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UK COVID-19 Update: New Advice on Oxford Vaccine for Under 40s, and Indian Variant Now of Concern

Editor's note, 7 May 2021: This article was updated with information from a Downing Street briefing.

These are the UK coronavirus stories you need to know about today.

Under 40s to be Offered Alternative to AZ/Oxford Vaccine

Most adults under the age of 40 will be offered an alternative to the AstraZeneca/Oxford vaccine because of a link to rare blood clots accompanied by low platelet counts.

At a Downing Street briefing, Dr June Raine, chief executive of the Medicines and Healthcare products Regulatory Agency, said there had been 242 cases and 49 deaths from over 28 million doses administered up until April 28.

However, she said: "The benefits of the AstraZeneca vaccine against COVID-19, with the associated risks of hospitalisation and death, continue to outweigh the risks of the vaccine for the vast majority of people."

However, she acknowledged that the balance of risk and benefit was "more finely balanced for younger people".

Prof Wei Shen Lim, COVID-19 chair for the Joint Committee on Vaccination and Immunisation, said the shift in advice demonstrated its "high priority on safety" and expected that the move would "further increase vaccine confidence".

A Government spokesperson said: "Everybody who has already had a first dose of the Oxford/AstraZeneca vaccine should receive a second dose of the same jab, irrespective of age, except for the very small number of people who experienced blood clots with low platelet counts following their first vaccination."

Asked at the briefing whether the new strategy could interrupt the UK's vaccination rollout, Prof Jonathan Van-Tam, England's deputy chief medical officer, replied: "We are still on target to offer a first dose to all adults by the end of July."

Latest figures show a quarter of the UK population is now fully vaccinated against COVID-19.

One 'Indian' Variant Now of Concern

Public health experts have reclassified one version of the SARS-CoV-2 variant first identified in India as a 'variant of concern' in the UK.

Public Health England (PHE) said that B.1.617.2 was "at least as transmissible" as B.1.1.7, the so-called 'UK' or 'Kent' variant.

There was currently insufficient evidence to indicate whether B.1.617.2, or the other two variants of Indian origin, caused more severe disease or rendered the vaccines currently deployed any less effective, it said.

Cases of B.1.617.2, also known as VOC-21APR-02, increased to 520 from 202 over the last week. Cases were spread across the country but concentrated in Bolton and London. Almost half of cases were linked to travel, or contact with a traveller, PHE said.

The other two variants originating from India remain under investigation.

Dr Susan Hopkins, COVID-19 strategic response director at PHE said: "We are monitoring all of these variants extremely closely and have taken the decision to classify this as a variant of concern because the indications are that this VOC-21APR-02 is a more transmissible variant."

Green Light for International Travel 

Transport Secretary Grant Shapps announced to a Downing Street briefing what he called "the first, albeit tentative, steps towards unlocking international travel" from 17 May using a traffic light-style risk system.

There are 12 'green' list countries, including Portugal, Gibraltar, Australia, New Zealand, and Israel.

Mr Shapps said people can travel to these destinations "as long as you take a pre-departure test before returning to England, and a second PCR test, 2 days after your return."

He added: "English residents will be able to use their existing NHS health app to gain access to their vaccine records. Alternatively, they'll be able to request a paper letter to verify the vaccination status." 

Turkey is among countries added to the 'red' list, which will mean Manchester City and Chelsea fans cannot travel to the Champions League final.

Excess Deaths in 2020

Excess deaths from all causes in 2020 were 14% above the five-year average in England and Wales, with COVID-19 being the main reason for excess deaths.

There were almost 76,000 excess deaths from all causes and in all locations, with COVID-19 responsible for 97% of the excess, a final analysis by the Office for National Statistics reported.

Among the other main findings for 2020 compared with the average for 2015-2019 were:

  • Deaths in private homes were 33% higher
  • Deaths in hospital were 4% higher – but would have been 16% lower if COVID was excluded
  • Deaths from influenza and pneumonia in all settings were 29% lower
  • Deaths from chronic rheumatic heart diseases were 36% above average
  • Cirrhosis and other diseases of the liver were 17% above average

Review of Face Masks for Students

The requirement for secondary school pupils in England to wear coverings on school premises could soon be lifted, a Government minister has said.

Education Secretary Gavin Williamson told the Daily Telegraph: "As infection rates continue to decline and our vaccination programme rolls out successfully, we plan to remove the requirement for face coverings in the classroom at step three of the roadmap.

"Removing face masks will hugely improve interactions between teachers and students, while all other school safety measures will remain in place to help keep the virus out of classrooms."

Removing the restriction would come no earlier than May 17 as part of the Government's third step of its roadmap out of lockdown.

Teaching unions have joined with a group of scientists to write to Mr Williamson calling for the rule on masks to remain until at least June 21. They pointed to data from the Office for National Statistics that suggested as many as 43,000 children and 110,000 staff in the UK could have been affected with 'long COVID'.

Dr Deepti Gurdasani, an epidemiologist at Queen Mary University of London, who signed the letter, said: "Scientists, school staff, parents and students are alarmed. We do not want a repeat of past mistakes that previously led to new waves, higher deaths, and prolonged lockdowns."

Vaccines Refusal Study

Doubting the safety of COVID-19 vaccines was the most common reason cited by people not wanting – or being hesitant -- about accepting an offer of vaccination, a study found.

Some people, particularly those in younger age groups, did not think they were at significant risk from COVID-19, research by the Office for National Statistics (ONS) found.

Relying on information from social media and unreliable sources added to concerns about the vaccine, it said.

The findings were based on 50 participants who took part in a 70-minute interview online or by telephone in February and March.

Commenting on the findings, statistician Hugh Stickland said: "What came across strongly was that participants had given considerable thought to COVID-19 vaccination. 

"Key concerns were the speed at which vaccines were developed and possible side-effects including, for some, potentially on their fertility.

"They were not 'anti-vaccers' or believers in conspiracies, and several mentioned that it mattered to them to take responsibility for staying healthy."

Reasons offered for not believing they needed to be vaccinated included a belief that they could protect themselves from SARS-CoV-2 by maintaining their own health and a strong immune system, or by taking steps to avoid catching infection in the first place.

The current level of positive sentiment towards COVID vaccines in adults aged 16 or over stood at 93%, the ONS said.

Mental Health

The mental health of 12% of the UK population deteriorated with the onset of the pandemic last year and did not begin to improve until July, according to a study in The Lancet Psychiatry.

However, the research, led by the University of Manchester, and based on data from 19,763 adults, found that most people experienced consistently 'good' or 'very good' mental health during the first 6 months of the pandemic.

People living in the most deprived neighbourhoods, ethnic minority groups, and those with pre-existing mental or physical conditions, were most likely to be affected by poor mental health.

Unaffected groups were more likely to be male, White, older, and from more affluent backgrounds.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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