Thousands of vaccinations planned for Tuesday have had to be cancelled following the latest change in advice on the use of the AstraZeneca vaccine.

Up to 15,000 appointments due to take place on Tuesday will have to be rescheduled by the HSE after the Department of Health said the vaccine should not be given to people aged under 60, according to informed initial estimates.

Most of those affected are high-risk and very high-risk patients who were due to receive the vaccine from GPs or in hospitals.

Hospital Report

This decision was based on a recommendation by the National Immunisation Advisory Committee (Niac), prompted by reports across Europe of unusual but severe clotting events as very rare side-effects to the vaccine.

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The HSE is now assessing the possible longer-term effects of the change, which has severely curtailed the possible use of the AstraZeneca vaccine. Over 800,000 doses of this vaccine are to be delivered to the State in this quarter.

Since most over-70s have either been immunised with other vaccines or will be shortly, the remaining substantial use for the AstraZeneca is with 60-69 year olds.

Updated guidance

The HSE on Monday night wrote to hospital groups and community healthcare organisations advising that all AstraZeneca vaccination clinics planned for Tuesday should be cancelled in light of the updated guidance.

“Anybody due to attend an AstraZeneca clinic is therefore advised not to do so. We will be in contact with patients in due course to rearrange their appointment.”

In its recommendation, Niac also says a second dose should not be given to anyone who developed unusual blood clots with low platelets after the first dose. Those aged 60 and older should receive their second dose 12 weeks later as scheduled, as should under-60s with a very high-risk or high-risk medical condition.

Those under 60 without a very high-risk or high-risk condition will have the interval between their doses extended to 16 weeks to allow for further assessment of the benefits and risks of the vaccine, as more evidence becomes available.

No one who has received a first dose of the vaccine is due to get a second dose until early May, leaving the health service some breathing space to redraft its plans.

Acting chief medical officer Dr Ronan Glynn said the change in advice was based on “an abundance of caution”.

“The [age] cut-off could easily have been less than 60 but this was done for an abundance of caution,” he told a briefing at the Department of Health.

Impact

He said it was difficult to be entirely clear what impact the change would have on the vaccine rollout.

“It will likely have an impact, but the extent of this remains to be seen.”

It was “not necessarily the case that this will have a material impact or delay on rollout”.

Dr Glynn said he appreciated there may be some vaccine hesitancy following the decision, but he felt people would be reassured once they understood the reasons for the change.

According to Prof Karina Butler, chairperson of Niac, the significant benefits of a national vaccination programme had to be balanced against the very rare risk of the reported blood clot events.

“While this is an extremely rare condition, consideration must be given to the fact that it has a very high risk of death or severe outcome,” she said.

Sources say an initial shipment of the Johnson & Johnson vaccine is expected on Wednesday, with 14,000 doses in the consignment. However, it is expected the goal of reaching 180,000 vaccinations this week will now be difficult to hit.

Responding to Niac’s recommendation, AstraZeneca said reviews by regulators in the EU and UK had shown its vaccine offers a high level of protection against Covid-19 and that these benefits continue to “far outweigh” the risks.

“Neither agency identified any risk factors, such as age or gender, or a definite cause for these extremely rare blood clotting events.”