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Public Health Wales statement on safety concerns with AstraZeneca COVID-19 vaccine

Published: 9 April 2021

Public Health Wales supports the expert scientific advice of UK expert groups that the benefits of vaccination with all COVID-19 vaccines in use continue to outweigh the risks of COVID-19. COVID-19 has caused over 120,000 deaths in the UK, with an average of 30 deaths a day still being reported. The vaccination programme has already saved over 6,000 lives.  

Following reports of an extremely rare and specific blood clot after vaccination with the AstraZeneca COVID-19 vaccine, the Medicines and Healthcare Regulatory Agency (MHRA) and the Joint Committee on Vaccination and Immunisation (JCVI) confirmed on 7 April 2021 that this type of blood clot with low platelets (sticky cells) are a possible side effect of the vaccine. However, they continue to advise that the benefits of vaccination with the AstraZeneca COVID-19 vaccine continue to outweigh the risks of COVID-19 for the vast majority of adults. 

Public Health Wales is aware of one confirmed case of this extremely rare type of clot in Wales after receiving AstraZeneca COVID-19 vaccine among over 1 million people who have received that vaccine.  

The expert scientific advice from the JCVI is that risk benefit remains strongly in favour of vaccination with the AstraZeneca vaccine for those aged 30 and over, and those aged under 30 who have underlying health conditions which puts them at higher risk of severe outcomes from COVID-19 infection. 

However, JCVI advise that adults aged 18-29 years old who do not have underlying health conditions should be offered an alternative vaccine balancing risks and benefits. Health Boards in Wales will be offering alternative vaccines to this group, while continuing to offer all available vaccines at all other ages.  

Those who have received a first dose of the AstraZeneca vaccine irrespective of age, should continue to receive a second dose. To date there have been no confirmed cases of the extremely rare and specific blood clots after receiving the second dose of the vaccine.     

Dr Richard Roberts, Head of the Vaccine Preventable Diseases Programme at Public Health Wales said:  

“The risk of these extremely rare blood clots is extremely low and the risk benefit in comparison to contracting COVID-19 disease is still very much in favour of vaccination.  

“For example, the risk of people in their 40s dying if they catch COVID-19 is 1,000 per million, so if 1 million in their 40s caught COVID-19 then 1,000 would die,  10,000 would be hospitalised and 160,000 would get ‘long COVID’. If all 1 million were vaccinated with two doses of AstraZeneca vaccine it would prevent over 900 deaths, 9,000 hospitalisations and 145,000 cases of long COVID, with the possibility there would be four cases of rare blood clot events and one additional death.  

 “No medicine or vaccine we receive is without risk and we accept these very low risks because of the benefits we receive. For example, the risk of blood clots in women who take the Oral Contraceptive Pill is higher than those not taking the pill, and this is accepted because of the benefits.     

“Common side effects after vaccination are normal and expected. For all approved vaccines in the UK, these side effects can include a sore arm, feeling tired, headache, mild aches or flu like symptoms, and a mild fever that normally last up to two or three days after vaccination. 

“If an individual experiences the following symptoms starting four days to four weeks after the vaccine they should seek medical care promptly: 

  • New severe headache which does not respond to simple painkillers 

  • An unusual headache which seems worse when lying down or bending over 

  • Headache accompanied by blurred vision, nausea and vomiting, weakness, drowsiness or seizures 

  • Unexplained pin-prick rash or bruising away from injection site 

  • Shortness of breath, chest pain, leg swelling or persistent abdominal pain. 

“Public safety remains at the forefront of our concerns and MHRA will continue to monitor vaccine safety working closely with JCVI and this issue will be kept under review. 

“Vaccination remains the best way to protect yourself against COVID-19 disease.”