Tag: public health

COVID Vaccination: Changed advice for under-30s

Under 30s in the UK should be offered an alternative to Oxford-AstraZeneca vaccine

The benefits of vaccination continue to outweigh any risks but the MHRA advises careful consideration be given to people who are at higher risk of specific types of blood clots because of their medical condition.

  • The MHRA is not recommending age restrictions in COVID-19 Vaccine AstraZeneca vaccine use.
  • The MHRA’s scientific review of UK reports of extremely rare and unlikely to occur specific blood clots with lowered platelets has concluded that the evidence of a link with COVID-19 Vaccine AstraZeneca is stronger but more work is still needed.
  • By 31 March 20.2 million doses of the COVID-19 Vaccine AstraZeneca had been given in the UK meaning the overall risk of these blood clots is approximately 4 people in a million who receive the vaccine.
  • Anyone who did not have these side effects should come forward for their second dose when invited.
  • The data suggest there is a slightly higher incidence reported in the younger adult age groups and the MHRA advises that this evolving evidence should be taken into account when considering the use of the vaccine.
  • The MHRA is now issuing updated guidance for healthcare professionals on how to minimise risks, as well as further advice on symptoms for vaccine recipients to look out for 4 or more days after vaccination.
  • Vaccines are the best way to protect people from COVID-19 and have already saved thousands of lives. Everyone should continue to get their vaccination when asked to do so unless specifically advised otherwise.

The Joint Committee on Vaccination and Immunisation (JCVI) have also published a statement (see below) following reports of an extremely rare adverse event after vaccination with the first dose of the AstraZeneca COVID-19 vaccine.

This includes information on the use of the vaccine in those under 30.

Updated information is being provided for people and healthcare professionals on the possible risk of extremely rare and unlikely to occur specific types of blood clots following vaccination with the COVID-19 Vaccine AstraZeneca, the Medicines and Healthcare products Regulatory Agency (MHRA) said today.

The MHRA has undertaken a thorough review into UK reports of a very rare and unlikely to occur specific type of blood clot in the brain, known as cerebral venous sinus thrombosis (CVST) occurring together with low levels of platelets (thrombocytopenia) following vaccination with the COVID-19 Vaccine AstraZeneca. It is also considering other blood clotting cases (thromboembolic events) alongside low platelet levels.

These reports have been analysed by the Government’s independent advisory body, the Commission on Human Medicines (CHM) and its COVID-19 Vaccines Benefit Risk Expert Working Group, which includes lay representatives and advice from leading haematologists.

Up to and including 31 March 2021, the MHRA had received 79 UK reports of blood clotting cases alongside low levels of platelets following the use of the COVID-19 Vaccine AstraZeneca:

  • 44 of the 79 cases were of CVST with thrombocytopenia
  • 35 of the 79 cases were of thrombosis in other major veins with thrombocytopenia
  • 79 cases occurred in 51 women and 28 men, aged from 18 to 79 years. It should be noted that more women have been vaccinated with COVID-19 Vaccine AstraZeneca than men.
  • Sadly, 19 people have died out of the 79 cases – 13 females and 6 males. 11 out of the 19 people who died were under the age of 50, 3 of whom were under 30. 14 of these 19 cases were of CVST with thrombocytopenia and 5 were of thrombosis with thrombocytopenia.
  • All 79 cases occurred after a first dose of the vaccine.

This risk, based on reports up to and including 31 March, is slightly higher than the risk calculated from the reports published up to and including 24 March. However, likelihood of these blood clots occurring is still extremely rare.

As a precaution, administration of COVID-19 Vaccine AstraZeneca in people of any age who are at higher risk of blood clots because of their medical condition should be considered only if benefits from the protection from COVID-19 infection outweighs potential risks.

Anyone who experienced cerebral or other major blood clots occurring with low levels of platelets after their first vaccine dose of COVID-19 Vaccine AstraZeneca should not have their second dose. Anyone who did not have these side effects should come forward for their second dose when invited.

Pregnancy predisposes to thrombosis, therefore women should discuss with their healthcare professional whether the benefits of having the vaccine outweigh the risks for them.

The MHRA recently confirmed that the evidence to date does not suggest that the COVID-19 Vaccine AstraZeneca causes venous thromboembolism without a low platelet count.

It is important to note that this type of blood clot together with lowered platelets can rarely occur naturally in unvaccinated people as well as in people with COVID-19 disease.

While the MHRA continues to investigate these cases, as a precautionary measure, anyone who has symptoms four days or more after vaccination is advised to seek prompt medical advice, such as:

  • a new onset of severe or persistent headache, blurred vision, confusion or seizures
  • develop shortness of breath, chest pain, leg swelling or persistent abdominal pain,
  • unusual skin bruising or pinpoint round spots beyond the injection site

Dr June Raine, MHRA Chief Executive, said: “Over 37 million doses of vaccines against COVID-19 have now been administered in the UK, saving thousands of lives through the biggest vaccination programme that has ever taken place in the UK.

“No effective medicine or vaccine is without risk. We continually monitor safety during widespread use of any vaccine. This is to ensure vaccines are performing as expected, to identify any new side effects that may arise, and to ensure the benefits continue to outweigh the risks.

“The public’s safety is always at the forefront of our minds and we take every report of a suspected side effect very seriously indeed. We thoroughly analyse each and every report as we receive it and although the number of reports of CVST and other thromboembolic events has increased over the last week, so has the overall number of vaccinations administered, therefore these blood clots remain extremely rare and unlikely to occur.

“We ask anyone who suspects they have experienced a side effect linked with their COVID-19 vaccine to report it to the Coronavirus Yellow Card website.

“It is still vitally important that people come forward for their vaccination when invited to do so.”

Professor Sir Munir Pirmohamed, Chair of the Commission on Human Medicines, said: “The independent Commission on Human Medicines (CHM) and its COVID-19 Expert Working Group, together with leading haematologists, has conducted a rigorous scientific analysis of all available evidence regarding reports of thromboembolic events occurring together with low platelets and COVID-19 Vaccine AstraZeneca and usage of the vaccine in different age groups.

“We have a rich source of data – the best data there is – and the MHRA and CHM will continue to keep this under close observation. The public deserve nothing less.”

JCVI statement on use of the AstraZeneca COVID-19 vaccine: 7 April 2021

Since the start of the pandemic over 4 million COVID-19 infections have been confirmed in the UK causing more than 120,000 deaths. Over 30 million people have received their first dose of COVID-19 vaccine since the start of the programme, which Public Health England (PHE) estimate has prevented at least 6,000 deaths in the first 3 months of 2021. Analysis of infection data since the introduction of the COVID-19 vaccines in the UK demonstrates that vaccination is highly effective and substantially reduces the risk of infection and severe COVID-19 disease.

There have been reports of an extremely rare adverse event of concurrent thrombosis (blood clots) and thrombocytopenia (low platelet count) following vaccination with the first dose of AstraZeneca ChAdOx1 nCoV-19 vaccine (AZD1222).

There has been no signal for thrombosis/thrombocytopenia following receipt of other COVID-19 vaccines approved for use in the UK (Pfizer-BioNTech and Moderna).

Given the very low numbers of events reported overall, there is currently a high level of uncertainty in estimates of the incidence of this extremely rare adverse event by age group.

However, the available data do suggest there may be a trend for increasing incidence of this adverse event with decreasing age, with a slightly higher incidence reported in the younger adult age groups.

In contrast, the risks of severe disease associated with COVID-19 increases steeply with age, with the youngest adults at lowest risk.

There are currently no known risk factors for this extremely rare condition, which appears to be an idiosyncratic reaction on first exposure to the AstraZeneca COVID-19 vaccine.

Alternatives to the AstraZeneca COVID-19 vaccine currently approved for use in the UK include the Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273 vaccines. 

JCVI has weighed the relative balance of benefits and risks and advise that the benefits of prompt vaccination with the AstraZeneca COVID-19 vaccine far outweigh the risk of adverse events for individuals 30 years of age and over and those who have underlying health conditions which put them at higher risk of severe COVID-19 disease. 

JCVI currently advises that it is preferable for adults aged <30 years without underlying health conditions that put them at higher risk of severe COVID-19 disease, to be offered an alternative COVID-19 vaccine, if available.

People may make an informed choice to receive the AstraZeneca COVID-19 vaccine to receive earlier protection.

There are some adults <30 without underlying health conditions who are in phase 1, who were prioritised due to an increased risk of exposure and/or to reduce the risk of passing the infection on to vulnerable individuals.

This includes health and social care workers, unpaid carers and household contacts of immunosuppressed individuals. Acting on a precautionary basis, if these persons are still unvaccinated, it is preferable for them to be offered an alternative COVID-19 vaccine, if available. 

JCVI is currently finalising its advice on phase 2 of the programme, particularly for healthy people under 30 years of age, and this will be published in due course.

To date, there are no reports of the extremely rare thrombosis/thrombocytopenia events following receipt of the second dose of the AstraZeneca COVID-19 vaccine. All those who have received a first dose of the AstraZeneca COVID-19 vaccine should continue to be offered a second dose of AstraZeneca COVID-19 vaccine, irrespective of age. The second dose will be important for longer lasting protection against COVID-19.

JCVI advises that all individuals offered a COVID-19 vaccine should be fully informed about the benefits and risks of vaccination. This should include clear information on the extremely rare thrombosis/thrombocytopenia adverse event, how to monitor for symptoms that might be related to the adverse event, and what action should be taken by individuals and health professionals in the event of such symptoms arising. 

PHE is preparing updated information for those being offered COVID-19 vaccines, and for health professionals, which will be available through the GOV.UK website.

NHS Lothian: Covid appointments

NHS Scotland will contact you about your coronavirus (COVID-19) vaccination (jab, injection) appointment when it’s your turn.

We urge you to please make every effort to attend the appointment you have been allocated. This allows NHS Scotland to continue to vaccinate everyone as quickly as possible.  

Getting to your vaccination appointment is classed as an essential journey. This means you can:

  • travel by public transport
  • share a car with someone not from your household
  • travel outwith your local authority area

You are advised to follow the standard guidance to protect yourself and others – wear a mask, keep a couple of windows slightly ajar to allow fresh air to circulate and sanitise your hands before and after the journey.

However, if you are still unable to attend or cannot get to the venue, you can rearrange your appointment. Every effort will be made to reschedule your appointment as soon as possible however it is important to understand that this is likely to mean you may have to wait longer for your appointment. 

At the moment, vaccine supply is limited which in turn restricts our ability to reschedule appointments for people who wish to change the time or location of their appointments.

Call handlers on the national booking line and on NHS Lothian’s local helpline will do all they can to help you. Please be patient and treat them with respect.

There are cases when rearranging appointments is essential. You should rearrange your appointment if you:

  • are feeling unwell with symptoms of coronavirus
  • have recently tested positive for coronavirus
  • have been told by NHS Test and Protect that you are a close contact of someone who has tested positive for coronavirus
  • live with someone who has recently tested positive for coronavirus
  • live with someone who has symptoms of coronavirus

If you have recently tested positive for coronavirus, even if you have no symptoms, you should wait until 4 weeks after the date you were tested to get the vaccine.

National Covid Vaccination Helpline   – 0800 030 8013
NHS Lothian Covid Vaccination Helpline    – 0300 790 6296

Twice weekly rapid testing to be available to everyone in England

Everyone in England will be able to access free, regular, rapid coronavirus (COVID-19) testing from 9 April, the UK Government has announced.

  • Everyone in England, including those without symptoms, will be able to take a free rapid coronavirus (COVID-19) test twice a week
  • Alongside vaccine rollout, regular testing is at the heart of plans to reopen society and the economy, helping to suppress and control the spread of variants
  • Updates will be made to the NHS COVID-19 app in England to coincide with the universal testing offer

Everyone in England will be able to access free, regular, rapid coronavirus testing from 9 April, the Government has announced.

In a significant step forward, which paves the way for businesses and society reopening, anyone will be able to access free, rapid lateral flow tests (LFDs) for themselves and their families to use twice a week, in line with clinical guidance.

Rapid testing has so far been available to those most at risk and people who need to leave home for work, including frontline NHS workers, care home staff and residents, and schoolchildren and their families. Now rapid testing will be offered to everyone, with people encouraged to take regular tests to help prevent outbreaks and reclaim a more normal way of life.

One in 3 people with COVID-19 do not experience any symptoms and may be spreading the virus unwittingly. Rapid testing detects cases quickly, meaning positive cases can isolate immediately. Since rapid testing was introduced, over 120,000 positive cases that would not have been found otherwise have already been identified by LFDs. By making rapid tests available to everyone, more cases will be detected, breaking chains of transmission and saving lives.

Alongside the rollout of the vaccine, regular testing is going to be an essential part of the easing of restrictions as it will help us quickly suppress the spread of variants. Through new testing technology, positive cases of variants of concern are being detected faster than ever before. More people getting a test will increase our ability to identify and control variants.

The NHS COVID-19 app has been breaking chains of transmission to protect users and their communities since its launch in September, with over 22 million people downloading the app to date. Updates will be made to the NHS COVID-19 app in England to coincide with the offer of rapid testing for everyone.

Prime Minister Boris Johnson said: “Massive efforts have been made by the British public to stop the spread of the virus.

“As we continue to make good progress on our vaccine programme and with our roadmap to cautiously easing restrictions underway, regular rapid testing is even more important to make sure those efforts are not wasted.

“That’s why we’re now rolling out free rapid tests to everyone across England – helping us to stop outbreaks in their tracks, so we can get back to seeing the people we love and doing the things we enjoy.”

Health and Social Care Secretary Matt Hancock said: “Around 1 in 3 people who have COVID-19 show no symptoms, and as we reopen society and resume parts of life we have all dearly missed, regular rapid testing is going to be fundamental in helping us quickly spot positive cases and squash any outbreaks.

“The vaccine programme has been a shot in the arm for the whole country, but reclaiming our lost freedoms and getting back to normal hinges on us all getting tested regularly.

“The British public have shown over the last year that they quickly adapt and always do what it is right in the interest of public health, and I know they will do their bit by getting tested regularly in the months ahead.”

Getting a rapid test

Getting a rapid test is quick and convenient. Over 100,000 businesses in England have registered their interest to provide rapid tests to their employees, and the offer of free testing is being expanded to companies with over 10 workers where on-site testing is impossible. The expanded regular testing offer for people without symptoms will be delivered through:

  • a home ordering service, which allows people to order lateral flow tests online to be delivered to their home
  • workplace testing programmes, on-site or at home
  • community testing, offered by all local authorities
  • collection at a local PCR test site during specific test collection time windows
  • testing on-site at schools and colleges

A new ‘Pharmacy Collect’ service is also launching which will provide an additional route to regular testing. People aged over 18 without symptoms will be able to visit a participating local pharmacy and collect a box of 7 rapid tests to use twice a week at home.

The best route for testing can be found at NHS.UK/get-tested. If testing at home, individuals will need to register their results online or by calling 119. They should self-isolate if positive and order a confirmatory PCR test.

Anyone with symptoms of COVID-19 should book a test online or by calling 119.

Dr Susan Hopkins, COVID-19 Strategic Response Director at PHE and Chief Medical Adviser to NHS Test and Trace, said: “Rapid testing helps us find COVID-19 cases that we wouldn’t otherwise know about, helping to break chains of transmission.

“These tests are effective in detecting people that are infectious and therefore most likely to transmit infection to others. They are another tool we now have to help maintain lower infection rates.

“I encourage everyone to take up the offer of these free rapid tests – they are quick and easy to carry out in your own home.”

Recent analysis from NHS Test and Trace shows that for every 1,000 lateral flow tests carried out, there is less than 1 false positive result. LFDs detect cases with high levels of virus and are very effective in finding people who don’t have symptoms but are very likely to transmit the disease.

NHS COVID-19 app updates

To coincide with the offer of free rapid testing for everyone, there will be updates to the NHS COVID-19 app in England from 8 April:

Everyone in a group must check in

In line with new regulations, when a group enters a hospitality venue, every individual must check either by scanning the official NHS QR code poster with the NHS COVID-19 app, or by providing their contact details. Previously, only the lead member of the group needed to provide contact details to check in.

Venue history sharing

If an app user tests positive, they will be asked to share their venue history in a privacy-protecting way via the app. This will allow venue alerts to be generated more quickly, and improve the ability to identify where outbreaks are occurring and take steps to prevent the virus spreading.

Additional venue alerts

If a person has been at a venue on the same day as several other people who have since tested positive for COVID-19, they may receive an alert advising them to book a test immediately, whether they are showing symptoms or not. This is to support finding asymptomatic cases who may have caught the virus but are not displaying symptoms.

New QR code posters

There will be new posters displaying QR codes for hospitality venues in England. Work has taken place with the industry to make the posters clearer and easier to use. All venues in England in scope of the regulations are legally required to display an official NHS QR code poster.

Scotland is expected to announce a similar set up later this week.

WHO-convened COVID-19 origins study: joint statement

Joint statement on the COVID-19 origins study convened by the World Health Organization (WHO):

The Governments of Australia, Canada, Czechia, Denmark, Estonia, Israel, Japan, Latvia, Lithuania, Norway, the Republic of Korea, Slovenia, the United Kingdom and the United States of America remain steadfast in our commitment to working with the World Health Organization (WHO), international experts who have a vital mission, and the global community to understand the origins of this pandemic in order to improve our collective global health security and response.

Together, we support a transparent and independent analysis and evaluation, free from interference and undue influence, of the origins of the COVID-19 pandemic.

In this regard, we join in expressing shared concerns regarding the recent WHO-convened study in China, while at the same time reinforcing the importance of working together toward the development and use of a swift, effective, transparent, science-based, and independent process for international evaluations of such outbreaks of unknown origin in the future.

The mission of the WHO is critical to advancing global health and health security, and we fully support its experts and staff and recognize their tireless work to bring an end to the COVID-19 pandemic, including understanding how the pandemic started and spread.

With such an important mandate, it is equally essential that we voice our shared concerns that the international expert study on the source of the SARS-CoV-2 virus was significantly delayed and lacked access to complete, original data and samples. Scientific missions like these should be able to do their work under conditions that produce independent and objective recommendations and findings.

We share these concerns not only for the benefit of learning all we can about the origins of this pandemic, but also to lay a pathway to a timely, transparent, evidence-based process for the next phase of this study as well as for the next health crises.

We note the findings and recommendations, including the need for further studies of animals to find the means of introduction into humans, and urge momentum for expert-driven phase 2 studies.

Going forward, there must now be a renewed commitment by WHO and all Member States to access, transparency, and timeliness.

In a serious outbreak of an unknown pathogen with pandemic potential, a rapid, independent, expert-led, and unimpeded evaluation of the origins is critical to better prepare our people, our public health institutions, our industries, and our governments to respond successfully to such an outbreak and prevent future pandemics.

It is critical for independent experts to have full access to all pertinent human, animal, and environmental data, research, and personnel involved in the early stages of the outbreak relevant to determining how this pandemic emerged.

With all data in hand, the international community may independently assess COVID-19 origins, learn valuable lessons from this pandemic, and prevent future devastating consequences from outbreaks of disease.

We underscore the need for a robust, comprehensive, and expert-led mechanism for expeditiously investigating outbreaks of unknown origin that is conducted with full and open collaboration among all stakeholders and in accordance with the principles of transparency, respect for privacy, and scientific and research integrity.

We will work collaboratively and with the WHO to strengthen capacity, improve global health security, and inspire public confidence and trust in the world’s ability to detect, prepare for, and respond to future outbreaks.

Student writings show what life is really like living in poverty

A new, powerful collection of writing has highlighted the lived experiences of people living with, and tackling, poverty in their communities.

Disturbing yet timely, this collection of writing from students of the Health Issues in the Community course (HIIC) reveals the corrosive effect that poverty and inequality are having on a day-to-day basis in modern Scotland.

As a society that believes in compassion and justice, the writings act as a call to action to address inequalities and the increasing number of people being swept up in the wake of crushing poverty. 

Public health specialists have drawn attention to the serious impact inequalities have – made even worse by the global health crisis brought on by the Covid-19 pandemic. 

Amidst the grim picture that is so minutely described, the writings are also witness to the power of community, of kindness, of the sense of ‘the commonweal’ that is alive in our communities. 

Broadcaster and journalist Lesley Riddoch, who provided the publication’s foreword, said: “From all the grimness of lockdown and the staleness of news comes this wee gem of a collection – words from folk who live at the sharp end of life in Scotland.

“I’ve no doubt that the folk involved in this HIIC course will use the insights and comradeship they’ve gained to start moving mountains – while taking care of one another.”

Health Issues in the Community is an SQA-accredited course for adults and young people that helps students understand what affects their health and the health of their communities.

Running for more than 20 years, HIIC brings a community development approach to tackling health inequalities and reaches more than 300 participants each year.

HIIC is managed by the Community Health Exchange (CHEX) and funded by Public Health Scotland. You can learn more about HIIC here. 

While the HIIC course encourages participants to widen and deepen awareness of health issues in their communities and their involvement, we cannot solve this issue alone. Political action is required by governments to ensure Scotland is no longer defined by poverty and inequality in the 21st century.

These writings provide the voices of lived experience to help make that a reality.

Fiona Garven, Director of the Scottish Community Development Centre, said: “These students’ writings are a stark reminder of the impact of poverty in communities across Scotland – and the power of people coming together to take action on the things that are important to them.

“With a firm foundation in community development practice, HIIC has been tackling health and social issues for more than 20 years. These writings act as further evidence for community-led responses to health inequalities, enabling students to explore and take action to address their own health issues and the health of their communities.”

Bill Gray, Organisational Lead, Public Health Scotland said: “Public Health Scotland is proud to have supported the development of the HIIC course and recognises the need to listen to voices from our communities has never been more important.

“Our Strategic Plan sets out a clear ambition to embed engagement with communities across all of our programmes of work and the experiences of HIIC participants, set out in this powerful new publication is an invaluable resource for anyone working to address health inequalities in Scotland.”

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Half of all adults in UK receive first dose of COVID-19 vaccine

Almost 95% of people aged 60 and over have been vaccinated

  • Health Secretary hails strength of the Union as UK passes major vaccine milestone
  • Matt Hancock calls on everyone to accept the jab when it’s offered

Half of all adults in the UK have received their first dose of the (coronavirus) COVID-19 vaccine, the latest figures show.

The UK health services vaccinated a total of 26.8 million people between 8 December and 19 March with first doses, while 2.1 million people have had their second dose so far.

The rollout is continuing at pace and the UK is on track to achieve the Prime Minister’s target of offering the vaccine to all over-50s by 15 April, as well as all adults by the end of July.

Health Secretary Matt Hancock said: “Vaccinating over half of all adults is a phenomenal achievement and is testament to the mammoth efforts of the NHS, GPs, volunteers, local authorities and civil servants in every corner of the UK.

“It shows the strength of the Union and what can be achieved when we work together as one United Kingdom to protect those most at risk. But the job is not done yet.

“During April, we will continue to vaccinate those most at risk and around 12 million people will receive their second doses as well. It is absolutely crucial people come forward as soon as they are eligible. When you get the call, get the jab, because the more people who are vaccinated the safer we will all be.”

The pace of the rollout means even more people will soon develop strong protection from serious illness from COVID-19 infection, saving lives and significantly reducing pressure on the NHS, which supports the Prime Minister’s roadmap to ease lockdown restrictions.

Around 4% of the adult population have had their second doses so far and there will be a strong drive over the coming weeks to vaccinate people with the second jabs within 12 weeks, as well as continuing to vaccinate those in the priority groups with first doses.

The UK government’s Vaccine Taskforce secured early access to 457 million doses of the most promising vaccines on behalf of the whole of the UK, Crown Dependencies and Overseas Territories. This allowed a co-ordinated and rapid deployment of vaccines to those most at risk.

Vaccines Minister Nadhim Zahawi (above) said: “I would like to thank everybody involved in this incredible vaccination programme across the whole of the UK for their tireless dedication to protecting the most vulnerable and saving lives.

“This is a momentous occasion and while the vaccines are the best way out of this terrible pandemic, the battle is not yet over.

“We continue to do everything we can to expand the vaccination programme even further and encourage people of all backgrounds and religions to get their jabs when eligible.”

All vaccines being used in the UK have undergone robust clinical trials and have met the Medicines and Healthcare products Regulatory Agency’s (MHRA) strict standards of safety, effectiveness and quality.

The Moderna vaccine has also been approved by the MHRA and will be deployed from the spring. Rolling reviews are also underway by the MHRA to assess the Janssen and Novavax vaccines.

Data from Public Health England’s real-world study shows that both the Pfizer and Oxford-AstraZeneca vaccines are highly effective in reducing COVID-19 among older people aged 70 years and over. We are already seeing a significant impact of the vaccination programme on reducing hospitalisations and deaths, and it is vital people come forward for their vaccine when invited.

The vaccines are available for free from thousands of vaccine centres, GP practices and pharmacies. Around 98% of people live within 10 miles of a vaccination centre in England, which includes mosques, Westminster Abbey and football stadiums.

Dr Nikki Kanani, NHS England’s primary care director and a GP, said: “Thanks to careful planning and the huge efforts of NHS vaccinators, volunteers and everyone working behind the scenes, the roll-out of the NHS vaccination programme – the biggest in health service history – continues to be a huge success.

“Their efforts meant the NHS had vaccinated half of all adults in England by Thursday, and as a GP and a vaccinator, it is source of great pride that we have now reached that major milestone across the whole of the UK.

“I would encourage anyone who is invited to come forward and book their vaccine. It is safe, quick and effective, and by having your vaccine you will join nearly 23 million people across England who’ve now been protected.”

Royal Pharmaceutical Society President Sandra Gidley said: “Vaccinating half of the UK population in such a short period of time is a huge achievement and I’m immensely proud of the role pharmacy teams have played.

“Pharmacists have been at the forefront of COVID-19 vaccinations, developing new treatments, ensuring a safe supply chain, and supporting vaccination clinics across the health service.

“I want to thank pharmacists working up and down the country in every setting, from large hospitals to those providing vaccinations in village halls, for their amazing efforts and for rising to the challenge during a time of national crisis.

“As we look to build on this success, pharmacists will continue to play a vital role in encouraging uptake of vaccines, particularly in communities where there are significant health challenges.

Professor Martin Marshall, Chair of the Royal College of GPs, said: “The hard work of GPs and our teams, along with colleagues across the NHS, to deliver the COVID-19 vaccination programme has been outstanding and ensured that vulnerable patients across the UK are protected from this terrible virus.

“It is excellent news that half the UK adult population – 26.8m people – have now received the first dose of the vaccine, with around 75% of these vaccinations taking place in primary care.

“This is an incredible milestone and the efforts of GPs and our teams have been pivotal to achieving it in such a short space of time, and despite the complexities and challenges of delivering a new vaccination programme on such a large scale.

“However, the hard work is far from over, and as long as there is supply, GPs and our teams will continue to vaccinate. Getting vaccinated is the best protection we have against this virus, and our best hope of getting back to a more normal life.

“We encourage patients to come forward for a vaccination when invited to do so.”

Background information

  1. There are a total of 52.7 million adults in the UK based on ONS data.
  2. PHE’s real-world data shows the efficacy of COVID-19 vaccines.
  3. Through the government’s Vaccines Taskforce, the UK has secured early access to 457 million doses of 8 of the most promising vaccine candidates, including:
    • BioNTech/Pfizer for 40 million doses
    • Oxford/AstraZeneca for 100 million doses
    • Moderna for 17 million doses
    • GlaxoSmithKline and Sanofi Pasteur for 60 million doses
    • Novavax for 60 million doses
    • Janssen for 30 million doses
    • Valneva for 100 million doses
    • CureVac for 50 million doses
  4. To date, the government has invested over £300 million into manufacturing a successful vaccine to enable a rapid roll out.

The UK government is committed to supporting equitable access to vaccines worldwide. The UK is the largest donor to the COVAX facility, the global mechanism to help developing countries access a coronavirus vaccine, and has committed £548 million in UK aid to help distribute 1.3 billion doses of coronavirus vaccines to 92 developing countries this year.

Dentists: Scottish Government must correct slip of the tongue on access crisis

The British Dental Association Scotland has urged immediate clarity from the Scottish Government, following comments from Health and Sport Secretary Jeane Freeman implying that NHS dentistry should be available at pre-pandemic levels.

Jeane Freeman stated today that “NHS services … should be as available now as they were before the pandemic started.”

While all treatments are now available from NHS practices, the service is operating at a fraction of its former capacity to keep to strict infection control protocols to limit the spread of the virus. The BDA understands practices across Scotland have been overwhelmed with calls following this statement. 

The Scottish Government is currently only providing enough PPE to treat 10 patients per day (or 5 for Aerosol Generating Procedures involving high-speed instruments) covering just 20-30% of pre-Covid patient numbers.

The BDA has called for real commitment to restore pre-pandemic levels of dentistry. Unlike the Northern Irish and Welsh administrations, the Scottish Government has so far made no commitments to help practices invest in ventilation equipment, that can radically reduce or element the ‘fallow time’ gaps between appointments, designed to reduce the spread of the virus.

It is also seeking urgent interim funding to keep the service sustainable and help practices deal with the unprecedented backlog of patients.

Recent official data indicated that between September and November 2020 the number of adults seen by NHS dentists was around a third of the 2018-19 average, before falling to 28% of the 2018-19 average in December 2020. 

In 2020, children and adults from the most deprived areas were less likely to have seen their dentist within the last two years than those from the least deprived areas (73.5% compared to 85.7% of children and 55.9% compared to 67.1% of adults). These inequalities in access between the most and least deprived areas have grown since 2019, particularly in children.

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: “Ministers seem to have forgotten that all dentists are operating at a fraction of their former capacity, to keep to strict infection protocols set by their government.

“With severe limits on access emergency and urgent cases need to be at the front of the queue. Sadly, this slip of the tongue has left phones ringing off the hook in practices across Scotland.

“We are facing an unprecedented backlog, and the Scottish Government needs to provide funding and support to restore routine services. As it stands if check-ups recommenced today, we wouldn’t be able to offer appointments for six months.

“Even before the pandemic Scotland’s oral health inequalities were a national scandal. Now that gap looks set to widen, with public health programmes suspended and millions unable to access care.

“Dentists are losing the chance to act on the early signs of decay, gum disease and oral cancers. If we’re ever going to turn the page we need to see real commitment from Government.”

Coronavirus vaccine fears: Keep using Astra Zeneca, urges WHO

The World Health Organization (WHO) has urged countries not to pause Covid vaccinations, as several EU countries halted their rollouts of the Oxford AstraZeneca jab.

It said there was no evidence of a link between the vaccine and blood clots.

Germany, France, Italy and Spain have now joined Denmark, Norway and Iceland in halting vaccinations as a precaution while data is examined.

WHO’s vaccine safety experts meet today to discuss the Oxford AstraZeneca vaccine.

The European Medicines Agency (EMA) will also meet and is due to draw conclusions on Thursday. It has also said the vaccine should continue to be used.

Scotland’s First Minister Nicola Sturgeon sought to reassure anxious Scots over safety concerns yesterday.

She told the daily media briefing: “We are of course – as I’m sure you are too – aware that some countries, most recently the Netherlands and the Republic of Ireland, have paused their use of the AstraZeneca vaccine.

“You might be hearing reports of this in the media and you might have concerns as a result. So I wanted to take the opportunity today to address this directly.

“In the UK, the decision to suspend the use of any vaccine is a matter for the Medicines and Healthcare Products Regulatory Agency (MHRA).

“The MHRA has confirmed to us that there is no current evidence of an increase in blood clots being caused by the AstraZeneca vaccine. That is the issue that has caused the pause in some other countries.

“As you would expect, though, the MHRA is continuing to monitor this carefully, and it remains in regular contact with other regulators. 

“There is, however, significant and growing evidence of the benefits of vaccination in reducing death, illness and we hope now, reducing transmission as well –  and the vaccination programme continues to make very good progress.

“So for all these reasons and based on the advice and opinion of the MHRA, we continue to urge people to come forward for vaccination included with the AstraZeneca vaccine when you are invited to do so.“

Indeed, I can confirm that, as of 8.30 this morning, 1,908,991 people in Scotland have received the first dose of the vaccine.

“That is an increase of 20,294 since yesterday.

“In addition, 1,907 people yesterday received the second dose, which brings the total number of second doses now to 161,945.

“So as of now, virtually all people over the age of 65 have had the first dose of the vaccine. So too have 53% of 60-64 year olds; 41% of 55 to 59 year olds; and 33% of 50 to 54 year olds.

“As the Health Secretary indicated when she was here on Friday, we expect the pace of vaccination to pick up significantly again this week in line with increased supplies.

“So we are expecting that, taking first and second doses together, there will be around 400,000 vaccinations done over the course of this week.”

MHRA response to the precautionary suspensions of COVID-19 Vaccine AstraZeneca

‘It has not been confirmed that the reports of blood clots were caused by the AstraZeneca COVID-19 vaccine. People should still go and get their COVID-19 vaccine when asked to do so.’

Dr Phil Bryan, MHRA Vaccines Safety Lead said: “We are closely reviewing reports but the evidence available does not suggest the vaccine is the cause.

“Blood clots can occur naturally and are not uncommon. More than 11 million doses of the COVID-19 Vaccine AstraZeneca have now been administered across the UK, and the number of blood clots reported after having the vaccine is not greater than the number that would have occurred naturally in the vaccinated population.

“We are working closely with international counterparts in understanding the global safety experience of COVID-19 vaccines and on the rapid sharing of safety data and reports.

“People should still go and get their COVID-19 vaccine when asked to do so.”

UK Government must act now as report shows infection control guidelines ‘fundamentally flawed’

A report commissioned by the Royal College of Nursing shows that the government’s COVID-19 infection control guidelines, which are used across the UK, are “flawed and need replacing”.  

The report, written by independent experts, analysed a literature review which underpins the current guidance and found that the review met just four of the 18 criteria the experts deemed essential. Crucially, the report found that the review failed to consider a key way in which COVID-19 is transmitted – airborne infection – about which growing evidence has emerged during the pandemic.  

For these reasons, the experts concluded the review provided only a “superficial account” of the available COVID-19 evidence and that the current guidelines based on the review need replacing.

In the report, the authors Professor Dinah Gould, an Honorary Professor of Nursing at London’s City University, and Dr Edward Purssell, also from City University, said: “UK infection prevention and control (IPC) guidance to prevent the spread of COVID-19 in health care settings, and the rapid reviews of the literature on which it was based, still identify droplet spread and hands as the major route, based on early advice from the World Health Organization (WHO).   
“Updated evidence indicates that aerosol spread is much more significant and the original advice from the WHO has been superseded. The UK guidelines are still based on this outdated evidence, however. They urgently need thorough revision and replacing.”  

The report highlights that the guidelines omit detail on the importance of ventilation and advise that higher level personal protective equipment (PPE) must only be provided in certain high-risk settings like intensive care, but that it’s up to individual health trusts to decide whether or not to provide them more widely to other staff.   

This has caused huge concern for members, especially with the emergence of highly infectious new COVID-19 variants. Members have also expressed concern about the lack of action on ventilation in UK hospitals as research suggests airborne transmission is a particular problem in poorly ventilated rooms. 

The RCN has repeatedly tried to engage the government on these issues and is calling for all NHS staff to be given a higher level of PPE as a precautionary measure pending the outcome of a review. 

RCN Chief Executive & General Secretary Dame Donna Kinnair said: “We have been battling this pandemic for more than a year now. ‘Following the science’ is a hollow boast when we have evidence showing the flaws.   

“The report and its findings must launch an official review and not be swept under the carpet as an inconvenience.

“Health care workers need to know everything possible is being done to keep them protected. It is inadequate to say they have masks if they aren’t fit for purpose. Staff are scared for themselves and their families and left any longer it’ll turn to anger.”

Blue do: Tory MSP slams NHS Lothian vaccination letters breakdown

NHS LOTHIAN: ‘THIS SHOULD BE RESOLVED VERY QUICKLY’

Lothian MSP Miles Briggs has said that an urgent investigation is needed into the breakdown in communication between the Scottish Government and people in the Edinburgh and the Lothians expecting their first vaccination letters.

The target to have everyone over 50 in Scotland vaccinated with the first dose of Covid-19 vaccine by mid-April, is expected to be met. Lothian residents are however being told they won’t get their first vaccination until May.

Additionally some residents aged 60 and over are phoning the Covid-19 vaccine helpline, to be told their vaccination is due next week, but they haven’t received a letter.  

Yesterday (Thursday 11th March) the Lothian MSP raised the issue of vaccination letters with the First Minister:

‘I have been contacted by a number of constituents who are becoming increasingly concerned about the roll-out of the Covid-19 vaccination programme in Edinburgh and about the inconsistencies relating to people in different age groups being called to be vaccinated.

‘I have raised those concerns with the Cabinet Secretary for Health and Sport. I appreciate that there will be some overlap within age groups, but there seems to be confusion about when those in the 60 to 65-year-old age group will receive their vaccination in Edinburgh.

‘I am sure that the First Minister agrees that it would be unacceptable for NHS Lothian residents to be behind those in other health board areas. What additional resources will NHS Lothian receive? Will she investigate the situation? Why is the Scottish Government not publishing age-specific vaccination uptake figures for health boards?

There has also been a delay to people hearing back from the online system where people submit a vaccination form if they think they should have had a vaccination appointment letter, due to the “high volume of enquiries”.

Lothian MSP, Miles Briggs, said: “It is the responsibility of the Scottish Government to distribute vaccination appointment letters to everyone in Scotland.

“This week something has obviously gone very wrong with people not receiving their letter, or being told their appointment is not until May.

“An urgent investigation is needed to give people clarity on when their appointment will be and they are not being forgotten about.

“The rollout of the Covid-19 vaccination is too important to get wrong and we all want it to happen as quickly as possible so that restrictions can be lifted safely.

“SNP Ministers have to date refused to provide a breakdown of the numbers of people in age groups in each Health Board who have received the vaccination. It would be totally unacceptable for people in Lothian to be at the end of the queue.

“I would encourage people aged between 60-65, due for COVID-19 vaccine, who live in NHS Lothian and who have not received an appointment letter then phone 0800 030 8013.”

Health Secretary Jeane Freeman insisted there are no ‘systemic problems’ when she led the daily media briefing this afternoon.

NHS Lothian finally clarified the situation this evening:

.’We are vaccinating the “priority groups” of patients as fast as the vaccine supply allows. We are currently vaccinating group 6 and next week (week commencing March 15) will extend into group 7, which is patients aged 60 years and over.

‘Appointment letters are being distributed by a central system to patients across Scotland. We understand there has been a delay in sending out some appointment letters this week (March 12).

‘This should be resolved very quickly and the letters are expected to arrive by this weekend. However, if you are over 60 and have not received an appointment letter by Monday (March 15), please call the national helpline on 0800 030 8013.’