UK Covid live: Van-Tam says AstraZeneca vaccine’s risk v benefit is finely balanced for younger people

 

Powered by Guardian.co.ukThis article titled “UK Covid live: Van-Tam says AstraZeneca vaccine’s risk v benefit is finely balanced for younger people” was written by Andrew Sparrow, for theguardian.com on Wednesday 7th April 2021 16.16 UTC

Three men in a park, one in a suit, another one with professional-looking gardening equipment.
Boris Johnson bumps elbows with a man during his visit to the Perran Sands holiday park in Perranporth, Cornwall, this afternoon. Photograph: Tom Nicholson/AFP/Getty Images
A man in a suit holds an ice cream in one hand and makes a thumbs-up gesture with the other
And here is Johnson eating an ice-cream during his visit. Photograph: Tom Nicholson/AFP/Getty Images

Updated

Here is the news release from the MHRA about today’s announcement.

And here is a page on the MHRA’s website with detailed briefing notes for healthcare professionals and vaccine recipients.

Scottish Conservative leader Douglas Ross has warned that smaller pro-union parties will only benefit the Scottish National party in next month’s Holyrood election.

Speaking to the Scottish Parliamentary Journalists’ Association after George Galloway launched his manifesto for the pro-union Alliance for Unity earlier today (see 2.45pm), Ross said:

It’s very clear that they are only going to harm the pro-UK side, they are not going to benefit the case for Scotland remaining in the UK, they’re going to take away the strong opposition that the Scottish Conservatives have been, and other pro-UK parties, rather than damaging the nationalist cause.

Ross added that voters should appreciate this is a “crucial” election in Scotland. He said: “The future of our country is at stake if the nationalists get another majority.”

Although polling earlier today (see 1.17pm) suggested that Scottish Labour is making gains on his party, threatening them for second place against the SNP, he insisted: “We can stop that obsession with independence and get back to the issue that really matters to people, which is our recovery from Covid-19.”

Douglas Ross.
Douglas Ross said the future of Scotland was at stake if nationalists win another majority. Photograph: Murdo MacLeod/The Guardian

Updated

Risks v benefits of Oxford/AstraZeneca vaccine shown on Van-Tam’s slides

Here are the three slides presented by Prof Jonathan Van-Tam during the briefing. They seek to present, in numerical terms, the risk-benefit balance, by age group.

They compare the number of people who would avoid ending up in intensive care as a result of the use of the Oxford/AstraZeneca vaccine against the number that might suffer a serious harm from the use of the vaccine.

The first slide covers the benefits and harms with a low rate of coronavirus in circulation – defined as 2 cases per 10,000, or about the rate it was in March. On the basis of these figures, it would be safer for under-30s not to take the AstraZeneca vaccine – although, as Van-Tam said, the figures do not take into account the risk of developing long Covid, or the fact that the benefit of the vaccine should last for longer than 16 weeks.

AstraZeneca benefits v risks - at low exposure risk
Benefits and risks of AZ vaccine – at low exposure risk Photograph: DHSC

But with a medium rate of coronavirus in circulation – defined as 6 cases per 10,000, or about the rate it was in February – even for the under-30s the balance of risk tips in favour of the vaccine.

Picture 862
Benefits and risks of vaccine – with medium exposure risk Photograph: DHSC

And with a high rate of coronavirus – defined as 20 cases per 10,000, or the situation at the peak – the vaccine benefits are even clearer.

Benefits and risks of AZ vaccine - with high exposure risk
Benefits and risks of AZ vaccine – with high exposure risk Photograph: DHSC

Updated

This is from Nadhim Zahawi, the vaccine deployment minister.

Van-Tam is summing up.

He says he hopes people will feel they have seen authentic experts doing their best to keep people safe.

And that’s it.

I will post a summary shortly.

Q: Are there any reasons women are at more risk than men?

Pirmohamed says of the 79 cases, 51 were in women. But that may be because more women have been getting the vaccine, he says. He says if you make allowance for the number of vaccines administered by gender, there is no difference, he says.

Q: Are there things that could be done to mitigate this risk?

Pirmohamed says an immune response seems to be targeting platlets. It is not clear why. When they understand this, they might be able to prevent it in individuals with risk factors, or they might be able to adapt the vaccine, he says.

Q: Does this mean young people could get the one-shot Janssen vaccine, and be able to go on holiday more quickly?

Van-Tam says the alternatifve now is the Pfizer vaccine.

The Moderna one will be available from mid-April in England.

The Janssen vaccine could become available over the summer, he says, but he says they do not know for certain when it will be available.

He says the UK’s plan was always to have “multiple horses in the race”.

He says it would have been impossible to pick this up without having deployed millions of doses of vaccine.

He says they do not know if other vaccines will present similar problems. They won’t know till the use them, he says.

Updated

Raine says the link between the vaccine and the blood clotting condition is “reasonably plausible”. But more work needs to be done on it, he says.

Q: Why can’t older people be given an alternative vaccine too? Some countries are not giving the AZ vaccine to the under-55s or the under-60s. Are they being too cautious?

Lim says every country has to make their own decisions. They take into account factors like the amount of Covid they have, the vaccines they have, and the amount of risk people will accept.

In some countries life expectancy will be much lower than in the UK. That means their assessment of risk will be different, he says.

He says, for the UK, they decided it was best to set the threshold at around the age of 30.

He says they do not know yet if this rare condition is related to one vaccine, or to several. And he says it may be linked to Covid, and not to the vaccine at all.

Van-Tam says the JCVI was free to make its own recommendation. It was free to decide what it wanted.

He says in the 40 to 49 age group, not using the AZ vaccine would avert 0.5 harms per 100,000 people. But it could risk an extra 51.5 ICU admissions. He says it would have been “absurd” to stop using the vaccine on people in that age group in those circumstances.

Van-Tam says many vaccine manufacturers are working on a vaccine for children. So the AZ vaccine is “not the only show in town”, he says.

Pirmohamed says there is a slightly higher risk of the rare clotting condition in younger people than in older people.

He says it is not clear why yet. More work needs to be done on this, he says.

He says the trial of the vaccine on children was paused out of an abundance of caution.

Q: Are the risks significantly higher for the under-30s?

Lim says it is not just the risk to an individual. There is a slightly higher risk to younger people compared with older people. But the key points is that the risk/benefit balance changes, because older people are at so much greater risk from coronavirus.

That is why the under-30s are being offered an alternative.

Van-Tam says his slides did not make allowance for the risk to young people of getting long Covid after an infection. The slides just focused on the risk of ending up in ICU.

Updated

Van-Tam says some people might have to wait longer for a jab, but impact on overall programme timetable ‘negligible’

Van-Tam says the impact of this on the overall timetable for the rollout of vaccines should be “zero, or negligible”.

He admits this is a course correction.

But he says this is normal in a vaccine programme.

The programme is a massive beast. If you sail a massive liner across the Atlantic, you are going to have to make at least one course correction.

He says the NHS will get the right vaccine to people.

But there might be a “small delay” for some people, and some people might have to travel a “slightly greater distance” to get their jab.

JCVI confirms under-30s to be offered alternative to AZ jab

Prof Wei Shen Lim is now giving the JCVI’s advice.

The information given to people getting the vaccine should be updated, he says.

People should get the AZ vaccine according to schedule, he says.

But he says people aged 18 to 29 who do not have an underlying health condition that puts them at greater risk from Covid should be offered an alternative to the AZ vaccine if one is available.

Van-Tam then show an alternative chart with the risk/benefit balance with a higher exposure risk (ie, if there were a high level of coronavirus in Britain). In those circumstances, even for younger people, the benefits are much stronger.

Van-Tam says risk/benefit balance for AZ vaccine for younger people could be finely balanced

Van-Tam says we have now heard from the regulators.

He is now presenting slides what illustrate the potential benefits and the potential risks.

He says the figures behind this slide assume that Covid cases are at a lower rate than they are now.

He says the figures also assume the vaccine benefit lasts for 16 weeks. But in practice the vaccines are expected to offer protection beyond that.

He says the chart shows that, in younger age groups, the risk/benefit balance is finely balanced. For older people, it is very clear, he says.

Risks v benefits
Risks v benefits Photograph: Sky News

Pirmohamed says people are at much greater risk of getting clots if they develop Covid.

He says more work is needed.

The benefits outweigh the risks for the vast majority of people.

But it more finely balance for young people, he says.

Sir Munir Pirmohamed is describing the new advice.

Pregnant women should discuss the risks with doctor, he says.

People with a history of blood disorders should only take the AZ vaccine when they have assessed if the benefits outweigh the risks.

And any people who do have clotting episodes should not take a second dose, he says.

MHRA chief says risk of rare blood clotting condition after AZ vaccine about four people per million

Raine says the benefits of the vaccine continue to outweigh the risks for “the vast majority of people”.

She says up to 31 March there had been 79 cases of this condition, with 19 deaths. All occurred after the first dose.

The risk is about four people in a million, she says.

She says three of the 19 people who died were under the age of 30.

MHRA chief says there’s ‘strong possibility’ AZ vaccine causing extremely rare blood clotting side effects

Dr June Raine is speaking now.

She says more than 20m doses of the AZ vaccine have been given in the UK.

No effective vaccine or medicine is without risk, she says.

She says clinical trials allow people to find common side effects. But rare side effects only become clear when large numbers of people are being vaccinated.

She says it is a “strong possibility” that the vaccine is causing these extremely rare side effects.

 

Van-Tam says ‘course correction’ being ordered to UK’s vaccination programme

Prof Jonathan Van-Tam starts. He says this is a medical and scientific briefing.

He says it is about the AstraZeneca vaccine, or the AZ vaccine as he calls it.

He says there is a “change of course, a course correction if you like” to the UK programme.

He says he would have been amazed, before the programme started, if you had told him there would be no need for a course correction with a programme of this nature.

Updated

The UK press conference is about to start.

Under-30s in UK should be offered alternative Covid vaccine to AstraZeneca jab, says regulator

Adults under 30 should be offered an alternative vaccine instead of the AstraZeneca jab if there is one available in their area and they are healthy and not at high risk of Covid, the UK government’s vaccination advisory body has said. My colleague Sarah Boseley has the story here.

Johnson says AstraZeneca vaccine ‘safe’

This is what Boris Johnson said to reporters about the AstraZeneca vaccine during his visit to Cornwall. He said:

I think the crucial thing on this is to listen to what the scientists, and the doctors, the medical experts, have to say. The MHRA is meeting, the JCVI is meeting, they’ll be setting out the position and we will get on with rolling out the vaccine and obviously we’ll follow very carefully what they have to say.

I don’t think anything that I have seen leads me to suppose that we will have to change the road map or deviate from the road map in any way.

Johnson said the vaccine was “safe”. He went on:

But the crucial thing for everybody is to listen to what the scientists, the medical experts have to say later on today.

You can really start to see some of the benefits of that – it’s pretty clear that the decline in the number of deaths, the decline in the number of hospitalisations is being fuelled, is being assisted, the steepness of that decline is being helped by the rollout of the vaccines so it’s very important for everybody to continue to get your second jab when you’re asked to come forward for your turn.

Updated

The EMA has a live tweets from its press briefing on its Twitter feed.

Boris Johnson has been speaking about the AstraZeneca vaccine on a visit to Cornwall. According to the Mail’s John Stevens, Johnson has stressed it is safe.

(PR experts may be wondering why Johnson is commenting at the very moment when the scientists are about the deliver a news conference. It is generally accepted that public health messages have more credibility when delivered by experts, not politicians.)

Why EMA has decided all age groups should continue to use AstraZeneca jab

More from the EMA’s safety committee which has concluded that while the Oxford/AstraZeneca vaccine should continue to be used to all age groups that unusual blood clots, with low blood platelets should be listed as a very rare side effect.

Those administered vaccine should be made aware of the possibility of very rare cases of blood clots combined with low levels of blood platelets occurring within two weeks of vaccination.

Most of the cases reported have occurred in women under 60 years of age within two weeks of vaccination. Based on the currently available evidence, specific risk factors have not been confirmed.

The blood clots occurred in veins in the brain (cerebral venous sinus thrombosis, CVST) and the abdomen (splanchnic vein thrombosis) and in arteries, together with low levels of blood platelets and sometimes bleeding.

The committee carried out an in-depth review of 62 cases of cerebral venous sinus thrombosis and 24 cases of splanchnic vein thrombosis reported in the EU drug safety database (EudraVigilance) as of 22 March 2021, 18 of which were fatal. The cases came mainly from spontaneous reporting systems of the EEA and the UK, where around 25 million people had received the vaccine.

The EMA said the reported combination of blood clots and low blood platelets was very rare, and the overall benefits of the vaccine in preventing Covid-19 outweigh the risks of side effects.

One plausible explanation for the combination of blood clots and low blood platelets is an immune response, leading to a condition similar to one seen sometimes in patients treated with heparin (heparin induced thrombocytopenia, HIT), they say.

Updated

The EMA press conference is starting now. My colleague Rhi Storer is covering it on our global coronavirus live blog. It’s here.

We don’t know what the MHRA will be saying yet, but it seems likely that their recommendations will mirror those of the EMA.

From my colleague Aubrey Allegretti:

Updated

EMA says people should keep using AstraZeneca jab because benefits outweigh risks

The European Medicines Agency has confirmed that the “overall benefit-risk remains positive” for the Oxford/AstraZeneca jab despite rare cases of blood clots.

The EMA guidance states that patients must be made aware of possible side effects. They say that “unusual blood clots should be listed as very rare side effects”.

A press conference is due to start shortly.

Updated

From Darren McCaffrey from GB News

From Reuters’ Guy Faulconbridge

Joint MHRA/JCVI press conference on AstraZeneca vaccine

The joint press conference for the Medicines and Healthcare products Regulatory Agency (MHRA) and the Joint Committee for Vaccination and Immunisation (JCVI) is about to start.

Here is the list of people due to be speaking.

Prof Jonathan Van-Tam, deputy chief medical officer for England

Dr June Raine, chief executive of the MHRA

Sir Munir Pirmohamed, chair of the Committee of Human Medicines (which advises the government on the safety of medicines)

Prof Wei Shen Lim, chair of the JCVI

What MHRA has said in the past about AstraZeneca vaccine and very rare blood clots

Although regulators in some European countries have changed their advice about the use of the AstraZeneca vaccine in the light of concerns about a possible link with blood clots, the Medicines and Healthcare products Regulatory Agency has until now insisted that people should keep taking the jab because the benefits far outweigh the risks.

But on 18 March the MHRA did issue new guidance, after five cases of cerebral venous sinus thrombosis (CVST) – an extremely rare blood clot in the brain – occurred in the 11 million people who had at that point had the vaccine.

Here is the news release the MHRA put out at the time. And here is an extract.

Given the extremely rare rate of occurrence of these CSVT events among the 11 million people vaccinated, and as a link to the vaccine is unproven, the benefits of the vaccine in preventing Covid-19, with its associated risk of hospitalisation and death, continue to outweigh the risks of potential side effects …

While we continue to investigate these cases, as a precautionary measure we would advise anyone with a headache that lasts for more than 4 days after vaccination, or bruising beyond the site of vaccination after a few days, to seek medical attention.

(CVST and CSVT are the same thing – both terms are in use.)

At the end of last week MHRA issued an update. It said by 24 March there had been 22 reports of CVST, and eight reports of thrombosis events with low platelets, out of a total of 18.1m AstraZeneca doses delivered at that point.

Updated

George Galloway has denied that his latest party – All for Unity, which is standing pro-union list candidates in the forthcoming Holyrood elections – is irrelevant, after polling under 2% in a new STV News/Ipsos MORI poll.

Launching a manifesto which included the idea of a confirmatory vote by region should Scotland end up voting for independence, Galloway said:

If we were irrelevant, none of you would be here and the Conservative party in particular would not be having a collective nervous breakdown.

Galloway, who has previously said that he would never share a platform with a Tory, is now encouraging people to vote for the Conservatives in the constituency poll and then All for Unity on the regional list. Challenged about this volte face, he said:

That was then and this is now. The danger of the break up of the country now is more acute.

He also warned that, if Alex Salmond – who is likewise standing list-only candidates with his new pro-independence Alba party – is elected then Scotland will take “the road to Catalonia”. He went on:

This election is effectively – if we lose it – the first stage of the next part of the neverendum, which if Alex Salmond has the whip hand, explicitly is the road to Catalonia. He’s not hiding it, it’s mass street protests, it’s immediate negotiation with the British government, it will be very quickly civil disobedience. It is a recipe for trouble in Scotland.

George Galloway (left) and Jamie Blackett at the All for Unity launch today.
George Galloway (left) and Jamie Blackett at the All for Unity launch today. Photograph: Andrew Milligan/PA

Any link between AstraZeneca vaccine and rare blood clots ‘at limits of what is detectable’, says former MHRA chief

On Radio 4’s the World at One Sarah Montague interviewed Prof Sir Kent Woods about what the Medicines and Healthcare products Regulatory Agency (MHRA) is likely to announce. Woods was chief executive of the MHRA between 2004 and 2013, and so he is better placed to speculate on this than almost anyone. For four years he was also chair of the European Medicines Agency, which is making its own announcement about the AstraZeneca vaccine at the same time. Here are the main points from the interview.

  • Woods said the possible link between the extremely rare type of blood clot and the AstraZeneca vaccine was “at the limits of what is detectable”. He said:

I think this possible association between the vaccine and these clotting events as being at the limits of what is detectable by the methods that we have. We’re talking about a small number of cases emerging in many millions of vaccinated individuals, which is an extremely low incidence rate.

We don’t know with precision how common these events are outside vaccination. In other words, it still remains possible that this is a chance association.

And then, of course, coronavirus infection itself does very considerably increase the risk of blood clotting events.

So what we don’t know is the background occurrence of these blood clotting events in the population now when we know there’s a lot of coronavirus around.

  • He suggested the regulators would have two options. He said:

I think that the policy options would include either regarding it as a risk which is so much smaller than the risk of Covid that the information should simply be added to the information sheet underlying the licensing of the product.

This is what usually happens, it is a continuous process of finding out new things about new medicines, and generally some statement is put into the information leaflets for health professionals and for patients. That would be one thing to do.

The other might be advice specifically to selectively use some other vaccine in particular sub-groups of patients. The question then would be, do we know enough about the alternative vaccines to be confident that that would be a good thing to do.

  • He stressed the dangers of advising particular groups of people to stop using the AstraZeneca vaccine. He said:

If it were considered that the very small risk should be avoided by not giving this vaccine to young women, the alternative might be either that they don’t get a vaccine, in which case they’d be exposed to a very, very much higher risk of complications from Covid itself.

Or if it were to be to advocate another vaccine in certain ages, then you’d have to be absolutely certain that the other vaccine didn’t have any other offsetting low level risks that might complicate the risk/benefit equation. So it’s not an easy decision to make.

  • He said the theory that the very rare blood clotting condition mainly affects younger women because of a link to taking the contraceptive pill was a “hypothesis to be explored”. (Many of the very small number of people who have developed cerebral venous sinus thrombosis [CVST] after taking the AstraZeneca vaccine have been women under the age of 55.)
  • He said until now the MHRA and the EMA have always said the benefits of using the AstraZeneca vaccine far outweigh any possible risks. But he criticised some European governments for issuing their own advice on this. He said that had caused “great confusion” and undermined confidence in the vaccine.

Updated

The latest edition of the Guardian’s Politics Weekly podcast is out. Rafael Behr steps in behind the mic and he chats to Gaby Hinsliff about Keir Starmer’s upcoming challenge at the ballot box. Following on from that, Peter Walker talks to a couple of Green party councillors about their plans to capitalise on Labour’s loss of dominance in the north of England. Plus, in a week that has seen violence break out in Northern Ireland, Lisa O’Carroll speaks to the EU ambassador to the UK, João Vale de Almeida.

Starmer says government’s policy on Covid-status certificates a ‘complete mess’

Here is the full quote from Sir Keir Starmer saying the government’s plans for Covid-status certificates are a “complete mess”. (See 11.50am.) Speaking on a visit to Plymouth, he said:

We do not support the government’s plans in their current form, it’s as simple as that.

In fact the government’s plans seem to be changing on an almost daily basis. Only a few weeks ago the prime minister was saying he was thinking of vaccine passports to go to the pub – now he says isn’t. One day he’s talking about tests – then it’s certificates. It’s a complete mess.

There isn’t a real plan around this and what I fear it will be is another example of the government with a plan that doesn’t work, costing lots of taxpayer money, when I think the focus should be on getting as many people vaccinated as possible – that’s the light at the [end of the] tunnel.

Sir Keir Starmer (second from left) speaking to students during a visit to the City College Plymouth Institute of Technology with Luke Pollard MP (right).
Sir Keir Starmer (second from left) speaking to students during a visit to the City College Plymouth Institute of Technology with Luke Pollard MP (right).
Photograph: Ben Birchall/PA

Updated

Only 3% of SNP supporters would back Salmond’s new Alba party, poll suggests

Alex Salmond’s new pro-independence party Alba has not yet made a breakthrough with nationalist voters, according to a major poll by Ipsos-Mori, which found only 3% of Scottish National party supporters will back it.

The poll for STV put Scotland-wide support for Alba, which Salmond launched 12 days ago, at just 3% and found that only 4% of SNP voters would support Alba with their second list vote in May’s Holyrood elections.

Those figures suggest Salmond, a former first minister and SNP leader, will struggle to get elected on the north-east regional list, despite fears amongst SNP strategists he may well win a seat due to his residual popularity in Aberdeenshire.

One Ipsos Mori analyst, Emily Gray, suggested the data showed Alba had inadvertently boosted support for the other pro-independence party, the Scottish Greens, to 12%, by reminding SNP supporters they could use their list votes for other parties.

In a significant boost for Nicola Sturgeon, the poll put the SNP constituency vote at 53%, up one point, with the Tories down three to 20% and Labour up three to 18%.

Polling experts regard Ipsos Mori surveys as more authoritative than others because it uses telephone canvassing of randomly-called voters instead of self-selecting panels of voters who sign up to participate in online polls – the method used by a large majority of commercial pollsters.

STV forecast 70 seats for the SNP, enough to give Sturgeon a Holyrood majority, leaving the Tories on 25 seats and Labour on 19. If the Greens secured a uniform 12% on the list, it would have a record 11 seats, but Alba none.

The STV poll also had sobering findings for pro-UK party leaders who have tried to portray Nicola Sturgeon as a politician who prioritises independence over recovering from the Covid crisis.

Anas Sarwar, the Scottish Labour leader, and Willie Rennie for the Lib Dems have both tried to pivot away from constitutional politics onto Covid and domestic policies, but the poll found 49% of voters believed independence and devolution were a priority, with just 15% identifying Covid as one.

Gray pointed out, however, that 62% of Conservative voters believed independence is the main issue, perhaps vindicating the decision by Scottish Tory leader Douglas Ross to make the UK’s future a central issue of his campaign.

Alex Salmond
Alex Salmond. Photograph: Murdo MacLeod/The Guardian

Updated

Public Health Wales has recorded no further coronavirus deaths, and 82 new cases.

A week ago today the equivalent figures were one death and 60 new cases.

Updated

The 3pm joint MHRA/JCVI briefing will feature:

Prof Jonathan Van-Tam, deputy chief medical officer for England

Dr June Raine, chief executive of the MHRA

Sir Munir Pirmohamed, chair of the Committee of Human Medicines (which advises the government on the safety of medicines)

Prof Wei Shen Lim, chair of the JCVI

Updated

MHRA and JCVI to hold press conference at 3pm amid speculation AstraZeneca guidance may be revised

The MHRA is going to hold a briefing at 3pm, it has been confirmed. It will be a joint affair with the Joint Committee on Vaccination and Immunisation. We’re expecting that they will provide an update on guidance for the use of the AstraZeneca vaccine in the light of concerns about its possible link to a form of extremely rare blood clot in the brain. (See 9.28am.)

Here is the clip of Sir Keir Starmer signalling that he is expecting an announcement from the Medicines and Healthcare products Regulatory Agency (MHRA) about the AstraZeneca vaccine this afternoon.

In Wales Plaid Cymru has launched its manifesto for the Senedd (Welsh parliament) election. Adam Price, the party leader, said that if Plaid formed a government, it would hold an independence referendum before the end of its first time in office. “Wales and Westminster are increasingly two different universes,” he said.

This is from ITV’s Paul Brand.

Sir Keir Starmer has been speaking to journalists on his visit to Plymouth. These are from Sky’s Joe Pike.

(Starmer might also have been referring to the European Medicines Agency, which is holding a briefing on the AstraZeneca vaccine this afternoon.)

Updated

Sir Keir Starmer trying block work during a visit this morning to the City College Plymouth Institute of Technology.
Sir Keir Starmer trying block work during a visit this morning to the City College Plymouth Institute of Technology. Photograph: Ben Birchall/PA

Louise Haigh, the shadow Northern Ireland secretary, has criticised Boris Johnson for not addressing the problems that have led to rioting in Northern Ireland over the past week. In a radio interview, she also said the government had not properly considered the impact its Brexit deal, and the effective border that places down the Irish Sea, would have in the region.

On the Today programme earlier Naomi Long, minister of justice in the Northern Ireland executive and leader of the cross-community Alliance party, said the government’s “dishonesty” over the consequences of hard Brexit has contributed to the anger felt by loyalists. She told the Today programme:

Instead of trying to work through the issues legally, it opted to promote lawlessness by suspending the Northern Ireland protocol.

They promised people unfettered access, which is not the case. And they denied the existence of borders, even as those borders were being erected.

I think that that dishonesty, and the lack of clarity around these issues has contributed to a sense of anger in parts of our community.

My colleague Lisa O’Carroll has a full write-up of Long’s comments here.

In a speech today Nicola Sturgeon, Scotland’s first minister, will say that the SNP will raise NHS inpatient, day case and outpatient activity in Scotland to 10% above the pre-pandemic level if it wins the Holyrood election. According to extracts released in advance, she will say:

If we are re-elected the SNP will bring forward a plan for a full-scale post-pandemic remobilisation of the NHS.

Our plan has three clear steps: firstly invest in, and recognise, the contribution of the magnificent NHS staff who care for us.

Secondly, enable more people to get the right support closer to their home.

Thirdly, building and maximising hospital capacity so more patients can be treated more quickly …

Our overarching aim will be to raise inpatient, day-case and outpatient treatment activity by 10%, compared to pre-pandemic activity, within the first year of the new parliament and to maintain that level for the rest of the term.

The Office for National Statistics has been producing regular reports showing, although young people have been at very little risk of dying from coronavirus, students have been particularly badly affected in other respects. An update has been published today, and it shows the average life satisfaction score for students in England was higher in March (5.2) than in January (4.6) or February (4.9). But life satisfaction improved for adults generally over that period, and in March students were still less happy than other British adults, who had an average life satisfaction score of 6.8.

Updated

Scottish Labour is proposing free school meals for all school pupils during the summer holidays. In an announcement ahead of next month’s Holyrood election, it says the SNP is only committed to free school meals for primary school pupils during the summer holidays. Anas Sarwar, the Scottish Labour leader, said:

By introducing summer meal clubs for all of Scotland’s school pupils, Scottish Labour will put the fight against child poverty and holiday hunger at the heart of our national recovery plan.

Elle Taylor, who works at a further education college in Llanelli, was the first person to receive a dose of the Moderna vaccine in the UK, PA Media reports. She received jab from staff nurse Laura French at West Wales general hospital’s outpatients department.

Speaking after receiving the vaccine, the 24-year-old told PA:

I’m very excited and very happy. I’m an unpaid carer for my grandmother so it is very important to me that I get it, so I can care for her properly and safely.

Elle Taylor, 24, an unpaid carer from Ammanford, receiving an injection of the Moderna vaccine at the West Wales General Hospital in Carmarthen this morning.
Elle Taylor, 24, an unpaid carer from Ammanford, receiving an injection of the Moderna vaccine at the West Wales general hospital in Carmarthen this morning. Photograph: Jacob King/PA

Updated

Prof Calum Semple, professor of child health at Liverpool University and a member of the government’s Scientific Advisory Group for Emergencies, told LBC this morning that he was not worried at all about the AstraZeneca vaccine. He said:

I’ll take myself, I’m 53, my risk of death from Covid is about one in 13,000, for me it’s a no-brainer, I need to have the vaccine …

This vaccine is safe. What do I mean by safe? You can look right, look left, look right again cross a road, it’s safe to cross because you don’t see any cars [but] you can trip, you can stumble.

Nothing is risk-free, but is the vaccine safe? I would say yes.

Welsh patients to be first in UK to receive Moderna Covid vaccine

Patients in Wales will from today become the first in the UK to receive the Moderna vaccine as part of a mass vaccination programme, with the first doses in Scotland set to come later this week, my colleague Harry Taylor reports.

Pharmacists carrying a cooler containing the Moderna vaccine at the West Wales General Hospital in Carmarthen this morning.
Pharmacists carrying a cooler containing the Moderna vaccine at the West Wales general hospital in Carmarthen this morning. Photograph: Jacob King/PA

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Prof Sir Kent Woods, the former chief executive of the Medicines and Healthcare products Regulatory Agency, told LBC this morning that he had “no reservations” about the AstraZeneca vaccine and that he was happy for younger relatives to have it. He explained:

Covid itself – the infection itself – is known to be associated with a substantial increased risk of blood clots of various kinds.

At a time when the population has got lots of Covid going around, it’s very difficult to know what the actual background rate of these clotting events is without the vaccine.

We can say I think, that if there is a connection, it’s a very, very rare one and this is why I am not concerned about the fact that relatives of mine have had the AstraZeneca vaccine in their 40s.

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MHRA should issue new guidance on AstraZeneca vaccine urgently, says health committee chair

Good morning. As Channel 4 News revealed on Monday, the Medicines and Healthcare products Regulatory Agency (MHRA) has been reviewing its advice about the use of the AstraZeneca vaccine following concerns about its links to a very rare blood clotting condition, and an announcement may be coming soon. On the Today programme this morning Jeremy Hunt, the chair of the Commons health committee, said a decision was needed as a matter of “urgency” – although he also stressed that in the past the MHRA had always acted quickly. He told the programme:

I think there is urgency; I think the one thing you can’t say about the MHRA is that they act slowly – they have been very, very fast and fleet of foot throughout this pandemic.

Currently the MHRA is advising people in all age groups to take the AstraZeneca vaccine if it is offered to them – although last month, in response to concerns about five cases of cerebral venous sinus thrombosis (CVST) – the extremely rare blood clot in the brain – occurring in the 11 million people who had then had the vaccine, the MHRA did issue some precautionary guidance. Since then more cases of CVST have occurred, but they remain a minuscule proportion of the total number of people vaccinated.

As my colleague Sarah Boseley reports in her overnight story, some UK drug safety experts believe there could be a causal link between the AstraZeneca jab and CVST. But they say vaccination programmes must continue, with risk mitigation for women under 55. Sarah’s story is here.

This morning Prof Adam Finn, a professor of paediatrics at the University of Bristol and a member of the Joint Committee on Vaccination and Immunisation (JCVI), said that figures up to 24 March showed 30 cases of CVST and seven deaths in the UK amongst more than 18 million people given the AstraZeneca jab. He said more up-to-date figures were due soon.

Most of these CVST cases are occurring in women under the age of 65 and Finn said this could lead to certain vaccines being used for certain age groups. Asked if younger people could be limited to certain vaccines, he told the Today programme:

That’s certainly possible. We are seeing another vaccine coming in [Moderna], and further vaccines are approaching licensure, and I know that the UK has made contracts for quite a wide range of different vaccines.

As time goes forward we will have much more flexibility about who can be offered what.

On the other hand, we do need to keep the programme going if the plan to open things up and allow things to get back to normal is to proceed without another wave of the pandemic coming through.

So it’s quite a tricky balancing act here, getting the balance right, getting vaccines coming through … getting the risk-benefit right for people coming forward.

Some European countries have decided to limit the use of the AstraZeneca vaccine to older people. In Germany it is only given to the over-60s, and in France to the over-55s.

Finn urged people being offered the vaccine at the moment to take it, saying the “risk-benefit is very strongly in favour of receiving the vaccine”.

Here is the agenda for the day.

9.30am: The ONS publishes a report on the impact of Covid on students.

9.30am: Plaid Cymru launches its election manifesto for the Senedd election.

2pm: Andy Burnham, the mayor of Greater Manchester, holds a press conference.

Afternoon: Boris Johnson is out on a visit, where he is expected to speak to the media.

And Sir Keir Starmer is visiting Plymouth today.

Politics Live has been mostly about Covid for the last year and I will be covering UK coronavirus developments today, as well as non-coronavirus Westminster politics. For global coronavirus news, do read our global live blog.

I try to monitor the comments below the line (BTL) but it is impossible to read them all. If you have a direct question, do include “Andrew” in it somewhere and I’m more likely to find it. I do try to answer questions, and if they are of general interest, I will post the question and reply above the line (ATL), although I can’t promise to do this for everyone.

If you want to attract my attention quickly, it is probably better to use Twitter. I’m on @AndrewSparrow.

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