m afraid, make it more difficult to persuade people to take it, even people who are above 30. Anything like this relies on confidence. I don’t understand what they thought they were doing,” he said. “And those people who are anti-vaxxers are now going to go and say ‘I told you so, we were right’. This is going to be very difficult and damaging. It plays into the hands of those who are trying their level best to disrupt the vaccination programme.”
The MHRA’s switch was “messy, confusing and very unhelpful” and risked jeopardising “all the hard work GPs are doing to persuade people, particularly those who are worried about getting the vaccine, to take it”, Duncan Smith added.
Another Tory MP, who did not want to be named, said: “A significant amount of people under 30 won’t take the AZ vaccine because of this statement.”
There are signs that the recent publicity over the apparent link between the AstraZeneca vaccine and blood clots, in Europe and now in the UK, is deterring some patients from accepting the jab.
One GP said: “People have already consulted about the blood clots worry and have decided to wait for more information. As we head into [vaccinating] the younger age groups my concern is that there will be more anxiety and uncertainty as a result of this for patients, and for [GPs], as we are their first port of call for advice.”
Women who are taking the combined contraceptive pill could also be reluctant to have the AZ jab as there was some evidence of a small increased risk of thrombosis, she added. However, there was no guarantee that anyone seeking to get the Pfizer jab instead of the AZ product would be able to do so, unless the local body overseeing the administering approved it, she said.
Ruth Rankine, director of the NHS Confederation’s primary care network, said fear about blood clots were not putting off large numbers of people from having their vaccine. “Our members have not reported a significant impact on numbers turning up for their vaccination, and we hope that by clarifying the recommendations and their basis, today’s announcement will be helpful in boosting people’s vaccine confidence.”
Prof Martin Marshall, chair of the Royal College of GPs, urged people to get the AZ vaccine, including those waiting for their second dose.
“It’s vital that patients understand that the risk of developing blood clots after receiving the AZ vaccine is incredibly low for all patient groups,” he said.
Marshall called on ministers and NHS leaders to ensure that vaccination sites have enough stocks of the Pfizer and Moderna vaccines to be able to immunise 18- to 29-year-olds. Rankine agreed, saying: “We will need ongoing clarity on supplies, whoever the manufacturer.”
Prof Jonathan Van-Tam, England’s deputy chief medical officer, said the MHRA’s new approach – which he called a “course correction” in the vaccine programme – might lead to patients experiencing delays getting a vaccine or having to travel further for an injection.
Stephen Reicher, a government scientific adviser, a member of SPI-B, the behavioural science subgroup of Sage, said the confusion now surrounding the AZ vaccine was partly due to ministers being overly positive about the jabs the UK has deployed.
“The difficulty is, if you overstate the positivity then when there are problems it looks as if you were in the wrong, you were inaccurate,” he said.
He added: “This is a cautionary tale which says ‘be transparent’ – don’t overdo the story, vaccines are positive enough as it is, don’t overstate that. We need to be transparent from here on in, and recognise that people are mature enough to make a balance of risks all the time, and that by and large not much has changed. Let’s not manufacture a crisis out of the situation we’re in.”
Prof Saad Shakir, director of the drug safety research unit at Southampton University, said the MHRA decision to recommend other vaccines for under-30s was a “welcome and suitably cautious” move. “I appreciate this news will cause some people concern. I would reiterate that these events are very rare and I hope people can take some comfort from the knowledge that robust, meticulous, research and monitoring is ongoing into any possible side effects.”