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Dr Ronan Glynn, Acting Chief Medical Officer, Department of Health and Professor Karina Butler, Chair of National Immunisation Advisory Committee (NIAC) Sasko Lazarov/RollingNews.ie

Q&A: Why Ireland changed its guidelines for the AstraZeneca vaccine - and how it'll affect the rollout

The HSE is going to consider over the next few days how this affects the vaccine rollout.

SENIOR HEALTH OFFICIALS answered questions last night about the implications of new advice on the administration of the AstraZeneca vaccine would have on Ireland’s vaccine strategy and the lifting of Covid restrictions.

NIAC has recommended that the Oxford-AstraZeneca vaccine be given only to people aged over 60 after reports of rare blood clotting events emerged.

Those rare blood clotting events occur in 4-10 cases in every million AZ vaccine doses administered, in which one person may die.

The HSE has cancelled AstraZeneca vaccine appointments due from today onwards, and is to consider how the announcement will affect the vaccine rollout over the coming days.

Here’s what we know so far.

The risk of blood clots versus the risk of Covid

20210412_201551 A graph comparing death (red) and ICU admission (blue) from Covid with the rare clotting side effect (yellow) from the Oxford-AstraZeneca vaccine. Gráinne Ní Aodha Gráinne Ní Aodha

Outlining the decision to limit the use of the vaccine to over 60s only, NIAC chair Professor Karina Butler said last night that someone aged 60-64 was 85 times more likely to die of Covid-19 than to have any clotting event from the vaccine – that includes all clotting events reported, and not just the rare thrombosis.

People aged 55-59 are 48 times more likely to die of Covid-19 than get a blood clot.

Among the 20-30 age group, the risk of dying from Covid was twice as likely, than to develop any clotting event related to the AstraZeneca vaccine, with the latter as a worst-case scenario.

Butler added that these figures only covered the most extreme possible result of contracting Covid-19, death, and didn’t take into account the “burdens” of Covid: the likelihood of getting hospitalised or being admitted to ICU with Covid, or the long-term effects of Covid-19, also known as long Covid.

The overall risk is taken from the EU regulator, the European Medicines Agency (EMA) and the UK regulator, the Medicines and Healthcare products Regulatory Agency (MHRA). The Covid risk figures are taken from the Irish data on Covid-19. 

Dr Niamh O’Connell also pointed out that of Covid-19 patients who are hospitalised, 8% experience clotting, and 27% of those who go into ICU could get a clot – though it was stressed that these were different clots to the rare ones linked to the AZ vaccine.

So can only 60-69-year-old get the AstraZeneca vaccine now?

No. The AstraZeneca vaccine was approved for use for the whole population before being limited to only under 70s over concerns about clinical trials not having enough data of the vaccine in over 65s.

However, those reports were subsequently reviewed and AstraZeneca was rolled out to over 70s again.

Professor Karina Butler said that on an operational basis, people aged over 70 have continued to receive mRNA vaccines (Pfizer and Moderna), and that yesterday’s announcement did not change that approach.

So, since that announcement, AstraZeneca is approved for “routine use” in people aged 60 and over.

The HSE is to decide whether over 70s will continue to receive the Pfizer and Moderna vaccines as the default, or whether there will be a reallocation of vaccines.

Why is the limit of the AstraZeneca jab to over 30s in the UK, but over 60s here in Ireland?

Acting Chief Medical Officer Dr Ronan Glynn stressed that although they are recommending the AstraZeneca vaccine for use over 60s, they could have put the limit at a lower age.

It was due to an abundance of caution that it wasn’t, he said.

He and Dr Lorraine Nolan of the HPRA pointed out that the AstraZeneca vaccine is still effective at stopping a significant proportion of the population from dying of Covid-19.

The reason the advice is changing, they added, is because they are in the “lucky” position of having other effective Covid-19 vaccines to choose from.

Can I choose what vaccine I get?

No.

There is no picking and choosing what vaccine you want, Professor Butler said.

For the age cohort specifically aged above 60, if you get offered an AstraZeneca vaccine, the advice is to accept that vaccine.

Speaking about how people should take what vaccine they’re offered, Dr Ronan Glynn said:

“If someone aged 65 is thinking of taking this vaccine if its offered to them in the coming weeks, versus waiting for the summer when there’s a surplus of other vaccines, I would highly, strongly recommend that they take what they are being offered now.”
“What’s being offered is a very safe, very effective vaccine for their age cohort. The risks of them catching Covid-19… and ending up dying of that disease are far, far, far higher than any potential risk on receipt of one of these vaccines.”

Can I still get the AstraZeneca vaccine if I’m under 60?

From today, all AstraZeneca vaccinations are paused, while the HSE comes up with an operational plan based on the new advice.

Professor Karina Butler said that she can’t speak for the programme on whether it would be “practical”, but said that NIAC’s recommendation is that the AstraZeneca vaccine can be given to those aged under 60 if they are made aware of the risks and an individual assessment is made for that person’s situation.

Why the delay between first and second doses for some people who have had the first AZ dose?

Health officials said that people under the age of 60 and with no conditions should be confident that the vaccine is safe and effective.

The reasoning for the delay between first and second doses being extended from 12 weeks to 16, was to reassure people as much as possible that the vaccine is safe.

Over 800,000 people in the UK have received a second AstraZeneca dose without any evidence of adverse events, Professor Butler said.

Germany and France have also begun to give mRNA vaccines as second doses to people who received their first AstraZeneca dose, and NIAC is monitoring how effective that approach will be, “so we will have more certainty” around that.

Are women under 60 more at risk?

Although initial studies suggested that it was mostly women under the age of 60 who experienced adverse blood clotting after receiving the vaccine, NIAC chair Professor Karina Butler said that this could be because it has been primarily given to healthcare workers, who are women aged under 60.

She noted that in the UK, the 79 rare blood clotting incidents of 30 million AstraZeneca doses administered were among men and women more evenly.

I’ve recently had the AstraZeneca vaccine – what should I do?

Dr Niamh O’Connell outlined the symptoms that people should keep a look out for – but added that these mightn’t necessarily be symptoms of a blood clot either:

The symptoms are: a persistent or severe headache, particularly if it is accompanied by a weakness in your leg or blurred vision. Other symptoms to watch out for are shortness of breath or a pain in your chest or tummy, or ‘pin-prick’ bruising.

Dr Ronan Glynn added that these rare blood clotting events tend to appear between four days and up to two weeks after receiving the AstraZeneca vaccine.

So there is no reason for the vast majority of those who have received AstraZeneca to worry – as they are past this time frame.

For those who are still within that time frame, it’s worth remembering that the incidence of these rare blood clotting events is extremely low: it’s 4-10 cases per 1 million doses administered, one of whom may die.

Have there been cases in Ireland?

The HPRA is still only aware of one suspected case of a rare blood clotting event – but it hasn’t been confirmed as an adverse event as a result of the AstraZeneca vaccine.

Dr Lorraine Nolan confirmed there was still one ‘case of special interest’, but didn’t confirm the details of the person’s condition, due to patient and data privacy reasons.

She did, however, say that as of now, there has been no reported incident of adverse events of low platelets and a clotting event together, which is the rare clotting incident associated with the Covid-19 AstraZeneca vaccine.

Dr Nolan also pointed out that European regulators were the first to become aware of this blood clotting event, and that when they began distributing the vaccine out to the population, they were “open” to the possibility of rare adverse events.

Dr Nolan said that Ireland’s population is so small that a rare event like this may not be spotted unless they looked at data abroad, as was done in this case with European and global data.

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    Mute Ciaran Mcguinness
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    May 1st 2025, 9:41 PM

    Great to see all the musicians come out in support of Kneecap. Keep up the protest.

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    Mute Del Ray
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    May 1st 2025, 10:08 PM

    @Ciaran Mcguinness: I used to think exploiting the troubles, kneecapping etc to sell music was wrong but then I realized they are just Harry Enfield characters. Enjoy them for that. Think more Kevin the teenager. They don’t really support Hezbollah. They aren’t really pro torture, anti gay, anti West. It’s all so unfair – as Kevin might say.

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    Mute Ciaran Mcguinness
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    May 1st 2025, 11:11 PM

    @Del Ray: I don’t agree with all they say; only with their right to say it. I’ve heard worse at gigs in the past.

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    Mute Regular John
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    May 1st 2025, 9:27 PM

    Absolute gôbshïtes, bill them for all the disruption they caused.

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    Mute Lone Hurler
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    May 1st 2025, 11:52 PM

    @Regular John: Far left violence. It should be called what it is.

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    Mute and the hit's just keep coming
    Favourite and the hit's just keep coming
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    May 2nd 2025, 10:52 AM

    @Regular John: well its basically a terrorist act against an airport so charge them with terrorism

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    Mute Jb Walshe
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    May 1st 2025, 9:33 PM

    That will keep the trolls busy on here for the night

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    Mute jn
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    May 1st 2025, 10:08 PM

    comment’s are open for this , more not stories to deflect from fffg disastrous governing

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    Mute Lone Hurler
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    May 1st 2025, 11:55 PM

    @jn: We know the Govt fund left wing activists for a whole range of issues, put paying them to gatecrash Shannon Airport is a bit of a stretch.

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    Mute Andrew Harrington
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    May 1st 2025, 9:37 PM

    Charge them as terrorists.

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    Mute Great Eagle
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    May 1st 2025, 10:17 PM

    @Andrew Harrington: Ten years in jail would seem appropriate and then be deported to Gaza

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    Mute Peter Wall
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    May 1st 2025, 9:27 PM

    Lefty dopes

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    Mute Ekumbe Adesiyan
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    May 1st 2025, 9:23 PM

    Violent, childish leftists.

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    Mute Daratheprofessional 1
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    May 1st 2025, 10:38 PM

    @Ekumbe Adesiyan: As opposed to extremely violent right wing government’s such as Israel or The U.S

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    Mute S Suilleabhain
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    May 2nd 2025, 11:49 AM

    @Ekumbe Adesiyan: says the guy with a huge gripe against same sex attraction ..that’s pretty childish

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    Mute Darran Macken
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    May 1st 2025, 9:23 PM

    They are very violent its crazy.

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    Mute Stephen McGovern
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    May 1st 2025, 10:38 PM

    @Darran Macken: I know, that poor fence! Won’t somebody think of the children!!

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    Mute KO
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    May 2nd 2025, 12:05 AM

    Good job announcing that security resources were cut at Shannon airport jic anymore terrorist wish to attack.

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    Mute Daniel Skelton
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    May 2nd 2025, 12:45 AM

    People who go around doing the whole Palestine thing, are usually bored and just want an excuse for something to protest about.

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    Mute liam mc meel
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    May 1st 2025, 9:46 PM

    Morons

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    Mute Lone Hurler
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    May 1st 2025, 11:53 PM

    @liam mc meel: Far left violent morons

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    Mute Padraig O'Brien
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    May 2nd 2025, 12:53 AM

    Is free speech really free. Right on protesters!

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    Mute nollaig o cellaigh
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    May 2nd 2025, 12:01 AM

    And what did this protest succeed in doing?

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    Mute Social Guy
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    May 2nd 2025, 3:36 AM

    So we can comment on this but not the “Journal Investigates” piece about transgender healthcare?? That piece of so-called journalism should come with a health warning of its own. An entirely one-sided piece of cr4p which makes no effort to provide any form of journalistic balance. It reads like a junior cert essay and should be marked as an Opinion article rather than “Investigates”. A perfect example of why The Journal is and will remain a free newspaper. Nobody in their right mind would pay for such reporting.

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    Mute P. V. Aglue
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    May 1st 2025, 9:52 PM

    “We crashed the gate doing 98 and said let them truckers roll”

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    Mute Mick Joe
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    May 2nd 2025, 6:44 AM

    These geniuses at Shannon and Kneecap , it shows that these Leftards don’t have much going on between the ears.

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    Mute liam mc meel
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    May 2nd 2025, 2:45 AM

    Should be a deep trench around it like dublin airport years ago.

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    Mute Jack
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    May 2nd 2025, 2:11 AM

    Great article on 2 infrastructure projects in Meath/kildare granted planning permission. It does not mention once what those projects entail, only waffle about “Renewable energy is fundamental in unlocking greater energy independence and security, as well as economic growth and the development of a stronger society,” Mahon continued.” One can only guess it’s using agricultural land that would be best purposed for food production, to be used for solar panels that will have less of a sustainable impact. When they don’t mention what’s involved you know it’s not good. There thousands upon thousands of acres of car parks and industrial buildings that can easily accommodate solar panels, but those planners insist on unnecessarily using agricultural land.

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    Mute Alex
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    May 2nd 2025, 9:11 AM

    @Jack: Ireland is overproducing meat anyway. 50% of it could be replaced by something useful.

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    Mute William O leary
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    May 1st 2025, 10:30 PM

    we,ll give them a house in case someone’s offended …..

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    Mute Meh Meh
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    May 1st 2025, 10:20 PM

    Meer to me Shannon, Snip, Snip Mr Burgess. The Van. Great movie.

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    Mute Ed Brennan
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    May 2nd 2025, 8:49 AM

    Charge them under anti terrorism Law.

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    Mute and the hit's just keep coming
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    May 2nd 2025, 10:54 AM

    @Ed Brennan: totally agree and into the special criminal court with no jury

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    Mute Alex
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    May 2nd 2025, 9:10 AM

    Next step is a van filled with explosives.

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    Mute Derek O Gorman
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    May 2nd 2025, 10:41 AM

    Prob hippie Brit smelly fk s on the dole. Remove their welfare

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    Mute gus wogan
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    May 2nd 2025, 4:29 PM

    I do not condone this form of protest, as much as I suport the Palestine people.

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    Mute chris gaffney
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    May 2nd 2025, 1:35 PM

    Please jail them. No need for a trial and throw away the key??

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    Mute Matt Rogers
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    May 3rd 2025, 6:32 AM

    Lots of comments on here about left-wing this and left-wing that when the truth is that the only lefties Ireland has ever had followed James Connelly into GPO and never came out again.

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