Dear Patients

We are receiving a lot of questions about COVID19 vaccines, particularly Astra Zeneca. This has led to our vaccination clinics taking longer and has resulted in a large increase in phone calls.

To help patients understand a bit more about the vaccines, we have attempted to answer some of the most common concerns below:

Can we chose which brand of vaccine we have?

It is not possible for patients to choose which brand of vaccine they have. GP practices use whichever vaccines we are supplied with. We follow NHS England and JCVI (Joint Committee on Vaccinations and Immunisations) guidance. This means that, if we need to give an alternative vaccine to those we have in stock, it will be a clinical decision, based on evidence, and we will arrange for that patient to have a different vaccine on a different day, possibly at a different site.

What about under 30s?

Currently, if someone is aged under 30, with no clinical risk factors, then we are suggesting that they have an alternative vaccine to Astra-Zeneca. This is because, for that specific group, as there is a relatively low circulating level of Covid-19 infection at present, the possible risk of side effects from the Astra-Zeneca Covid-19 vaccine is greater than their risk of complications from Covid-19. If the level of Covid-19 in the community goes up, then that risk may change and it may be that, because they are more likely to catch it, the risk from Covid-19 infection is greater than the possible risk from the vaccine. Certainly, if someone is aged under 30 and they have a clinical risk factor which means they are more likely to be seriously affected by Covid-19 infection, even with the current relatively low levels in the community, the benefit of having the Astra-Zeneca Covid-19 vaccine outweighs the possible risk and those people should still have the AZ vaccine.

What about over 30s?

The NHS says the reason for not having an Astra-Zeneca Covid-19 vaccine is a past history of major thrombosis (blood clots) of very particular types, as detailed below.

The contraindications to having Astra-Zeneca Covid-19 vaccine are a past major thrombosis (blood clot) with thrombocytopenia (low platelets). This is an extremely rare situation. It includes previous reactions to the Astra-Zeneca Covid-19 vaccination and previous heparin-induced thrombocytopenia (this would be diagnosed in hospital and the patient would know about it).

People who have a history of cerebral venous sinus thrombosis (rare blood clot in the brain) without low platelets, and people with acquired or genetic thrombophilia (a proven condition associated with blood clots occurring more easily), or antiphospholipid syndrome, may wish to discuss the risks and benefits of Astra-Zeneca Covid-19 vaccination with a clinician.

A history of having had a blood clot alone (without low platelets or proven tendency to clots) is not a reason not to have the AZ vaccine.

What about post vaccination side effects?

After you have received your vaccination people can have fatigue, fever, flu-like symptoms and headache after the vaccine. These conditions are normal and tend to resolve in the 4 days or so after the vaccine.

If, from 4 days to 4 weeks after the vaccine, you develop:

• a severe headache which is not helped by painkillers, which is getting worse, or is worse when lying down, or is associated with blurring of vision, nausea or vomiting, problems speaking or seizures,

• a rash under the skin which looks like little bruises and doesn’t go away with the glass test,

• shortness of breath, chest pain, leg swelling, or persistent, severe tummy pain.

You should telephone 111 or 999. Anyone feeling extremely unwell should not be calling the GP as this is a serious (rare) emergency situation.

We hope that this helps explain some of the things people are asking about.

If you have any further questions please go to the most comprehensive COVID19 resource:

https://www.nhs.uk/.../coronavirus.../coronavirus-vaccine/

Thank you for your understanding.

Published: Apr 16, 2021

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