What exactly is happening with AstraZeneca?

Sam Russell wrote: »

My point about Gardai being given any excess doses of vaccine was that they are always available (well those on duty) and are able to arrive with little notice. Now, on another point, there are just 14,000 of them which is one days worth of vaccine at the current rate, so no biggie if they got vaccinated ahead of others. There are Gardai self isolating after coming into contact with quaritine subjects who tested positive.

Yes. The point being that there is a logic to vaccinating people who do high risk jobs, such as the gardai, as a priority. Which is precisely the point.

That appears to be the message from the HSE - most people will be vaccinated by September.

Most people is not the same as everyone who wants one. Most people can be 51% of people, or even 51% of people eligible for the vaccine, or even 51% of people who are eligible and who want it.

I also maintain suspicion about these high level projections by the HSE because they have been wrong before and, more importantly, it masks the lack of detail.

In any event, my point is that if they can guarantee that everyone who wants one can get one, then doing it by age makes sense as an easy way to roll it out. But that is not the scenario that we have. If we have to distribute a limited quantity of vaccines in 2021 (assuming that there will hopefully be wide availability in 2022), then we should distribute them to gain the maximum public health benefit. Priority no. 1 is to give the vaccine directly to the most vulnerable i.e. those at a high risk of death or serious illness as a result of covid. But when that is achieved, as will hopefully be done soon, the vaccines should be distributed in a manner that achieves the best possible public health result.

Now, there are other factors to public health beyond the immediate issue of ensuring that people don't catch covid and don't develop severe symptoms, but just looking at those two factors, it makes sense that once those at high risk of severe symptoms are vaccinated, that emphasis should change to including vaccinations to stop the spread in addition to continuing to vaccinate people by risk profile.

And you accept that it is possible to select certain high risk jobs and vaccinate them.

It would seem unfair to me (and NPHET - see below) that you would vaccinate a 40 year old computer programmer who is working from home alone over a 25 year old shop employee who lives in shared accommodation, but leaving fairness out of it, society as a whole would benefit more from vaccinating the latter as the latter is more likely to catch and spread covid than the former is.

NPHET expressly acknowledge this in their working document on Covid from last year. They even point out that if there is evidence to suggest that the vaccines reduce transmission risk, then people aged 18-34 should be prioritised due to their increased level of social contact and increased role in transmission. This isn't for the benefit of those aged 18-34, but rather its a reflection of the reality that a 20 year old student might socialise a bit during the term (no judgment being passed) and then go home to their families at the weekends. Stopping the spread of the virus can be an effective way of protecting everyone.

If the flow of vaccines is as expected by the HSE, the whole question of who should be first will be moot by the end of May. Teachers will be on holiday, so they will not matter one way or the other - the older ones will be vaccinated while the younger ones will be self isolating at home.

I don't know why you're mentioning teachers, but Gardai are the most apposite example. It's easy to dismiss the teachers, but that simply isn't who I am talking about. More importantly, however, it isn't about individual considerations, it's about public health. So the government are going to have to put on their big boy pants and do what is in the best interests of public health, not just follow the path of least resistance.

If by the end of May all over 70s, those with serious medical conditions and frontline healthcare workers are fully vaccinated, then we will be doing well for ourselves. But that is still only a fraction of the total population. It will not render the issue of who to vaccinate next moot as you suggest. The other 80% of adults aren't all teachers and aren't all going away on summer holidays.

Age is simple, we all know when we were born (even if some would rather others did not know). Profession is a difficult matter as it gets blurred at the edges. Are hospital porters or cleaners 'health care workers' or are they just porters and cleaners?

They may not all have been vaccinated with frontline health care workers but do get vaccinated with other healthcare staff and should be vaccinated as a priority. Porters have direct contact with patients and hospital staff, and cleaners have to physically enter and clean the fittings, some of which had contact with covid patients. It's simple really - if you go into a hospital with a broken leg, and the porter or cleaner has covid, then you are at risk of catching covid. Vaccinating hospital porters and cleaners pays a greater dividend to society because of this. It's also the right thing to do, not just in my view as starred above, but also in NPHETs view under the principle of reciporicity:

The principle of reciprocity requires that special consideration be given to those groups who play an essential role in responding to the pandemic and, in doing so, place themselves at greater risk of being infected than the general population.

It is entirely reasonable and fair that a 30 year old hospital porter should be vaccinated in priority over a 40 year old who is working from home. And it really isn't all that difficult to establish or administer such schemes.

They all know how old they are. Everyone should accept that they must wait for their turn to come around - meanwhile Wash hands, wear a mask, and keep distance - but most important, stay at home except for essential reasons. Exercise allows you to venture out up to 5 km (not otherwise).

Stay safe.

I feel like we are talking at cross purposes. I'm discussing the public health advice and how that has been altered for political expediency. You are talking about the individual advice on how to behave in the next few months. These are very different debates.

Deleted User wrote: »

https://www.google.com/amp/s/medicalxpress.com/news/2021-04-ema-links-astrazeneca-vaccine-thrombosis.amp

Apologies if this link isn't ligit, someone more in the know might confirm. Will this mean it will be paused again?

It should mean that anyone who is to receive the AZ vaccine should be informed that there is a small risk of thrombosis and blood clots if you take it, and then people can make the informed decision whether to take it or not. It will be added to the list of known rare side effects. Most people, I suspect, will still take it.

The HSE already has this warning up on their website:

https://www2.hse.ie/screening-and-vaccinations/covid-19-vaccine/astrazeneca/side-effects.html

Very rare cases of unusual blood clots along with low levels of blood platelets have been seen in less than 1 in 100,000 people after vaccination with the AstraZeneca COVID-19 vaccine

robinph wrote: »

Is this blood clot risk something that sneaks up on you and people don't notice they have been affected by it until it's too late? Or does the instructions on vaccination just need to change to tell potentially affected people to keep any eye out for symptom X and call this phone number the moment you notice something, they then treat the clot and all is well?

Would have thought if the symptoms are noticeable that something like a blood clot is treatable relatively easily.

It can be both. You might notice it or you might not. It might dissolve naturally with no ill effects or it might be very serious:

https://www.healthline.com/health/how-to-tell-if-you-have-a-blood-clot#legs-or-arms

However, the risk seems to be very low at the moment, possibly lower than the risk of a blood clot as a result of a long haul flight or the risk from sitting at a desk for 8 hours a day in an office job.