Use of the AstraZeneca COVID-19 (AZD1222) vaccine: updated JCVI statement, 7 May 2021

JCVI had updated its advice to state that, in addition to those aged under 30, unvaccinated adults aged 30 to 39 years who are not in a clinical priority group at higher risk of severe COVID-19 disease, should be preferentially offered an alternative to the AstraZeneca COVID-19 (AZD1222) vaccine, where possible and only where no substantial delay or barrier in access to vaccination would arise.

For those under 40 years who are of older age, male, obese (BMI above 30), from certain ethnic minority backgrounds or experiencing socio-economic deprivation, the risks of acquiring and/or suffering complications of COVID-19 are higher. Every effort should be made to remove barriers to accessing vaccination in those individuals.

For those aged 18 to 29 years the precautionary advice for a vaccine preference is stronger, reflecting a gradient in the benefit-risk balance with age.

This new advice is specific to the current UK context and is based on all of the following remaining favourable:

• the current low incidence of disease
• the availability of alternatives to the Astra-Zeneca (AZD1222) vaccine
• the strength of the whole vaccine programme in terms of maintaining speed and uptake

Should there be a deterioration in any of the above factors, JCVI advises that vaccination of adults aged 30 to 39 years with any of the UK-authorised vaccines is always better than no vaccination, except where there are specific contraindications.

Due to its storage and transport requirements, the AstraZeneca (AZD1222) vaccine is much more easily delivered in some settings, and in these settings may be the only vaccine it is practical to offer. In such circumstances JCVI advises that the benefits of receiving the AstraZeneca (AZD1222) vaccine outweigh the risks, and individuals in this event should be offered the AstraZeneca (AZD1222) vaccine.

JCVI considers that there continues to be no safety concerns for this extremely rare adverse event following receipt of a second dose of AstraZeneca (AZD1222) vaccine. All those who have received a first dose of the AstraZeneca (AZD1222) vaccine should continue to be offered a second dose of AstraZeneca (AZD1222) vaccine, irrespective of age. The second dose will be important for longer lasting protection against COVID-19.