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The UK AstraZeneca advice for under-30s

AstraZeneca, a viral vector vaccine for the prevention of Covid-19, was approved by the Medicines and Healthcare products Regulatory Agency (MHRA) on 30th December 2020

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The UK AstraZeneca advice for under 30s

AstraZeneca, a viral vector vaccine for the prevention of Covid-19, was approved by the Medicines and Healthcare products Regulatory Agency (MHRA) on 30th December 2020. Clinical trials showed that AstraZeneca was safe and effective in preventing Covid-19. According to the AstraZeneca press release on 25th March 2021, the Phase III clinical trial found that AstraZeneca was 76% effective against symptomatic Covid-19 and 100% effective at preventing hospitalisation and severe disease. Furthermore, it was reported that the vaccine was 85% effective against symptomatic Covid-19 in people above 65. AstraZeneca was added to the UK Covid-19 vaccination programme from 4th January 2021. Public Health England (PHE) estimates that the Covid-19 vaccination programme prevented 10,400 deaths in individuals aged 60 and over up to the end of March 2021.

Several European countries, including France, Italy, Germany and Spain suspended the use of AstraZeneca in mid-March following reports of blood clots in some recipients. The leading European countries said that this pause of AstraZeneca was a “precautionary measure”. However, after the European Medicines Agency (EMA) declared AstraZeneca to be “safe and effective”, the European countries resumed their roll-out of AstraZeneca. 

On 7th April, the MHRA published a statement following reports of an extremely rare adverse event after vaccination with the first dose of AstraZeneca. The MHRA confirmed that the benefits of AstraZeneca outweighed the risks for the vast majority of people. However, MHRA said that there is a link between AstraZeneca and rare blood clots which are accompanied by a low level of platelets. The MHRA received 79 reports from the UK of extremely rare blood clotting accompanied by low levels of platelets in individuals who were given their first dose of AstraZeneca. Of these 79 cases, 19 individuals died, 11 of which were below the age of 50 and 3 individuals were under 30 years of age.  By the end of March 2021, 20.2 million doses of AstraZeneca have been given to individuals in the UK, the overall risk of these blood clots is about 4 in a million.. 

Dr June Raine, MHRA Chief Executive, said: “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 (cerebral venous sinus thrombosis) 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.”

The Joint Committee on Vaccination and Immunisation (JCVI) which advises the government health departments on such matters published an independent report on the use of AstraZeneca on 7th April 2021. According to this report, “there is currently a high level of uncertainty in estimates of the incidence of this extremely rare adverse event by age group” but “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”. The committee advised that “prompt vaccination” with AstraZeneca far outweighs the risk of adverse events for individuals above the age of 30 and those who have underlying medical conditions which put them at increased risk of severe Covid-19 disease. However, it is preferable that individuals below the age of 30, who do not have an underlying medical condition which puts them at increased risk of severe Covid-19 , be offered an alternative vaccine. Pfizer and Moderna are the two other vaccines against Covid-19 that are approved for use in the UK.  

JCVI says that those adults who have had their first dose of AstraZeneca should continue to receive their second dose, irrespective of age. This is because to date, there are no reports of the rare blood clotting alongside low platelet levels after the second dose. The adverse event is only reported following the first dose of AstraZeneca. GPs have been told to cancel the AstraZeneca vaccine appointments from 9th April 2021, which have already been booked for individuals under 30 who are 

to receive their first dose of vaccine. Individuals, who are affected by the cancellations,  will then be asked to contact their GP team to discuss the benefits and risks associated with AstraZeneca or another Covid-19 vaccine. 

MHRA suggests a possible link between AstraZeneca and extremely rare blood clots with low platelet levels. However, these blood clots and low levels of platelets are very rare, and the benefits of AstraZeneca outweigh the risks for the vast majority of people. The JCVI advises that individuals under 30, who do not have any underlying medical condition, should be offered an alternative vaccine where possible. Individuals who had their first dose of AstraZeneca, and have not  suffered  adverse effects of blood clots, should go for their second dose vaccine appointment when invited.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

Health

UN World Food Program Lowers Aid in South Sudan

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800px Sudan Envoy USAID and WFP Aid

The United Nations World Food Programme (WFP) recently decreased aid services in South Sudan, a major blow for the Central African country where over two-thirds of the population faces food shortages and hunger. 

“Faced with increasing humanitarian needs and insufficient funding, we have taken the painful step to suspend food assistance to 1.7 million people,” said Adeyinka Badejo-Sanogo, WFP Acting Country Director in South Sudan. Instead of assisting an estimated 6.2 million people in the country, the WFP will now only provide aid for 4.5 million. 

Large floods over the last three years have destroyed farms and homes across South Sudan, displacing hundreds of thousands of people. This year, UN officials anticipate more flooding, which will put around 600,000 people at risk of displacement. Violence in South Sudan has similarly forced many people to leave their homes, placing them in vulnerable situations. According to Ms. Badejo-Sanogo, “So far this year, we have seen 200,000 people newly displaced as a result of conflicts.”

South Sudan’s people are in a dire situation, and the international community must make greater efforts to send humanitarian aid to the country. Unfortunately, the Russia-Ukraine War has already diverted many countries’ focus, and nations are struggling with their own economic problems.

But ultimately, even if aid to South Sudan can be increased, it is only a temporary solution. Developing the infrastructure to combat flooding and quelling violence in the nation will create more sustainable long-term solutions.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Health

The End of Roe v. Wade Has Dangerous Consequences for Women’s Health

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When the Supreme Court overturned Roe v. Wade, they did not just steal bodily autonomy from women, but also their future health. By overturning Roe, the Supreme Court has now put pressure on physicians prescribing life saving medications to women.

Abortion has now been banned in six states, and that number is likely to rise swiftly to 16 states. Twelve states have passed trigger laws. Some states have not completely banned abortions, however they have implemented gestational age limits on abortions. While other states have not decided whether or not to ban abortions, the courts and lawmakers will be deciding the fate of women. Only 20 states have abortion protections in place.

These new bans have also brought into question the future of birth control. Will states begin restricting or even outlawing birth control? Although Republicans have dismissed concerns about banning birth control, Democrats have been warning that it is a distinct possibility. Indeed, after Missouri’s strict new ban on abortion went into effect, one major hospital system in Kansas briefly stopped providing emergency birth control, even to victims of rape. 

But the potential healthcare ramifications of these laws do not end there. Many drugs cause birth defects in pregnant women, which raises the question: If women cannot legally terminate a pregnancy, can these drugs legally be prescribed to women of child-bearing ages in states with abortion bans?

“I believe that prescribing is going to become much more defensive and conservative,” rheumatologist Mehret Talabi told Medscape. “Some clinicians may choose not to prescribe these medications to patients who have childbearing potential, even if they don’t have much risk for pregnancy.”

Teratogens are medications which can cause birth defects. Many teratogenic medications include treatments for acne, cancer, rheumatoid arthritis and psoriasis.

“Doctors are going to understandably be terrified that a patient may become pregnant using a teratogen that they have prescribed,” Talabi said. “While this was a feared outcome before Roe v. Wade was overturned, abortion provided an escape hatch by which women could avoid having to continue a pregnancy and potentially raise a child with congenital anomalies.” “

Other physicians also shared their fears that doctors would now be wary of prescribing many medications, some of those with little data on pregnancy. 

Dr. Megan Clowse, a Duke University rheumatologist who works with women who are or wish to become pregnant, told Medcape: “Women who receive these new or teratogenic medications will likely lose their reproductive autonomy and be forced to choose between having sexual relationships with men, obtaining procedures that make them permanently sterile, or using contraception that may cause intolerable side effects..”

Dr. Clowse noted that many drugs commonly prescribed to patients with rheumatic diseases, including methotrexate, mycophenolate and cyclophosphamide, are linked to birth defects and loss of pregnancy.. 

“I am very concerned that young women with rheumatic disease will now be left with active disease resulting in joint damage and renal failure,” she said.

One of these drugs, methotrexate, is an effective cancer treatment and many rheumatic conditions, but has also been used to cause abortions. “If legislators try to restrict access to methotrexate, we may see increasing disability and even death among people who need this medication but cannot access it,” Dr. Talabi said.

Mayo Clinic gastroenterologist Dr. Sunanda Kane told Medscape she feared that several of the teratogenic medications used in her field to treat viral hepatitis, constipation and inflammatory bowel disease, would now be affected. While she said doctors in her field generally only prescribe medications with high teratogenic potential to women of childbearing age when they use multiple forms of birth control to prevent pregnancy, she noted that doctors may be less likely to prescribe such drugs if abortion is not available as a legal option. 

“The removal of abortion rights puts the lives and quality of life for women with rheumatic disease at risk,” Dr. Clowse added. “For patients with lupus and other systemic rheumatic disease, pregnancy can be medically catastrophic, leading to permanent harm and even death to the woman and her offspring. I am worried that women in these conditions will die without lifesaving pregnancy terminations, due to worries about the legal consequences for their physicians.”

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Daily Brief

Children Under 5 to get Covid-19 Vaccine by Next Week

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A child gets the Pfizer–BioNTech COVID 19 vaccine
  • The FDA’s outside vaccine advisers finally approved Moderna’s two-shot vaccine for children under age 5. The panel is also set to vote on whether Pfizer’s three-shot series is suitable and safe for this age group.
  • This is the last remaining group in the US to get vaccinated and many outside experts agree that the benefits of Moderna’s COVID-19 vaccine outweigh the risks for children under 5.  If all the regulatory steps are cleared, vaccines can be available by next week.
  • Dr. Joy Portnoy of Children’s Hospital in Kansas City, MO, also a  panel member, stated “there are so many parents who are absolutely desperate to get this vaccine and I think we owe it to them to give them a choice to have the vaccine if they want to.”
  • FDA reviewers stated that both brands appear to be effective and safe for children as young as 6 months, and the most common side effects, which are fever and fatigue, appear to be less common than seen in adults. 
  • Although the two vaccines use the same technology, the shots have not been tested against one another.
  • Once the FDA approves the shots, the CDC will decide on a formal recommendation. Pfizer’s vaccine will be available to children 6 months to 4 years, while Moderna’s vaccine will be for 6 months to 5 years. 
  • Pfizer’s shots are 1/10 of the adult dose, while Moderna’s shots are ¼ of the adult dose. 
  • Moderna is also seeking regulatory approval outside the US for younger children as well. 12 countries already vaccinate children under 5 with other brands.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Society

Monkeypox could be sexually transmitted disease – WHO

Monkeypox virus is caused by skin to skin contact and may be a sexually transmitted disease, warns the World Health Organisation.

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monkeypox

The World Health Organisation (WHO) has started its research on the reports that the monkeypox virus is present in the semen of patients. 

This presents a possibility that monkeypox could be sexually transmitted from one patient to their partners.

It is reported that most cases are in men who have sexual relations with men. 

The WHO has said that the main transmission of the rare disease is through close interpersonal contact.

In Italy and Germany, scientists say that they have detected viral DNA in semen for a small number of monkeypox patients. The virus found in the semen was capable of infecting another person. 

The WHO monkeypox incident manager in Europe, Catherine Smallwood said during a press briefing “this may have been something that we were unaware of in this disease before.”

“We really need to focus on the most frequent mode of transmission and we clearly see that to be associated with skin to skin contact,” she added.

The monkeypox outbreak is now considered a global outbreak. In more than 30 countries there have been more than 1,600 with over 500 cases in the UK. 

A vaccine of monkeypox is available and the WHO has recommended that close contacts and healthcare workers should be vaccinated first. 

WHO’s regional director for Europe, Hans Kluge said “Europe remains the epicentre of this escalating outbreak, with 25 countries reporting more than 1,500 cases, or 85% of the global total.”

Regarding the race to stockpile vaccines, he added “once again, a ‘me first’ approach could lead to damaging consequences down the road.”

“I beseech governments to tackle monkeypox without repeating the mistakes of the pandemic – and keeping equity at the heart of all we do.”

In the current outbreak, so far no deaths have been reported. But experts warn that every year monkeypox causes deaths in some countries, where the disease exists as endemic. 

The WHO is also considering changing the name of the Monkeypox virus. Consideration came after 30 scientists wrote letters to the WHO that it is not correct but rather discriminatory to give the name of the rare disease as African. 

Some of the Scientists has suggested hMPXV as new name of the virus to address the “urgent need” for a “non-discriminatory and non-stigmatising” name for the virus.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Health

Monkeypox: Something To Be ‘Concerned About’ Says Biden

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On Sunday, President Joe Biden, in his first public comments on the disease, said that recent cases of monkeypox that have been identified in Europe and the United States were something “to be concerned about. It is a concern in that if it were to spread it would be consequential.”

During the President’s first trip to Asia he was asked about the disease as he spoke to reporters at Osan Air Base in South Korea – “They haven’t told me the level of exposure yet but it is something that everybody should be concerned about,” Biden said. As for the vaccine, Jake Sullivan, Biden’s national security adviser, told reporters that the United States has a supply of “vaccine that is relevant to treating monkeypox. We have vaccines available to be deployed for that purpose,” he said. 

Monkeypox is a virus that originates in wild animals like rodents and primates, and occasionally jumps to people. Most human cases have been in central and west Africa, where the disease is endemic. 

According to CDC’s website, Centers for Disease Control and Prevention, Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, hence the name ‘monkeypox.’ The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo during a period of intensified effort to eliminate smallpox. Since then monkeypox has been reported in humans in other central and western African countries.

A detailed investigation of the outbreak in Europe, including determining who the first patients were, is now critical, says Shabir Mahdi, a professor of vaccinology at the University of Witwatersrand in Johannesburg.

“We need to really understand how this first started and why the virus is now gaining traction. In Africa, there have been very controlled and infrequent outbreaks of monkeypox. If that’s now changing, we really need to understand why.”

WHO reports about 3,000 monkeypox cases a year in Nigeria. Oyewale Tomori, a virologist who formerly headed the Nigerian Academy of Science, said that outbreaks are usually in rural areas when people have close contact with infected rats and squirrels.

Monkeypox typically causes fever, chills, rash and lesions on the face or genitals. Luckily, to date, no one has died in the outbreak. The estimation by WHO suggests that the disease is fatal for up to one in 10 people. The infection typically lasts two to four weeks and usually clears up on its own.

Britain’s Health Security Agency reported 11 new monkeypox cases on Friday, saying “a notable proportion” of the infections in the U.K. and Europe have been in young men with no history of travel to Africa and who were gay, bisexual or had sex with men.

Dr Susan Hopkins, the Chief Medical Adviser for the U.K.’s Health Security Agency stated that “the evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact. We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.”

Monkeypox spreads when someone comes into close contact with another person, animal or material infected with the virus. The virus can enter the body through broken skin, the respiratory tract or through the eyes, nose and mouth. Monkeypox is not generally considered a sexually transmitted disease, though it can be passed on during sex. Health authorities stress that we are not on the brink of a serious outbreak and the risks to the general public remain very low.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Health

Oklahoma’s Anti-Abortion Bill: The Newest Development in the United States’ Abortion Controversy

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This Thursday, Oklahoma legislators passed what many have deemed as the most restrictive bill banning abortions in the U.S. The bill prohibits all abortions, except those that are required to save the mother’s life or are the result of rape/incest. The draft law is likely to be ratified by the state governor, Kevin Stitt, and further limit abortion access in the state.

Oklahoma’s measure has garnered national attention for a multitude of reasons. For one, the bill bans abortions immediately after fertilization; this is in stark contrast to pro-abortion laws across the U.S., which permit abortions up to 24 weeks of pregnancy. In September 2021, Texas passed a similarly restrictive abortion law, but even that measure enables abortions up to six weeks of pregnancy. Moreover, the Oklahoma measure comes right after the recent Supreme Court leak draft, which shows that the majority of the court is in favor of overturning the landmark Roe v. Wade ruling. If Roe v. Wade is overturned — which could happen as soon as late June or early July — many U.S. states (including Oklahoma) stand poised to immediately prohibit access to abortions. 
Oklahoma’s bill, along with the SCOTUS leak, highlights how abortion rights in the U.S. are contingent upon the 1973 Roe v. Wade ruling and subject to change suddenly. Indeed, the recent discussions surrounding abortion shed light on the American judicial system and how volatile landmark rulings can be. Looking ahead, Americans must see whether or not the Supreme Court overturns Roe v. Wade. If so, abortion laws across the country will change drastically, and Americans will have to familiarize themselves with dozens of new laws and restrictions. If not, the legal systems of the U.S. will have been examined and questioned nonetheless.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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