The National Immunisation Advisory Committee has said that the benefits versus the risks of the AstraZeneca vaccine may vary by age and as alternative Covid-19 vaccines are available in Ireland, it has revised the recommendations for the use of the vaccine.

It said that the vaccine is not recommended for people aged under 60, including those with medical conditions with very high or high risk of severe coronavirus disease.

NIAC also recommended that a second dose of the Astrazeneca vaccine should not be given to anyone who "developed unusual blood clots with low platelets after the first dose".

The latest advice also states:

  • Those aged 60 and older should receive their second dose 12 weeks later as scheduled.
  • Those aged under 60 years with a very high risk or high-risk medical condition should receive their second dose 12 weeks later as scheduled.
  • Those aged under 60 years without a very high risk or high-risk medical condition should have the scheduled interval between doses extended to 16 weeks to allow further assessment of the benefits and risks as more evidence becomes available.

The HSE has advised that all AstraZeneca Covid-19 vaccination clinics planned for tomorrow should be cancelled.

"Following full consideration of the updated guidance, the HSE will advise further in terms of wider implications for the administration of the vaccination programme," it said in a statement.

UL Hospitals Group confirmed that all vaccinations scheduled for the Radisson Hotel in Limerick tomorrow are deferred. "We will issue a further update tomorrow."

Deputy Chief Medical Officer Dr Ronan Glynn said the decision to restrict Astrazeneca to people over 60 will "not necessarily" have a "material impact or delay on the roll-out of the vaccination programme".

He said the extent of the impact remains to be seen.

Asked if the recommendation to limit the use of the AstraZeneca to over 60s could have an impact on the easing of Covid-19 restrictions, he replied: "I certainly hope not."

Speaking on RTÉ's Claire Byrne Live, Dr Glynn reiterated: "I am hoping [the new advice] won't be unduly disruptive."

He said it was a "bit too early" to consider ditching AstraZeneca from Ireland's vaccination roll-out. "It remains a pivotal and important part of our vaccination programme."

Professor Karina Butler, chairperson of NIAC, said there was a need to balance the significant benefits of a national vaccination programme with the very rare risk of these reported blood clot events.

"While this is an extremely rare condition, consideration must be given to the fact that it has a very high risk of death or severe outcome," she said.

"As the risk/benefits of [AstraZeneca] vaccine may vary by age and as alternative Covid-19 vaccines are available, NIAC has revised the recommendations for use of this vaccine."

Prof Butler added: "We strongly encourage everyone to accept the Covid-19 vaccine they are offered. A high uptake of vaccine in every age group is needed if Covid-19 is to be controlled, so that public health restrictions may be safely removed."

The development follows the European Medicines Agency's finding last week, of a possible link between the AstraZeneca vaccine and rare blood clotting issues in adults who received it.

The EMA has added unusual clotting events with low platelet counts as very rare side effects to the vaccine product information. These rare events are estimated to occur between 4 and 10 in every 1 million people, one of whom may die.

Prof Butler told a media briefing that people who have had a first dose of AstraZeneca can be reassured that it is "safe and effective".

Dr Ronan Glynn said that for people who are under 60 who got their first dose of Astrazeneca many weeks ago, "if you have not had a clotting event in the first two weeks after receiving it, it is very unlikely you will have one".

Prof Butler said studies on receiving a second dose of a different vaccine to that used in a first dose should be publishing results in the coming weeks.

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The NIAC chairperson showed a graph highlighting how the risks from Covid were much greater than from AstraZeneca.

If you are over 60, she said, then you are 85 times more likely to die from Covid than suffer a clotting event and that is taking the most cautious use of the data.

For people aged 20 to 34, that falls to twice as likely to die from Covid.

Prof Butler said her advice to anyone who is 60, for example, and scheduled to get AstraZeneca, is that the vaccine is the best thing for them and the risks are "infinitesimal" compared to risk from Covid.

People will not have a choice of Covid-19 vaccines, she confirmed.

Dr Ronan Glynn said the risks from Covid in the community are "still significant" and anybody in their 60s who is offered Astrazeneca should take it.

Consultant haemotologist Niamh O'Connell told the media briefing that if you go to hospital with Covid you have an 8% chance of having a clotting event and if you go to ICU, the probability is 27%.

She said mild side effects from vaccines are common but if you have a persistent or severe headaches, especially combined with other issues such as weakness in an arm or leg or blurred vision, "of course people should seek medical attention".

Dr Glynn said there is ongoing work at EU level around the development of a vaccine certificate and Ireland is actively involved in that process.

"Hopefully we can get to a point where we can have a common document, or process, so that when someone says they are fully vaccinated we can be assured they are."

A professor of experimental immunology at Trinity College Dublin said he was a "bit surprised" that NIAC had "went as high" as 60 for the AstraZeneca age limit.

Prof Kingston Mills said the vaccine was already not recommended for the over 70s so the decision meant that it would now be given only to those in the 60 to 70 age cohort.

There are 400,000 people in this age group in Ireland.

"It is a bit tough on them where they are being told that someone who is say, 59 or 71, can't have a vaccine but if you're 61 or 69 you can take it - so it's muddying the waters somewhat," he said.

Prof Mills told RTÉ's Claire Byrne Live that rational analysis would probably show that the benefit outweighs the risk even for a 50-year-old or younger as the risks are very small.

Last week, the Health Products Regulatory Authority said it was investigating the first Irish case of a very rare blood clot involving a 40-year old woman from Dublin with cerebral venous sinus thrombosis, a clot in the brain.

Up to that case, the HPRA said it had received 16 reports of blood clots occurring following vaccination with the AstraZeneca vaccine but none described a rare blood clot.

How will new Astrazeneca advice impact roll-out?

So far 233,700 doses of the AstraZeneca vaccine have been administered here.

The impact of the change on the national vaccination campaign is not yet known but between April and June, Ireland is expecting deliveries of 813,000 AstraZeneca vaccine doses.

That accounts for 20% of anticipated doses for the second quarter. The breakdown for AstraZeneca shots due is 224,000 for April, 262,000 for May and 327,000 in June.

The total of 813,000 AstraZeneca doses for Q2 compares with 2,128,000 for Pfizer BioNTech, 383,000 Moderna jabs and 605,000 doses of the single shot Johnson & Johnson product.

That's a total of 3.9 million for the forecast estimate for Ireland based on EU aggregate level information.

Dr Ronan Glynn said the decision to restrict Astrazeneca to people over 60 will "not necessarily" have a "material impact or delay on the roll-out of the vaccination programme".

He said the extent of the impact remains to be seen. He "fully appreciates" people may have some concerns and some anxiety and if they do they should contact their GP.

In a statement later, Dr Glynn said: "We will continue to monitor the roll-out of AstraZeneca in Ireland and internationally in collaboration with the HPRA and the NIAC.

"The Department of Health, the HSE and the High-Level Taskforce will now work together to ensure that these updated recommendations are incorporated into the ongoing implementation of the vaccination programme."

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AstraZeneca issues statement following NIAC decision

In a statement, AstraZeneca said: "We recognise the decision taken by the National Immunisation Advisory Committee. Implementation and roll-out of the vaccine programme is a matter for each country to decide.

"Reviews from the regulatory authorities in the EU and UK have reaffirmed the vaccine offers a high-level of protection against all severities of Covid-19 and that these benefits continue to far outweigh the risks.

"Neither agency identified any risk factors, such as age or gender, or a definite cause for these extremely rare blood clotting events.

"In addition the World Health Organisation last week noted that, whilst concerning, the events under assessment are extremely rare, with low numbers reported among the almost 200 million individuals who have received the AstraZeneca Covid-19 vaccine around the world.

"Of these 200 million people, real-world data has suggested thousands of deaths have been prevented."

The statement concluded: "AstraZeneca has worked closely and quickly with regulators to implement changes to the product information and understand the epidemiology and possible mechanisms that could explain these extremely rare events.

"We will continue to collaborate with the NIAC in order to provide all available data to inform their decisions."


Many EU countries have introduced age restrictions on the use of the Astrazeneca vaccine, limiting its use to older people.

Last week, NIAC said that the overall benefit of the highly-effective vaccine, in protecting people from severe Covid-19 disease, hospitalisation and death, outweighed the risks of this very rare event.

It said that healthcare professionals and vaccine recipients should be informed that very rare, complicated clotting events had been reported in a small number of people, who recently got the vaccine.

The UK has limited the use of the vaccine to those aged over 30 years, while France has limited the vaccine to over 55s. In Ireland, over 233,700 doses of the AstraZeneca vaccine have been administered.

Health officials said they expect that 180,000 more people will receive vaccination against coronavirus infection this week.