Side effects

U.S. Medicines Regulator to Add Warning to Pfizer and Moderna Vaccines Over Link to Heart Inflammation

The U.S. Food and Drug Administration (FDA) is set to add a warning to the Covid vaccines made by Pfizer and Moderna after the Centers for Disease Control and Prevention (CDC) said there is a “likely link” between them and cases of heart inflammation, particularly in children and young adults. The MailOnline has the story.

The CDC made the announcement Wednesday during a presentation. 

The Covid Vaccine Safety Technical (VaST) Work Group discussed nearly 500 reports of heart inflammation, known as myocarditis, in vaccinated adults under the age of 30.

The group of doctors said the risk of myocarditis or pericarditis following vaccination with the mRNA-based shots in adolescents and young adults is notably higher after the second dose and in males  

It comes as the Advisory Committee on Immunisation Practices (ACIP) is set to meet this week to assess the possibility of a link between the heart condition and the mRNA vaccines. 

The Moderna and Pfizer vaccines use mRNA technology, while the Johnson & Johnson vaccine uses the more traditional virus-based technology. 

According to the presentation, there have been 484 preliminary reports of myocarditis or pericarditis in young people under age 30 as of June 11th.

So far, 323 have been confirmed by CDC and 148 are still under review.

In total, 309 patients were hospitalized, of which 295 were discharged and 79% have since recovered.

Nine patients are still hospitalized with two in intensive care units. There was no data available for five patients. 

Males were much more likely to report heart inflammation after receiving a second dose than women.

As of June 11th, there were 9.1 per million reported cases of myocarditis/pericarditis in females ages 12-to-17 compared to 66.7 per million in males of that age group.

What’s more, rates among females ages 18-to-24 and ages 25-to-29 were 5.5 per million and 2.6 per million respectively.

Ang males, rates were 56.3 per million for the 18-to-24 age group and 20.4 per million in the 25-to-29 group.

In Australia, the AstraZeneca Covid vaccine is facing further criticism over its links to a variety of side effects. The vaccine will have been almost completely phased out of the country’s roll-out by October.

Worth reading in full.

Thousands of Women Suffering Period Problems Following Covid Vaccination

Britain’s medicines regulator has received reports from almost 4,000 women, mostly aged between 30 and 49, who have suffered period problems after taking a Covid vaccine. Reports were gathered until the middle of May – before the vaccine rollout opened for the whole adult population – so more up-to-date figures could show a much lower age range for period problems. The Sunday Times has the story.

Official data, obtained by the Sunday Times, show that the Medicines and Healthcare products Regulatory Agency (MHRA) received 2,734 reports of period problems linked to the AstraZeneca vaccine, 1,158 related to the Pfizer jab, and 66 linked to the Moderna vaccine up to May 17th.

The issue, typically involving “heavier than usual” bleeding, could have affected many more women who would not have thought to report their experience. The majority of issues were reported in women aged between 30 and 49.

Asked why the problems had not been added to the official list of possible side effects of the Covid vaccines, the MHRA said a review with experts had found that there was no need to do so. The “current evidence” did not suggest an “increased risk” of period problems after the jab, it said, but it had published information on reports of menstrual disorders in its weekly report on adverse reactions.

Victoria Male, a Reproductive Immunologist at Imperial College London, said more women were likely to have been affected than the number of case reports. “It’s definitely true that not everyone will be reporting any menstrual changes they have noticed to Yellow Card [the MHRA’s scheme for people to report suspected side effects] simply because not everyone knows that it exists and that they can file a report,” she said.

Although a clear link between the Covid jab and menstrual disorders had not been established, “lots of people have contacted me to tell me about changes that they have noticed in their periods following vaccination”, Male said. “The kinds of things they are telling me about, mostly periods that are heavier or later than usual, are very similar to the reports we are seeing in Yellow Card.”

Angharad Planells, 34, from Cheltenham, said her period had been 11 days late after her second dose of the AstraZeneca vaccine. “My whole life I’ve been pretty regular and I track my period on an app. It was super late,” she said. “When it did start, it was one of – if not the – most painful periods I’ve ever had, to the point where I felt a bit nauseous.”

Planells, who reported the suspected adverse reaction to the MHRA, added: “I would still have the vaccine again. I have had family members die from Covid. It’s just the lack of information out there.”

Worth reading in full.

AstraZeneca Covid Vaccine Recommended Only for Australians Aged 60 and Over

The Australian medicines regulator has recommended that the AstraZeneca Covid vaccine is only used in those aged 60 years and over amid further reports of blood clotting following vaccination, as well as reports of a link between the AZ vaccine and an illness that can leave patients paralysed.

Five out of the 12 confirmed and probable new cases of blood clotting following vaccination are actually in people over the age of 60, according to the Australian Therapeutic Goods Administration (TGA). A further four cases are in people less than five years away from turning 60. All remaining cases are in people above the age of 50.

The Guardian has more.

Pfizer will be the preferred vaccine for eligible people under 60 following a recommendation from the Australian Technical Advisory Group on Immunisation (ATAGI). However, people who have had their first shot of AstraZeneca will be advised to have their second shot of the same vaccine.

The Health Minister, Greg Hunt, said the opening of Pfizer to people aged 50 to 59 would mean that the 2.1 million people in this cohort who have yet to have the AstraZeneca shot will receive the Pfizer vaccine instead.

The TGA reported on Thursday there were a further 12 reports of blood clots and low blood platelets assessed to be confirmed or probable cases of thrombosis with thrombocytopenia syndrome (TTS) linked to the AstraZeneca vaccine in the past week.

The new cases include three confirmed in 55 and 65 year-old women from Victoria and a 53 year-old woman from NSW. The nine new probable cases include: a 54 year-old man from the Northern Territory, a 65 year-old woman from Tasmania, 50 and 56 year old men and a 69 year-old woman from Victoria, a 58 year-old woman from South Australia, 59 and 80 year-old men from Queensland, and a 67 year-old woman from NSW.

It takes the total of Australian reports of TTS following the AstraZeneca vaccine to 37 confirmed and 23 probable.

The estimated risk of TTS following the first dose is 3.1 per 100,000 for people under 50, 2.7 for people between 50 and 59, 1.4 for people between 60 and 69, 1.8 for people 70 to 79, and 1.9 for people over 80 years of age.

The Chief Medical Officer, Professor Paul Kelly, said the new cases had “changed the rate” for those between 50 and 59, changing the risk profile more in line with those under 50. There have been two deaths in Australia linked to TTS, and Kelly stressed it remains a very rare condition.

“Remember this remains a very rare but sometimes serious event; we’re picking it up much more commonly than other countries because we’re looking more fully,” he said. 

“For most people, they’ve been diagnosed early, there was a large proportion of those with a less severe form of this rare syndrome, and most of those have been discharged from hospital already.”

Last week, the Italian Government also restricted the use of the AZ vaccine to people over the age of 60 after the death of a teenager with blood clots following vaccination.

The Guardian report is worth reading in full.

CDC to Hold Emergency Meeting Over 226 Cases of Heart Inflammation in American Teens Who Have Had Pfizer or Moderna Vaccines

The U.S. Centers for Disease Control is set to hold an emergency meeting over a greater than expected number of cases of heart inflammation among young Americans who have received two doses of either the Pfizer or Moderna Covid vaccine. The MailOnline has the story.

[CDC leaders] will gather on June 18th to discuss 226 plausible cases of heart inflammation in young people – mainly affecting teenage boys and young men – after they have received their second doses of the vaccines. 

CDC bosses said Thursday the number of cases is higher than expected, although still rare.

[CNBC reports that, according to the CDC, scientists expected only between 10-102 cases of myocarditis or pericarditis.]

A total of 226 cases have been reported that may meet the CDC’s “working case definition” of myocarditis and pericarditis following the shots, the agency said. 

Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the outer lining of the heart.

Among the 226, three are in intensive care, 15 are hospitalised, and 41 have ongoing symptoms. The rest – 167 – have recovered.  

It is not clear if either condition is caused by the shots and the reports of cases are extremely rare. 

The CDC continues to urge everyone aged 12 and older to get vaccinated.

These types of heart inflammation can be caused by a variety of infections, including a bout of Covid, as well as certain medications…

Cases are reported through the U.S. Vaccine Adverse Event Reporting System (VAERS).

The system accepts reports from everyone regardless of the plausibility of the vaccine causing the symptom.

In total, VAERS received 573 reports of myocarditis and pericarditis after the patient had received their second dose. 

A total of 372 reports were from people who had the Pfizer vaccine, while the remaining 201 had Moderna.

Another 216 cases of the heart inflammation were also reported after dose one of the vaccines. 

More than half of the cases reported after people had received their second dose were in people between the ages of 12 and 24, the CDC said.  

This group accounts for less than nine per cent of doses administered.  

Almost four-fifths of cases were in males. 

The overwhelming majority of the cases have occurred within a week of vaccination. 

Symptoms included chest pain and breathing difficulties. 

This comes just one day after Moderna asked the U.S. Food and Drug Administration to extend the emergency use of its Covid vaccine to American children aged 12 and over.

The U.K. Medicines and Healthcare products Regulatory Agency approved the use of the Pfizer vaccine in British children aged 12-15 earlier this month, though the Joint Committee on Vaccination and Immunisation said that the decision on whether or not to vaccinate children against Covid is down to the Government given that it is a “political” matter. So far, the petition on the Gov.uk website against the vaccination of children has been signed by over 50,000 people.

Worth reading in full.

Stop Press: Watch Tucker Carlson react to this news.

We Shouldn’t Vaccinate Children as a Matter of Principle Because of the Side Effects, Says Government Vaccine Adviser

Adam Finn, Professor of Paediatrics at the University of Bristol and a member of the Government’s Joint Committee on Vaccination and Immunisation (JCVI), was on BBC Radio 4’s Today programme this morning (around the 50 minute mark) taking a surprisingly strong line against vaccinating children because of the “side effects”. Here’s an edited transcript of what he said:

The main priority at the moment is to try and immunise as many people as possible who are at risk of getting really sick with this virus, because that’s the one thing we want avoid is another big surge of hospitalisations and deaths, and that isn’t going to happen in children. … Children are very rarely seriously affected by this infection. …

The evidence we’ve got with children, particularly young children, is that they are not very infectious to each other or to adults around them and that the majority of the transmission of the infection is in the adult population in fact. …

There is a certain amount of transmission going in secondary schools, so in teenagers, but in fact we’ve been surprised about how little transmission we’ve picked up in schools and of course this time around there’s been a lot more testing and awareness of what’s going in schools. …

In normal times, just as in pandemic times, we simply wouldn’t want to immunise anybody without needing to. It’s an invasive thing to do, it costs money, and it causes a certain amount of discomfort, and vaccines have side effects. So if we can control this virus without immunising children we shouldn’t immunise children as a matter of principle. …

I’m optimistic that we in particular in the U.K., with the high coverage we’re achieving and the extremely effective vaccine we’ve got, that we can achieve population immunity and I’m afraid it’s an open question as to whether we need to immunise any children at all and if we do how many children we need to immunise.

This is quite a change of tune for Professor Finn, who last month told BBC Breakfast that children had been “left behind” in vaccination and vaccine trials, saying: “We’re impatient now to get on and do the necessary trials in children so that these vaccines can start to be used, and actually circumstances are holding us back so it’s a very frustrating situation to be in.”

He did add, though, that side-effects appeared to be worse in younger people: “There is evidence for more or less all of the vaccines against Covid that the side-effect rate, the reactogenicity that we see, basically goes up the younger you are.”

At the time of these earlier comments the AstraZeneca trials in children were paused while the MHRA investigated blood clot links. What has Professor Finn seen since then that persuaded him that maybe vaccinating children isn’t so pressing after all? Is this a sign that the side-effects, at least in the young, are beginning to be taken seriously by the Government?

Major Study Finds “Abundance of Patients Admitted to Hospital With Covid Within Seven Days of Vaccination”

A new study of Covid hospital patients has found once again a spike in infections post-vaccination – what the authors call “an abundance of patients admitted to hospital within seven days of vaccination”.

The ISARIC4C consortium’s COVID-19 Clinical Information Network (CO-CIN) enrolled 52,280 Covid patients who were admitted to hospital between December 8th and April 10th. Of these, 3,842 had received at least their first vaccine dose, which is 7.3% or one in 14.

The researchers found that the median time between receiving a first jab and the onset of Covid symptoms was nine days. Since the median time from infection to symptom onset is five days, this suggests the majority contracted the disease in the days after vaccination.

The graph above shows how many of the vaccinated Covid patients experienced symptom onset on each day since vaccination. Note the massive spike on the day of vaccination and the three days afterwards. Although the authors do not say it in so many words, clearly the vaccines here are bringing on the symptoms. Why else would the frequency of symptom onset increase by 400% from the day before vaccination to the day of vaccination and in the following days?

The authors offer a few potential explanations. They suggest elderly and vulnerable people who had been shielding may have become infected through the exposure involved in the vaccination programme. Or perhaps they stopped shielding or being careful as soon as they got vaccinated, wrongly assuming they were immune.

The authors also raise the possibility that recent asymptomatic or mild COVID-19 could be triggered by vaccination into “symptoms likened to COVID-19 symptoms including fever”.

The study’s co-lead Dr Calum Semple, Professor in Child Health and Outbreak Medicine at the University of Liverpool, was clear where he stood on this, saying that the spike indicated “people are letting their guard down because they’ve been vaccinated. There is evidence here that people are unfortunately assuming that they’re protected very quickly after vaccination and that’s not the case.”

Such behavioural change was likewise blamed by Michael Day writing in the BMJ in March. Dr Clare Craig wrote a thorough riposte in the same journal, pointing to ONS data showing that the vaccinated did not increase their social contact and asking how it would explain similar spikes in care homes. She suggested other explanations were more likely, such as a drop in white blood cells in the days after vaccination as observed in the Pfizer trial, which may temporarily suppress immunity.

The spike in symptomatic Covid from day zero plainly cannot be explained by behaviour change, and as the authors suggest looks very much like the vaccine somehow re-triggering an old or existing Covid infection.

The good news from the study is that the vaccinated did not make up a large proportion of those hospitalised with Covid during December and January, though by late February and March (when all the over-65s were vaccinated) they made up a sizeable chunk of a much reduced total.

The authors note that the first dose of the vaccine doesn’t appear to reduce death among the high-risk hospitalised, saying “mortality appears to remain high for people in high-risk vaccination tiers who are admitted to hospital with symptomatic SARS-CoV-2 infection (COVID-19) despite vaccination 21 days or more previously”. It is not clear if this is a temporary effect owing to adverse effects of the vaccine or a permanent gap in the protection it offers.

How much longer can governments and scientists ignore the evidence of the post-vaccine spike in infections, found in study after study? When will they stop lazily blaming people for getting themselves infected and commit to investigate it properly?

Coronavirus Spike Protein Alone May Cause Lung Damage

Research on mice has found that exposure to the SARS-CoV-2 spike protein by itself, without the rest of the virus or any viral replication, is enough to cause COVID-19-like symptoms, including severe inflammation of the lungs. Dr Pavel Solopov, Research Assistant Professor at Old Dominion University in America, who led the research, told the Medical Xpress:

Our findings show that the SARS-CoV-2 spike protein causes lung injury even without the presence of intact virus. This previously unknown mechanism could cause symptoms before substantial viral replication occurs.

The researchers injected genetically modified mice with a segment of the spike protein and compared them after 72 hours with a control group injected with saline. The outcome was unmistakable, according to the Medical Xpress.

The researchers found that the genetically modified mice injected with the spike protein exhibited COVID-19-like symptoms that included severe inflammation, an influx of white blood cells into their lungs and evidence of a cytokine storm – an immune response in which the body starts to attack its own cells and tissues rather than just fighting off the virus. The mice that only received saline remained normal.

The researchers did not, according to this report, indicate whether the finding has any significance for the vaccines and their side effects. The Pfizer, Moderna, AstraZeneca and Johnson & Johnson vaccines all work by delivering genetic material that induces cells around the body to produce the spike protein, which the immune system then becomes primed to recognise. A question arising from this research is whether, if the spike protein is pathogenic in its own right and not just a means of gaining entry to cells, this explains any of the Covid-like side-effects of the vaccines, including some of the rare serious ones.

Other research has suggested that “the SARS-CoV-2 spike protein (without the rest of the viral components) triggers cell signalling events that may promote pulmonary vascular remodelling and pulmonary arterial hypertension as well as possibly other cardiovascular complications”. These matters should continue to be investigated.

Worth reading the Medical Xpress report in full.

(Image: Using a newly developed mouse model, researchers found that exposure to the SARS-CoV-2 spike protein alone was enough to induce COVID-19-like symptoms including severe inflammation in the lungs. The left images show healthy mouse lung tissue while the right images show tissue from mouse lungs exposed to the spike protein. Credit: Pavel Solopov, Old Dominion University.)

Deaths Linked to Covid Vaccines are 30 Times More Common than with Other Vaccines – Is the Safety Reporting System Fit for Purpose?

There follows a guest post by Dr Ros Jones, a retired Consultant Paediatrician and member of HART.

We have heard a lot in the last few weeks about Yellow Card reports for any adverse effects of vaccination, so I shall seek here to give a little background to the system and where it can work well but where it can seriously fall short. 

The Yellow Card system was introduced in 1964 following the thalidomide disaster as a way of formalising the reporting of adverse effects, especially for new drugs. Tear-out cards, printed on yellow paper, were inserted at the back of the British National Formulary (BNF), which acts as the bible for UK prescribing. This book, updated twice yearly, was given to every practising doctor. Any doctor or pharmacist seeing a patient with unexpected symptoms relating to a prescribed medicine could quickly complete one of the cards and send it to the regulatory authority. But already you can spot the problem here – the system depends on the health care professional recognising that the symptom might be related to a particular drug, so if the connection is not made then neither is the report. Take for example a busy orthopaedic SHO treating an elderly lady with a fractured hip. Will they think to report this as an adverse reaction to her blood pressure tablets? This matters. Studies show up to one third of hospital admissions are due to iatrogenic causes i.e., drug side-effects. Nowadays, the BNF is an online book and the Yellow Card system is also online, so perhaps even more ‘out of sight, out of mind’, especially if the ward is really busy at the time. If you ask colleagues whether vaccine adverse outcomes have been reported to MHRA, they often reply: “I’m not convinced it was the cause, it could have been due to anything.” But physicians are not responsible for deciding whether a clinical event was caused by a drug or was coincidental – that is the role of the MHRA

All new drugs and vaccines are subject to trials, starting with animal trials usually involving a number of different species, then building gradually through small pilot studies on humans to establish dosage regimes (for example) and short term safety, before rolling out to large scale trials looking for both efficacy and longer term safety. In such trials, all adverse outcomes will be reported, with the control group acting as the base-line for any symptoms against which the new drug is compared. The system works well for reasonably common side-effects and here the size of the trials is important. You will see in drug information leaflets side effects listed as “very common: affecting greater than 1 in 10 people”, through to “very rare: affecting less than 1 in 10,000”. Generally speaking, “very rare” side effects are only listed if severe. Many drug and vaccine trials are only large enough to detect “uncommon” side effects and for any new drug it is only through post-marketing surveillance that rarer side-effects can be discovered. New drugs are marked in the BNF with a black triangle for two years, to remind doctors to complete yellow card reports. In addition, most drug trials will exclude certain groups – for example children, pregnant women and people with risk factors such as kidney and liver disease, so safety for these groups is very much dependent on animal studies or assumptions from other similar drugs. Species difference in adverse effects may occur too, so damage to the developing foetus may only be seen after a drug starts being used by humans. Certain age groups that are under-represented in trials, such as the very elderly, may also be at greater risk. If post-marketing surveillance reveals an unexpected problem then the drug licence may be withdrawn or modified (e.g. limited to certain age groups, as with the AstraZeneca vaccine). 

AstraZeneca No Worse Than Other Vaccines for Blood Clots, Study Finds

A new pre-print from a team at the University of Oxford has found that the AstraZeneca vaccine, which is being restricted or banned around the world over links to blood clots, does not appear to cause the rare side effect at a much greater rate than the Pfizer or Moderna vaccines. However, on the basis of current reporting rates, the same complications are many times more likely to be caused by the disease itself, they say. The Independent has the story.

The risk of developing a rare brain clot from COVID-19 is about eight times greater than from the AstraZenecaOxford vaccine, according to a new study.

Researchers at the University of Oxford, who are not linked to the vaccine, also found that people infected with coronavirus are “manyfold times” more likely than normal to develop the rare clotting disorder, known as cerebral venous thrombosis (CVT), where blood clots in the veins that run from the brain.

“There’s no doubt that Covid is a much greater risk of this [condition] than any of the vaccines,” said Professor Paul Harrison, a co-author of the study.

The research, which has yet to be peer-reviewed, drew comparisons between more than 500,000 COVID-19 patients in the US and 34 million people in Europe who have received the AstraZeneca vaccine, as well as the background level of CVT in the general population.

For COVID-19, the incidence rate of CVT stands at 39 cases per one million people, the study showed. But for a million people vaccinated with the AstraZeneca jab, there will be just five cases of CVT over a two-week period. …

The study also suggested that four cases of CVT are likely to occur in one million people vaccinated with either the Moderna or Pfizer/BioNTech jab. However, the scientists warned that the data on this is too thin to establish any firm conclusions.

The researchers acknowledge a number of limitations in their research.

The scientists warned that all comparisons must be interpreted cautiously since data are still accruing and drawn from different sources. They added that their research was unable to determine the relative risk of developing CVT after vaccination due to uncertainty around the baseline rate for this condition.

Nor did the study address the incidence rate of thrombocytopenia in COVID-19 patients and people who had been vaccinated. This condition, where a patient presents abnormally low levels of platelets, has been detected alongside CVT in the cases of concern reported to date. …

The Oxford researchers drew their COVID-19 patient data from a US-based electronic health records network which had recently been used by the team to show the neurological and psychiatric consequences of coronavirus.

This database, which is made up of a total of 81 million US patients, provided clear detail on CVT cases that had been detected among people infected with coronavirus, the experts said – though they acknowledged there may be under-reporting of the condition in medical records.

As for the incidence rate of CVT among people vaccinated with the AstraZeneca jab, this was taken from the European Medicines Agency’s database, which covered more than 34 million individuals at the time of publication.

A further observation is that the COVID-19 patients in the study are drawn from a “federated electronic health records network recording anonymised data from healthcare organisations, primarily in the USA”. This suggests they are hospital patients, or at least those who have sought medical assistance, and so are not representative of all Covid infections but only the more serious. This contrasts to the vaccinated group, which is the healthy population as a whole, albeit with more vulnerable groups often vaccinated first. This may skew the comparison considerably, making blood clots among those infected with Covid appear much more common than they are.

How will regulators respond, having restricted one vaccine over this issue (and increasingly the Johnson & Johnson one as well), will they not have to be consistent? Will they remove the restrictions from AZ and J&J, or apply them equally to the other two, or somehow justify the discrepancy? Will be interesting to watch this play out.

The AstraZeneca Scare May Be Overdone, But Rare Side Effects May Still Occur

Eighteen countries have now suspended use of the Oxford-AstraZeneca vaccine pending a review by the European Medicines Agency (EMA) into concerns about it causing serious blood clots. They are: Sweden, France, Italy, Spain, Germany, Iceland, Portugal, Ireland, Bulgaria, Denmark, Slovenia, Netherlands, Norway, Luxembourg, Cyprus, Latvia, Indonesia and Venezuela.

Many scientists and commentators have criticised the regulators and governments taking these decisions as misapplying the precautionary principle – in a number of cases, as Toby notes, speaking without a hint of self-awareness as those same commentators have been cheerleaders of the lockdowns for the last 12 months, typically justified through an abuse of the precautionary principle on scant data.

The head of Italy’s medicines regulator, Nicola Magrini, today claimed the bans across Europe were part of a politically driven snowball effect with countries within the EU coming under pressure to follow suit. Given the hard time European countries have given the Oxford jab in recent weeks (definitely not because it’s British, of course) – swinging, as Ross Clark remarks, “from accusing the company – and Britain – of hoarding the vaccine and failing to supply it to EU countries, to claiming that it is ineffective, back to accusing us of hoarding it again” – it is easy to buy this argument and suspect the actions are not simply all about safety. If that is so, you have to wonder what these governments think they’re doing, playing politics with vaccines, and whether their electorates will thank them for depriving them of long-awaited inoculations for the sake of scoring a few points against renegade Blighty and awkward AstraZeneca.

Is there anything to the concerns? Commentators today have been quick to point out that COVID-19 is “100,000 times more dangerous, compared to the tiny possibility of an issue with clotting”. There is also the inconsistency (raising questions of politics again) of targeting the AstraZeneca vaccine when, according to data from the MHRA, more people have reported blood clots after having the Pfizer vaccine than the Oxford one – up to February 28th there were 38 reports from 11.5 million doses of Pfizer, compared to 30 from 9.7m of AstraZeneca.

On the other hand, blood disorders as a whole have been reported at more than twice the rate in relation to the AstraZeneca shot compared with Pfizer, while a letter in the BMJ yesterday argued that if you look at reports of deep vein thrombosis and vascular (blood vessel) disorders then the Oxford vaccine comes out much worse.