Loneliness during the pandemic was greater in areas with more young people, says new research and also in places with higher crime and unemployment. And think twice about buying an suv if you live in a city why drivers need to think about their Carbon Footprint in urban areas. Good afternoon. The uk Medicines Regulator will give an update in an hours time about its investigation into the Oxford Astrazeneca Coronavirus Vaccine, amid concerns about a potential link to extremely rare blood clots. The briefing will take place as the European Medicines Agency will outline its own recommendations, with European Health ministers due to meet afterwards to discuss the findings. Meanwhile, the roll out has begun of the third Coronavirus Vaccine in the uk. The first person to receive the Moderna Vaccine was a 24 year old carer in carmarthen in west wales. It comes as uk researchers found people diagnosed with covid 19 in the previous six months were more likely to develop depression, dementia, psychosis and stroke. In brazil, more than 4,000 covid deaths were reported within 2a hours for the first time, as a more contagious variant continues to fuel a surge in cases. This first report is from our Health Correspondent Anna Collinson. A third Coronavirus Vaccine has officially arrived in the uk. First in line for the moderna jab, and dressed for the occasion in a sparkly face covering, was 24 year old elle taylor from ammanford in wales. Very excited, very happy. Im an unpaid carerfor my grandmother so its very important for me that i can get it so i care for her properly and be safe. The Moderna Vaccine is also being rolled out in scotland today, with the rest of the uk set to follow. There are 17 million doses available extra so that helps with the supply issues. It is also kept at a normal temperature so its far more robust and able to be taken around mobile into rural areas and those kind of things so that will help us along the way keeping to our timetable. This expansion of the roll out comes as the uk and europes regulator are preparing to report on another key vaccine. Investigations are taking place to see if the Oxford Astrazeneca jab may be linked with very rare blood clots. Scientists say an unusual constellation of features have been picked up in cases detected so far. The interest is that these cases are associated with low platelet counts, which we dont normally see in cases of thrombosis, so that makes them stand out and also makes them match cases we have heard about from other european countries. For the people being offered the vaccine at the moment, the risk benefit is very strongly in favour of receiving the vaccine. If it transpires there is a link between the astrazeneca vaccine and rare blood clots, its estimated it could cause one death out of 2. 5 Million People vaccinated in the uk. At this stage, for the groups of people we are vaccinating, the benefits of having an astrazeneca vaccination far, far outweigh any risks, so please attend for your vaccination. These cases at the moment are incredibly rare. Last night, a trial for the oxford vaccine on children and teenagers was temporarily halted, while the team await further information from the uks regulator. They say they have taken an extremely cautious approach particularly as children are most unlikely to become seriously ill from coronavirus. With the target to offer the vaccine to all adults by the summer, labour and the government are united in wanting to tackle any hesitancy. It is a safe vaccine, lots of adults have had it, including myself, and i think its very important we ensure theres maximum confidence in the roll out of the vaccine and where it is safe, we need to say its safe. Cheap and effective, the Astrazeneca Jab has been rolled out at speed around the globe, including here in georgia. The manufacturer has also promised to make the jab available to the developing world on a nonprofit basis. If regulators in the uk or europe recommend any restrictions, the decision could have Rippling Effects across the world. Anna collinson, bbc news. 0ur Medical Editor fergus walsh told me the Vaccine Regulators have a delicate balance to strike. They have got a difficultjob because they have got to analyse whether or not these very rare blood clots that have been identified some days after people have received the Astrazeneca Jab is a random association or if there is a now it is thought to be about one in 600,000 people immunised in the uk, a higher incidence in the eu. But we dont really know what the Background Risk is for these particular types of plots, associated with low Platelet Levels and we know that covid, for example, increases your risk so it is possible some of the people affected had actually got covid as well. So individual case reports need to be followed up. In germany, most of the cases were among younger women and thatis cases were among younger women and that is one of the reasons why several eu countries have restricted the Astrazeneca Jab to older adults. And so what should people do . People will be watching who have had their first dose and are waiting for the second, some will still be called up and given an appointment, it can be worrying. I and given an appointment, it can be wor inc. ,. , and given an appointment, it can be wor inc. , and given an appointment, it can be war in. ,. , , and given an appointment, it can be wor inc. , , worrying. I have had my first dose of astrazeneca worrying. I have had my first dose of astrazeneca and worrying. I have had my first dose of astrazeneca and i worrying. I have had my first dose of astrazeneca and i will worrying. I have had my first dose| of astrazeneca and i will definitely be there on the day and time i am called to have my second dose. You have to look at the benefits against the risks. We now have three highly effective vaccines. The vaccine roll out in the uk has been an enormous success and we have seen it has helped, along with lockdown, to really bring down the deaths and hospitalisations. We have to keep that front and centre. The people being called for theirjabs now, definitely, the benefits outweigh the risks so if you are in your 40s, for example, and you get covid, you still have a one in 1000 chance of dying. When it comes to people in their 20s and 30s, the Risk Benefit Ratio Analysis is more complex and thatis Ratio Analysis is more complex and that is the sort of thing that may well be addressed this afternoon. Fergus walsh, there. Lets talk about this with professor polly roy, chair of virology at the London School of hygiene and tropical medicine. Shejoins me now. Good afternoon. Good afternoon. Lots to talk about good afternoon. Good afternoon. Lots to talk about and good afternoon. Good afternoon. Lots to talk about and i good afternoon. Good afternoon. Lots to talk about and i want good afternoon. Good afternoon. Lots to talk about and i want to good afternoon. Good afternoon. Lots to talk about and i want to speak good afternoon. Good afternoon. Lots to talk about and i want to speak to i to talk about and i want to speak to you about the Moderna Vaccine because that is new today but can i just pick up where fergus walsh left off and talk about astrazeneca and concerns, and i say this because they could be people watching the coverage this afternoon who are heading off in ourfor their vaccination in an hourfor their vaccination in an hourfor their vaccination and might have concerns. Im interested in your thoughts about everything we are seeing across europe from your perspective as a virologist. Across europe from your perspective as a virologist as a virologist. Well, the vaccine itself, the as a virologist. Well, the vaccine itself, the way as a virologist. Well, the vaccine itself, the way it as a virologist. Well, the vaccine itself, the way it is as a virologist. Well, the vaccine itself, the way it is made, as a virologist. Well, the vaccine itself, the way it is made, it itself, the way it is made, it really doesnt seem to have any problem, to me. Why it is making some very rare blood clot problems, i think it may not be directly related, it may be Something Else, i dont know. People may have some other issues dormant, which were triggered by the vaccine. We cant really say anything. The cause is not known. So i would still think that this vaccine is very good. Millions of people have taken it and nothing happened, so one has to be cautious but i dont find any problem with this vaccine yet. But of course, since we have had some problems with the platelets and the blood clot problem, we cant say why it is happening and nobody can really find the cause as well, i dont think it is possible yet because even if you tried very much to find out, scientifically, in a laboratory, it is not possible to find out what is the reason we have got this because there is no marker, no biomarker, no nothing that will tell us exactly why it is happening. So i think it is a very rare and it may be a condition that certain people get it. Because each persons Immune System is different. So i dont know how we can absolutely say it is related to the vaccine. 0n the other hand, we do have at theirjabs, as you say, the Moderna Vaccine and the Pfizer Vaccine, and they do not seem to have any problem with the blood clots. However, they have sometimes, very rarely, also, some side effects like allergies. But they are also very rare. So i think every vaccine or medicine we take has some kind of rare occasion where it is a problem and it is not necessarily directly related to that particular drug or vaccine. Maybe it is something to do with the persons union system or the health, which is really dormant will stop persons Immune System. And then it is triggered by the medicine or vaccine. Medicine or vaccine. Sorry to interruat medicine or vaccine. Sorry to interrupt but medicine or vaccine. Sorry to interrupt but there medicine or vaccine. Sorry to interrupt but there is medicine or vaccine. Sorry to interrupt but there is clearly | medicine or vaccine. Sorry to l interrupt but there is clearly an awful lot that is still to be learned and you have absolutely made that very clear but in terms of the moderna, we have seen the first vaccines rolled out in west wales today. Explain for us the difference with the moderna compared to the other two authorised vaccines in this country and why it is going to be so useful. This country and why it is going to be so useful this country and why it is going to be so useful. Well, moderna is very similar to the be so useful. Well, moderna is very similar to the pfizer be so useful. Well, moderna is very similar to the Pfizer Vaccine, be so useful. Well, moderna is very similar to the Pfizer Vaccine, it be so useful. Well, moderna is very similar to the Pfizer Vaccine, it is i similar to the Pfizer Vaccine, it is mrna based but pfizer has made a small portion of the spike protein which makes the antibody in humans. So they use only receptor binding domain, which is very specific. If some mutation occurs on that position, in any virus, they may not protect completely. The Moderna Vaccine on the other hand, using the same spike that astrazeneca had come they made it mrna based and they dont use any vector but they use the same complete spike protein which will trigger the complete antibody. So if there is a mutation in one position, it is still able to function so i think they have a much more robust Antibody Response that the Moderna Vaccine will give so i am very hopefulfor the Moderna Vaccine will give so i am very hopeful for it. It is like astrazeneca, as i said, or any other adenovirus based vaccine but they have not used a vector, and they are one step ahead because the messenger rna, immediately it is presented to the antigen sales, it makes the antibody, and they dont have to go through a vector from dna to messenger rna, from protein to antibody. So they are one step ahead. , ,. , antibody. So they are one step ahead. ,. , � antibody. So they are one step ahead. , � antibody. So they are one step ahead. , � , ahead. 0k, professor, im so sorry to cut ahead. 0k, professor, im so sorry to out you ahead. 0k, professor, im so sorry to out you off ahead. 0k, professor, im so sorry to cut you off because ahead. 0k, professor, im so sorry to cut you off because it ahead. 0k, professor, im so sorry to cut you off because it is ahead. 0k, professor, im so sorry to cut you off because it is such ahead. 0k, professor, im so sorry to cut you off because it is such a l to cut you off because it is such a busy afternoon, very good to have your expertise. Thank you for joining us. We will speak again, professor polly roy from the London School of hygiene and tropical medicine. Lots to fit in this afternoon because we are edging up to the briefing at 3pm. You will be able to see it here. We know we will be hearing from the deputy Medical Officerfor england, be hearing from the deputy Medical Officer for england, Jonathan Van Tam. You can follow the briefing live here at 3pm. Brazil has recorded more than 4,000 coronavirus deaths in 24 hours a grim record for the country. The Public Health system has been overwhelmed by a surge in the number of cases since the beginning of the year, as paul adams reports. Sobbing. 0vercrowded hospitals, a Health System on the brink of collapse, and a population living in fear. Covids spotlight has ranged across the globe and now has brazil locked in its harsh glare. For the first time, the country has recorded more than 4,000 covid related deaths in just 24 hours. Brazils death toll now stands at around 337,000 second only to the United States. Still behind both the us and britain in terms of death per capita, but a contagious new variant is fuelling the latest surge the death toll in march twice as high as the previous month. I think brazil now is not only the epicentre of the pandemic worldwide, its a threat to the entire effort of the International Community to control the pandemic on the planet. If brazil is not under control, the planet is not going to be under control its not going to be safe because we are brewing variants, new variants every week. The countrys defiant president , jair bolsonaro, continues to oppose a lockdown. Damaging the economy, he says, would be worse than the virus itself. Without citing evidence, hes linked Quarantine Measures with obesity and depression. Hes even tried to reverse restrictions imposed by local authorities. What we are facing here in brazil, what we have here, it is a sad situation that is the consequence of the lack of coordination in the federal level by the national government. We have here, it is president bolsonaro confronting governors and mayors. The government is under pressure. It knows the world is watching with a critical eye. The countrys new Foreign Minister says theres a balance to be struck. Translation this is urgent, and president bolsonaro has l instructed me to face this mission. I emphasise the urgency of health, the urgency of the economy, and the urgency of sustainable development. Scenes like this are undermining confidence in the government. The president says 2021 will be the year of vaccinations, but fewer than 10 of brazilians have had their firstjab. Some say much more drastic action is needed. Paul adams, bbc news. People diagnosed with covid 19 appear to be at greater risk of developing psychological and neurological conditions, including depression, psychosis and stroke. A study by Oxford University examined the Health Records of more than half a million patients in the United States, and found almost all the main Brain Illnesses were more common in people whod caught the virus. Heres our Health Reporter rachel schraer. Coronavirus breaks into our cells and multiplies wherever in the body it finds itself. Thats why it causes such a wide range of symptoms from the lungs, to the gut, to the brain. The team at the university of oxford looked over half a million looked at over half a million Patient Records in the us to see if conditions affecting the brain were more common in those whod had covid. They looked at 14 conditions including anxiety, depression and psychosis, stroke, brain haemorrhage, and dementia. All of these conditions were seen more often in people whod had a Covid Infection in the previous six months. But these conditions all have very different causes. It could be that in some people, the virus actually gets into the brain and causes some damage. It could be the way your body is reacting to the virus, produces a sort of immune or inflammatory response that, again, contributes to the problems. And for other people, it may simply be a psychological effect, if you like, of the stress that having covid and thinking what might happen to you next is the important factor. The study couldnt prove the virus itself was definitely causing the changes, but patients recovering from covid were more likely than similar people whod had flu or another infection to develop a psychological or neurological condition. And the sicker coronavirus patients had been, the more likely they were to develop these complications. Rachel schraer, bbc news. The headlines on bbc news. The uks Medicines Regulator will hold a briefing this afternoon to give an update on possible links between the astazeneca vaccine and rare blood clots in adults. It comes as the uk now has its third Coronavirus Vaccine. The first doses of the Moderna Vaccine have been given out in wales, with a 24 year old carer the first to get the jab. Brazil records more than 4,000 covid deaths in 24 hours, its worst day since the start of the pandemic its Health System is overwhelmed. Loneliness reported during the pandemic was more prevalent in places with a high concentration of young people, according to the latest research. A study by the office for National Statistics shows People Living in areas with higher rates of unemployment or crime were also more likely to say they felt isolated, and that 7 of people in britain felt lonely often or always over the autumn and winter. Harry farley reports. Hello. There you go. Thank you. Every week, maria calls in on sue. It is a brief exchange, but its a lifeline. It is my birthday today. I know, happy birthday thank you. Data from the 0ns suggests that since spring last year, an extra 1. 1 Million People say they often or always feel lonely. Some people have not seen anyone for a year, or not properly, apart from people doing the shopping or if they have to go to the doctors or something, they have not really been out. And you know, you just chat to them for as long as you can. But it is very isolating and i think some people have gone downhill as well, with their physical health, because of that sort of lack of purpose. These figures suggest it is young people, and particularly those in urban areas, who have most felt the effects of lockdown. With social events curtailed and travel limited, those not usually isolated have faced loneliness. My mood has been low, very low. Loneliness is a very strange thing. Ive never prior to this encountered any loneliness. Ive always been surrounded by people and been very busy. And then to spend 12 months without Human Contact Hasjust been hard, very hard. Ive been working from home so that in particular has been harder because ive not had that day to day connection with people, with my colleagues. So these last few months have been particularly hard. The 0ns also said areas with high rates of unemployment had greater levels of loneliness. The pandemic has affected all of us in different ways. But across the country there are communities prepared to reach out and help those in need. Harry farley, bbc news. Police looking for the student Richard 0korogheye have been searching Epping Forest in essex following the discovery of a body in a lake there on monday. The 19 year old has been missing from his home in west london for more than a fortnight. Helena wilkinson reports. It remains a mystery as to what happened to Richard 0korogheye. An intelligent, quiet, focused boy, his family say. A gentle giant, loved by everyone. His family last saw him more than two weeks ago on March The 22nd when he left home in west london. Here he is that night in the area, captured on cctv, without a jacket and without medication. The 19 year old has sickle cell disease. The Oxford Brookes business and Technology Student was then seen again this time in loughton in essex, in the early hours of the following day. Police say he had taken a taxi to a residential street and was heading towards Epping Forest. Its what led officers here, to this ancient woodland. The metropolitan police, supported by colleagues from the essex force, have been carrying out extensive searches. On monday, they found a body in this lake. It has yet to be formally identified. Richards mother says her son had been shielding since the start of the pandemic, which took its toll. Imagine staying in for that length of time, without seeing friends. The only opportunity he had to go out was going to his appointments, really. And really, thats it. Nothing else other than that. Searches in the area where a body was found are continuing. What was it that drew this 19 year old from his home in west london . Why did he head towards the forest . What happened to him . His family desperately need to know. Helena wilkinson, bbc news. Some other news now. Workers from the Delivery Firm deliveroo have gone on strike, in a dispute over pay and conditions. Socially distanced protests were held in cities including london, york, sheffield, reading and wolverhampton. The independent workers� union of Great Britain said its members are calling for decent pay as well as improved Employment Rights and safety protections. Lets speak to our business presenter alice baxter. Alice presenter alice baxter. We have been talking a lot about alice we have been talking a lot about deliveroo and the Stock Exchange also bring us up to date with all of that. Absolutely right, jane. The general mood music and pretty much everything surrounding this ipo has not gone the way that deliveroo had wanted. What began life as something being billed as the biggest Share Offering to hit the biggest Share Offering to hit the city of london is now being dubbed the worst ipo to happen in the history of london. Lets talk about what is happening to the share price injust a moment but about what is happening to the share price in just a moment but as you alluded to, on the real streets and in the real world out there, yes, hundreds of Deliveroo Riders are making a socially distance to protest against their pay and conditions. In response to that, by the way, deliveroo itself has said, we are proud that Rider Satisfaction is at an all time high and that thousands of people are applying to be riders each and every week. Riders are at the heart of our business and today we are beginning a new consultation with riders about how we can invest our new £50 Million Community fund. They are trying to say there is not a huge issue when it comes to riders Job Satisfaction but this was precisely theissue, satisfaction but this was precisely the issue, why so many of the big, well known investors, the people that manage our pensions, aviva, standard chartered, for example, publicly said they would not be taking part in the Share Offering. So what is happening to the share price . Lets scroll back to last week when the company floated, it was billed as this 1. 5 billion ipo, initial public offering, when a company goes to the stock market to raise cash. It was going to be one of the biggest in the history of the city of london but it didnt go their way. They ended up floating their way. They ended up floating the shares at the bottom end of what the shares at the bottom end of what the company had originally gone for. It then still slumped around 31 . Today, theres been a bit of good news on that front because the share price has inched up around 2 , shares currently trade in, let me just check, at 280 6p per share, still well below the 300 90p that they floated at last week. 390 p. Not a great story and what is happening today is that this is the first fully open day of trading, when all of the smaller retail investors, around 70,000 of them, can get involved and sell their shares if they want to. Many are choosing not to, interestingly, they are keeping their shares in their back pockets, hoping they might see a bit of a rebound in the share price but another twist in the tail of this fascinating company which has undoubtedly been one of the winners in coronavirus but they certainly have not won in their ipo. Alice, thank you. The latest Business News from alice baxter, there. People living in cities have been urged to think twice before buying suvs which are meant for the countryside. The Motoring Organisation the rac says drivers should choose vehicles which are less polluting, when they dont Need To Plough across rivers or fields on their way to the shops. Research suggests most Sports Utility Vehicles are now bought by people who live in urban areas, particularly london. Roger harrabin reports. 4x4 Wheel Drive cars are officially called suvs, Sports Utility Vehicles. To people who hate their bulk on city streets, there is a less respectful title chelsea tractors. New Research Shows that most of them are indeed bought in kensington and chelsea, Hammersmith And Fulham and westminster, london boroughs where wealthy residents can afford the prices. It is a far cry from the origins of the chelsea tractor, the Humble Workhorse land rover, loved by farmers, Country Dwellers and the military. Their appeal has spread into the towns. Two thirds of these cars are being sold to People Living in cities where there are no opportunities to drive off road. So actually, our call is not so much to consumers to think twice. What we are asking for is for these vehicles to stop being advertised in the uk. It is part of a trend towards bigger cars that has kept Carbon Emissions from transport unacceptably high. The classic mini, for instance, was 3. 05 metres long. The new version mini is 3. 82 metres long. Compare the huge mercedes gls. It is 5. 21 metres. And beasts like this are too big for a conventional parking space. If suv drivers were a country, they would be seventh in the world for Carbon Emissions. People choose different cars for different reasons. It might be style. It might be safety. It might be seating position. Indeed, it might be size. If people have got a big family, they want a bigger car. If they want to tow things, they might need a bigger car. But not all suvs are big and dirty. Some of the cleanest cars are now coming in the style of suvs. That means electric suvs, although they are only part of the solution. They waste energy, dragging tonnes of steel with heavy batteries through city streets, like this electric hummer, based on an American Army truck. It is a beast. Banning advertising for suvs would help, campaigners say, just as adverts for smoking are banned. It wont work, motoring groups warn. They say people buy suvs for all of the space inside and because they are good to drive. Roger harrabin, bbc news. Now its time for a look at the weather. Hello. It is another cold day out there. More cloud around than many of us have seen over the past couple of days. Despite the cloud though, most places are looking dry, just still a a few snow showers peppering the far north and north east of scotland. Some Rainjust Edging in towards Northern Ireland as we get into this evening. Temperatures still very much rooted into single figures. Some less cold air moving in from the atlantic with the cloud and the rain to Northern Ireland, into Western Scotland into parts of wales and the western side of england overnight. Towards the south and far east, here is where there still are some clear spells, still a frost going into tomorrow morning, just not as cold as it has been over the last few nights. Now, tomorrow is looking very wet in north west scotland. We will see some patchy Rain Elswhere for Northern Ireland, for england and wales, though for east anglia and South East England it will stay mainly dry here and these westerly winds are introducing that less cold air. Temperatures for some back into double figures. That is not going to last very long colder again by the weekend. The uks Medicines Regulator will hold a briefing at 3pm to give an update on possible links between the astazeneca vaccine and rare blood clots in adults. You can watch it here live on the news channel. It comes as the uk now has its third Coronavirus Vaccine. The first doses of the Moderna Vaccine have been given in wales, with a 24 year old carer the first to receive it. Brazil records more than 4,000 covid deaths in 24 hours, its worst day since the start of the pandemic. Its Health System is overwhelmed. A study of us patients suggests people diagnosed with covid 19 appear to be at greater risk of developing conditions including depression and psychosis. Loneliness during the pandemic was greater in areas with more young people, says new research, and also in places with higher crime and unemployment. And, think twice about buying an suv if you live in a city why drivers need to think about their Carbon Footprint in urban areas. Sport now and for a full round up from the bbc sport centre. Good afternoon. Lets start with the premier leage Club Liverpool who say racist abuse on social media cannot be allowed to continue this after their players Trent Alexander arnold and naby keita were targeted. Both had racist emojis sent to them on the platform instagram in the lead up to Tuesdays Champions League tie with real madrid. In a statement, the club said the abuse was utterly unacceptable and added it will not be enough until the strongest possible preventative measures are taken. Once again, they said, we are sadly discussing abhorrent racial abuse the morning after a football game. The club will work with relevant authorities to try to identify and prosecute offenders. Manchester city midfielder Kevin De Bruyne has signed a two Year Contract extension with the club, keeping him at the etihad until the summer of 2025. Hejoined in 2015, and hes made over 250 apperances, winning seven major trophies, and theyre in with a chance of taking four more this season. De bruyne is 30 now, and he said he couldnt be happier. Ifeel proud because i have been here now for six years and, obviously, this feels like home. It has been the longest time that i have been at the club. To get the extension now, at my age, feels also like a very proud moment because, obviously, it means that they trust me until i get really old in football terms. Theres one more english side still to play in the Champions League. Chelsea take on porto tonight, having lost for the first time under manager Thomas Tuchel at the weekend. They were thrashed 5 2 by west brom but their Champions League form has been exceptional, topping their Group Without losing a game and knocking out Spanish League leaders Atletico Madrid in the last 16. The challenge is to be totally focused on our strengths and to play an intensive game and to narrow the focus down into 45 minutes and then another 45 minutes. Then, we will see what results we get and how we will deal with it in the second leg. The final of the World Snooker championship is set to be played in front of a capacity crowd on the 3rd of may. Its one of the pilot events designed to find ways to get fans back safely, without social distancing. The crucible can hold 980 spectators, and the plan is for it to be a third full for the opening round, increasing as the tournament progresses. Face coverings will be required in the venue and fans will have to take a covid 19 test before arriving, and another five days afterwards. The first mens major of the year gets under way tomorrow with the masters at augusta. Dustinjohnson is the defending champion, after winning the delayed 2020 edition that finally took place last november. The last player to win back to back masters was tiger woods, who is missing as he recovers from a car crash. And johnson is not quite as sure about his form as he was last year. Maybe about his form as he was last year. Not quite as go was maybe not quite as good a shape as i was in november, but i feel like it is coming together, i am starting to hit a lot of the same shots and getting a lot more comfortable with the golf ball and i feel like it is in a pretty good form. Australias women have extended their one Day International winning streak to 23 matches, after beating new zealand in tauranga to clinch their series with a game to spare. They posted 271 7 from their 50 overs, built on rachael haynes� 87, before bowling out their hosts for 200. Spinnerjessjonassen taking three wickets as the white ferns lost seven forjust 80 runs. Australia havent lost a one day series since they were beaten by engand in 2013. Quite some record. Thats all the sport for now. I will see you again later this afternoon. Lets talk a little bit more about coronavirus in many parts of the world as we adapt to that briefing at 3pm. Head up to that briefing. Hungary is relaxing its covid restrictions, with many shops and Services Allowed to reopen, despite the fact that the country is in the grip of a third wave, with hospitals at full capacity. The Prime Minister, viktor 0rban, said he felt a moral imperative to start reopening the economy, but medical experts say the move is premature. Nick thorpe has more from budapest. Big changes, really, for hungarians. Shops, which have been closed for weeks or months will be allowed to reopen. There are some restrictions within the shops. No more than four people in a smallish shop at the same time. But its a Big Change For Hungarians who have really been locked down for a long time, many of them very heavily locked down since the middle of november. And, of course, some nonessential Services Like hairdressers, car mechanics, things like that, also reopening today. Hungary is pretty much ahead within the European Union. I think its second only to malta. Thats because the Prime Minister, viktor 0rban, took a gamble, basically by ordering the russian and chinese vaccines at a time when they were not, theyre still not, approved by the European Medicines Agency. So that was a gamble which seems to have paid off. It meant that hungary had plenty of vaccines, including the astrazeneca. In hungary thats one of the five vaccines available. So, basically, the Prime Minister, viktor 0rban, here is taking another gamble. He said when hungary reaches 2. 5 million vaccinations, which was some time yesterday, out of a population of 9. 7 million, as you said, he said he had a moral imperative to reopen the country. There is a huge demand, huge frustration in the public, about not being able to go about their ordinary days work. And i think the Prime Minister recognised that. But there are these doubts, these challenges to him from within the medical profession. The Human Rights Group Amnesty International says the coronavirus pandemic has deepened inequalities Around The World. Its annual report says the worst impact has been on the most vulnerable people, leaving women and migrants further marginalised in some parts of the world. Aru na iyengar reports. The Global Pandemic has affected everyone, but the impact is far from evenly spread. Amnesty international is scathing in its report. It says women and refugees, like these in congo, have suffered the most. It points to Domestic Violence figures, which have risen in many countries, fuelled by victims being isolated with their abusers. Women were largely the primary victims, in gender terms, of covid 19. Throughout the world, groups that were vulnerable, individuals that were vulnerable, because of years of neglect, because of Austerity Measures that had wilfully neglected investment in health care, these individuals were hit the hardest. They had the least and they received the least. The report also says governments have used covid 19 to repress dissent. The philippines, nigeria, brazil and india are accused of using the pandemic as an excuse for tougher policing. Countries such as china are accused of suppressing information, and rich countries are criticised for not thinking globally and refusing to share knowledge on vaccine production. Amnesty says necessary restrictions taken to deal with a Health Crisis should be short, focused and proportionate. It says, instead, many countries have extended their extraordinary powers. It concludes that covid has been weaponised by leaders Around The World. For decades, china imposed a one child policy on families, to prevent what they feared would be an unmanageable population. In recent years, the rules have been relaxed, allowing couples to have two children. But it now seems most young couples in china dont want to have big families. 0ur correspondent Stephen Mcdonell has been speaking to young people about their plans. Chinese kids are sometimes called Little Emperors because parents, limited to one child only, gave their offspring everything. Then came the two child policy. But, for many, one has remained well and truly enough. You just have to ask parents with a single child if they want more. Translation i havent even considered it. Neither emotionally nor financially could i afford it. In chinas once prosperous north east, dwindling populations in many towns have led to a suggestion that this could be the first region to scrap both limits altogether. But this may not produce more children. Translation for me, its already hard to raise this one. It feels better to put all your energy into one child or we might feel guilty that we cant properly take care of many. Theres been a huge shift in attitude from generation to generation here in china. Older generations, they come from big families and it was a really crucial thing, in terms of their lives. But for younger people, its not the same, they really dont want to have as many kids, its not as important for them. The one child policy came into force in the early � 80s to stop an already massive population exploding. Later, people in rural areas and those from ethnic minorities were allowed multiple kids. Yet for the vast majority, over three decades, having more than one child meant being fined. China in 2021 is a completely different place. Young couples want different things. When you look at birth rates throughout history, poverty tends to produce people. Thats because every new human being is an extra pair of hands to go to work. Then along comes prosperity and its not as important to have kids for this reason. Another factor is that this huge country has now produced generations of people simply accustomed to small family life. It might be hard to get them to change. Stephen mcdonell, bbc news, changchun. It is at quarter to three. Just a reminder, we will bring you that News Briefing two at 3pm. We expect to hear a bit more about the astrazeneca vaccine, but before we get to that, we will take a few minutes to talk about an entirely different story which we have not had a chance to touch on here today. A bicycle which belonged to Princess Diana is to be sold at auction. Before her engagement, Diana Spencer often rode her 1970s blue raleigh traveller Around London, and used it to cycle to work at a Nursery School in kensington. The bike was deemed unfit for a princess and was sold after her engagement to prince charles. Lets hear from the Auctioneer Mark Ellin Whojoins Me now. Hello, good afternoon. Good afternoon. Hello, good afternoon. Good afternoon hello, good afternoon. Good afternoon. ~. , afternoon. What can you tell us about this afternoon. What can you tell us about this bike . Afternoon. What can you tell us about this bike . I afternoon. What can you tell us about this bike . I think afternoon. What can you tell us about this bike . I think this afternoon. What can you tell us about this bike . I think this is l afternoon. What can you tell us j about this bike . I think this is a rime about this bike . I think this is a prime example. About this bike . I think this is a prime example, you about this bike . I think this is a prime example, you never about this bike . I think this is a | prime example, you never know about this bike . I think this is a prime example, you never know what is coming through the front door next. It is a really unique item, outwardly it is just a blue rusty 19705 outwardly it is just a blue rusty 1970s raleigh bike, as you said, but with one very important to previous owner and she was famously photographed riding this bike to work every day. Remember she was only 18 or 19 years old at the time, so this was her mode of transport, but as soon as she was engaged to be married, they did not think it was suitable transport for a princess, it was suggested they hide it away, which is what she did, and consequent, about the time of the Royal Wedding in 1981, she had sold it forjust a Royal Wedding in 1981, she had sold it for just a few pounds Royal Wedding in 1981, she had sold it forjust a few pounds to a friend of her fathers and it was just tucked away for quite a few years. Here it is in our salerooms. We have seen a few here it is in our salerooms. We have seen a few images here it is in our salerooms. We have seen a few images of here it is in our salerooms. We have seen a few images of the here it is in our salerooms. We have seen a few images of the bike here it is in our salerooms. We have seen a few images of the bike now. | here it is in our salerooms. We have | seen a few images of the bike now. I do not want to be rude, but a cynic might say if i am going to bed for this, how do i really know it was hers . ~. , , hers . Well, we are completely rel ini hers . Well, we are completely relying on hers . Well, we are completely relying on a hers . Well, we are completely relying on a letter hers . Well, we are completely relying on a letter that hers . Well, we are completely relying on a letter that we hers . Well, we are completely| relying on a letter that we have with it. It is a letter of provenance from the friend of dianas father who is the original owner of the bike, a letterfrom him saying he bought it from dianas father and it was her bike she used when she lived in london. It has quite a history to this bike. It was dubbed the shame at bike because it was thought to be shameful to be used by princess Around London. Can ou used by princess Around London. Can you imagine that . The very notion there was something embarrassing about it, we are trying to encourage people to go Around London on bikes now. Is it in working order . You said it was a bit rusty, but if someone buys it, cannot use it . It looks it. Someone buys it, cannot use it . It looks it have someone buys it, cannot use it . It looks it. Have you someone buys it, cannot use it . It looks it. Have you not someone buys it, cannot use it . It looks it. Have you not sat someone buys it, cannot use it . It looks it. Have you not sat on someone buys it, cannot use it . It looks it. Have you not sat on it . Someone buys it, cannot use it . It looks it. Have you not sat on it . I | looks it. Have you not sat on it . I honestly have looks it. Have you not sat on it . I honestly have not. Looks it. Have you not sat on it . I honestly have not. You looks it. Have you not sat on it . I honestly have not. You have looks it. Have you not sat on it . I honestly have not. You have not. Looks it. Have you not sat on it . I i honestly have not. You have not had a iuick honestly have not. You have not had a quick little honestly have not. You have not had a quick little test . Honestly have not. You have not had a quick little test . Maybe honestly have not. You have not had a quick little test . Maybe you honestly have not. You have not had a quick little test . Maybe you would j a quick little test . Maybe you would not tell me if you had. Goodness, what sort of value are you expecting . It what sort of value are you exoecting . What sort of value are you expecting . What sort of value are you exiectin . ,. ,. ,. ,. ,. , expecting . It was a solder ago at auction, expecting . It was a solder ago at auction. So expecting . It was a solder ago at auction, so about expecting . It was a solder ago at auction, so about five expecting . It was a solder ago at auction, so about five years expecting . It was a solder ago at auction, so about five years ago | expecting . It was a solder ago at| auction, so about five years ago it came up for sale and it did make nearly £10,000. The interest has moved on from then, there is far more interest in the royalfamily in general, particularly diana, in the wake of the be crown, the series. There is a global interest now and i will auctions reach a global audience, so are we think 15 to 20000 and we think that is attainable. In 20000 and we think that is attainable. 20000 and we think that is attainable. ,. , , attainable. In all seriousness, the way auctions attainable. In all seriousness, the way auctions are attainable. In all seriousness, the way auctions are run attainable. In all seriousness, the way auctions are run now, attainable. In all seriousness, the way auctions are run now, you attainable. In all seriousness, the | way auctions are run now, you will have people on the line presumably from All Over The World i guess. For the last from All Over The World i guess. Fr . The last year, our auctions have been completely online, so we have no audience in the room, so we just have a computer, the audience is in the thousands, and they are all over the thousands, and they are All Over The World. We do not know who the buyers are, they are all anonymous, and it is a completely different experience to what it used to be, but were getting used to it and it has gone very well. {lilia but were getting used to it and it has gone very well. Has gone very well. 0k, all at the best for that, has gone very well. 0k, all at the best for that, thank has gone very well. 0k, all at the best for that, thank you has gone very well. 0k, all at the best for that, thank you very has gone very well. 0k, all at the l best for that, thank you very much. You can let me know privately later whether you really have had a quick race around the block. A little girl from wiltshire has become the inspiration for a new doll to help teach children about downs syndrome. Six year old rosie hit the headlines last summer when her family built a full size replica of her favourite dolls house in their back garden. The toy Company Behind the original house got in touch to say theyd like to base a new doll on rosie, to help educate others about the condition. Matt treacy has the story. Meet rosie. Say hello. Hello doll is that your doll . Yeah this is the tree house that started it all. A Life Size Replica of rosies favourite Toy Built Last year. Just messing around, i thought it would be fun, really, for the Screenshot Ofjust having a screenshot, to stick it on aianb. I got this message suddenly from my phone from aianb saying, youve got a booking this weekend. So i was like, what . News of the unusual stay captured the imagination of people Around The World and the boss of the company that makes the dolls got in touch. I actually came across a tweet and i said to jason, look, id love to make a one off doll for rosie. And id like to gift it to her for christmas. But this was to be a special doll. Rosie has down syndrome so subtle details were included in the toy and the packaging to explain her condition. We dont tell people that this is a doll with down syndrome. We let them purchase it and then they discover on the inside theres a little leaflet explaining what it actually means to have down syndrome. So weve got a diagram to show, the eyebrows and the nose and the face and shes got her boots, you know, theyve modelled her boots on rosies boots that really helped her be able to walk and have a normal life. I think its going to be a really nice educational thing for kids to look at and read and, you know, play, just like they play with any other doll. When others saw the finished product, they wanted one as well. Now its been made available in toy shops in 35 different countries. Theyve sold hundreds already and hopefully we can sell more. And 1 for every purchase will go to our local charity who helps to support rosie and other families in the community. And what i hope from this is that it lets children know that she is just like them. Shes just different. I believe all kids should have a diverse toy box so that they can develop that empathy, so it is, its extremely important to us. To her, this is like a normal day, she just loves going outside, loves going in the tree house, loves playing with her dolls, just loves life. Matt treacy, bbc news. The time is edging up to seven minutes before three. Back to coronavirus now and the uk Medicines Regulator will give an update shortly about its investigation into the 0xford astrazeneca Coronavirus Vaccine amid concerns about a potential link to extremely rare blood clots. We know this has overtime been a much bigger issue and a matter of some debate and concern in Continental Europe and to that end, we are going to hear a briefing from the European Medicines Agency which is due to get under way at 3pm as well. As i mentioned, the European Medicines Agency will hold a News Conference shortly. 0ur correspondent Anna Holligan is at their headquarters in amsterdam. Good afternoon in a very chilly amsterdam, thank you for standing outside for us. We know we are going to hearfrom the ema, i canjust see the participants in that News Briefing where you are already sitting down inside. Talk us through what we might expect from your perspective that. What we might expect from your perspective that. Well, we are due to hear from perspective that. Well, we are due to hear from them perspective that. Well, we are due to hear from them in perspective that. Well, we are due to hear from them in Just Perspective that. Well, we are due to hear from them in just a perspective that. Well, we are due to hear from them in just a few to hear from them in just a few minutes time. This is at the team that specialises in Adverse Reactions to medicines and they have been studying the specific case studies, a very small number of the specific case studies, from Around The World to try to establish whether there is any causal link at all between these rare blood clots and the Oxford Astrazeneca vaccine or whether these cases are purely coincidental. Governments across the continent right now are looking for clarity, as are the people going into the surgeries today expecting to get this shot. At the moment, the advice from the ema is if you are offered the Oxford Astrazeneca jab, take it. They said last month that any potential risk is outweighed by the benefits, but what we are expecting to hear today is probably a bit more on the balance of that, because in these rare cases, they seem to have mostly affected younger women and that is why some countries on the continent have taken this kind of unilateral action, so germany has postponed the use of astrazeneca among the under 60s, here in the netherlands too. In france it is only going to people over the age of 55. So what the ema says today is a critical. It is not just about an opinion on a piece of paper. It is potentially about whether or not people are prepared to take this vaccine, because at the moment, there are two obstacles to the ballot in the eu. 0ne moment, there are two obstacles to the ballot in the eu. One is the supply and secondly Public Confidence was to cut the roll in the eu. ,. , ~ , confidence was to cut the roll in the eu. ,. , ~ , the eu. That is a key point. The rollout in the eu. That is a key point. The rollout in the the eu. That is a key point. The rollout in the eu. The eu. That is a key point. The rollout in the eu. There the eu. That is a key point. The rollout in the eu. There has the eu. That is a key point. The rollout in the eu. There has been roll out in the eu. There has been theissue roll out in the eu. There has been the issue of Public Confidence, so it will be interesting to hear from the ema from that perspective too. Precisely. Vaccines are seen as the key to emerging from the pandemic, returning to a normal kind of society, but they are only effective if people are actually able to take them or prepared to take them, if they have the faith to take them. That is why the guidance from the ema is critical, because this is the regulatory body that guides policy across the eu. Determines whether or not vaccines are safe and this data is being looked at in the real world in real time. These vaccines are being rolled out faster than normal because of the urgency and at the moment, as i say, the information from the ema and the uk regulator is if you are offered this vaccine, then take it, because the benefits it seems outweigh the risks. Thank ou ve it seems outweigh the risks. Thank you very much it seems outweigh the risks. Thank you very much for it seems outweigh the risks. Thank you very much for an it seems outweigh the risks. Thank you very much for an in it seems outweigh the risks. Thank| you very much for an in amsterdam with the European Medicines Agency. More from their later. 0ur Health Correspondent Anna Collinson is with me. She willjoin me to listen to this News Briefing we are expecting. There are a number involved here, the deputy Medical Officer for england, the representatives of the mhra, so this is quite broad brush in this country. It is a very difficult Balancing Act here. Absolutely. And as anna touched on there, what we are hoping we may see from this particular Press Conference involving the mhra, the uks regulator, and Thejoint Committee On Vaccination and immunisation, is a bit more detail about these a Blood Clot Cases. So that we have not had much of a breakdown of gender or age groups. Anna was talking about it there, in germany they have more of that detail, so that is one thing a scientist in particular are hoping will come out of that. It is interesting that hosting will be professorJonathan Van Tam, deputy professor Jonathan Van Tam, deputy chief professorJonathan Van Tam, deputy chief Medical Officer professorJonathan Van Tam, deputy chief medical 0fficerfor professorJonathan Van Tam, deputy chief Medical Officer for england. 0ver chief Medical Officer for england. Over the past year he has become a particularly popular with the public, famous for her loving a metaphor, and if they are going to announce any changes, any slightest change, they need to get the nesting spot on, so the government will be hoping if anything is going to be announced, Jonathan Van Tam will leave that. The messaging spot on. The ema will also be announcing theirfindings in the next on. The ema will also be announcing their findings in the next hour on. The ema will also be announcing theirfindings in the next hour or so too. Their findings in the next hour or so too. ~ ,. , their findings in the next hour or sotoo. ,. , their findings in the next hour or sotoo. ,. , so too. Absolutely, thank you very much. So too. Absolutely, thank you very much anna so too. Absolutely, thank you very much. Anna collinson so too. Absolutely, thank you very much. Anna collinson will so too. Absolutely, thank you very much. Anna collinson will be so too. Absolutely, thank you very much. Anna collinson will be here| much. Anna collinson will be here while we wait for that News Briefing to begin. We are told the british one at that and i was referring to Possiblyjust One at that and i was referring to possibly just ate few minutes delayed, so that gives us a bit of time to pause and look at the weather. Hello. It is another cold day out there. More cloud around than many of us have seen over the past couple of days. Despite the cloud though, most places are looking dry, just still a few snow showers peppering the far north and north east of scotland. Some Rainjust Edging in towards Northern Ireland as we get into this evening. Temperatures still very much rooted into single figures. Some less cold air moving in from the atlantic with the cloud and the rain to Northern Ireland, into Western Scotland into parts of wales and the western side of england overnight. Towards the south and far east, here is where there still are some clear spells, still a frost going into tomorrow morning, just not as cold as it has been over the last few nights. Now, tomorrow is looking very wet in north west scotland. We will see some patchy Rain Elswhere for Northern Ireland, for england and wales, though for east anglia and South East England it will stay mainly dry here and these westerly winds are introducing that less cold air. Temperatures for some back into double figures. That is not going to last very long colder again by the weekend. This is bbc news. Im jane hill. The headlines. The deputy chief Medical Officer Jonathan Van Tam will hold a briefing shortly on possible links between the astrazeneca vaccine and rare blood clots. Stay with us for live coverage. It comes as the uk now has its third Coronavirus Vaccine. The first doses of the Moderna Vaccine have been given today in scotland and wales, with a 24 year old carer the first to receive it. Brazil records more than 4,000 covid deaths in 24 hours, its worst day since the start of the pandemic. Its Health System is overwhelmed. A study of us patients suggests people diagnosed with covid 19 appear to be at greater risk of developing conditions including depression and psychosis. Loneliness during the pandemic was greater in areas with more young people, says new research, and also in places with higher crime and unemployment. And think twice about buying an suv if you live in a city. Why drivers need to think about their Carbon Footprint in urban areas. Good afternoon. Welcome to bbc news as we talk a lot about Coronavirus Vaccines this afternoon. The European Medicines Agency is beginning a briefing very shortly for its latest update about the conclusion of its assessments of risks, if there are any, regarding the covid 19 astrazeneca vaccine. Lots of talk as we have been saying about possible links with rare blood clots, that is in relation to the Astrazeneca Jab. That briefing is due to begin very shortly at its headquarters in amsterdam. 0n the one hand, we are very much keeping an eye on that. Meanwhile, in london, we are expecting a briefing shortly, coming from the Department Of Health and a number of speakers will be at that briefing in london, led by professorJonathan Van Tam, the deputy chief Medical Officer for england. We will be hearing from the Chief Executive of the mhra among others as well. All of this in relation to concerns in some quarters, are there links between the Astrazeneca Jab and a very rare blood clot . Anna collinson is with me as we listen to the briefing, it was due to start dead on 3pm but is a very slight delay, i am being told. But again, just to remind people as theyjoin us as we hit 3pm. This is about blood clots, a very specific type, a very rare type but people, some people will have concerns, this is what we are excited to hear more about. Absolutely, yes, as you say, these are extremely rare forms of blood clots, but what has been particularly noticeable when investigations have been taking place, looking into these type of blood clots that have been detected, notjust in the uk but in other countries as well, is what has been described as an unusual constellation of features that have been picked up. Most significantly, low platelet counts. We dont normally see that in places of cases of thrombosis. That makes the cases of thrombosis. That makes the cases is a standout and slightly easier to detect even though the cases are extremely rare. It has meant that scientists have been able to spot the cases in other european countries, including in places like germany. This has led to some countries restricting the use of the astrazeneca vaccine in certain age groups. Many cite this precautionary principle that they dont want to take any kind of risk, even before a causal link has been found, they will take this approach. Different countries have different approaches. The uk is very reliant on astrazeneca and as you know, we have gone through months of extremely tight lockdown with high numbers of cases, so the uk took a more balanced approach. Mil cases, so the uk took a more balanced approach. Cases, so the uk took a more balanced approach. All right, thank ou for balanced approach. All right, thank you for now. Balanced approach. All right, thank you for now, and balanced approach. All right, thank you for now, and we balanced approach. All right, thank you for now, and we are balanced approach. All right, thank you for now, and we are going balanced approach. All right, thank you for now, and we are going to l balanced approach. All right, thank| you for now, and we are going to go to amsterdam to hear from The Medicines agency. I to amsterdam to hear from The Medicines agency. Medicines agency. I am very delighted medicines agency. I am very delighted to medicines agency. I am very delighted to have medicines agency. I am very delighted to have with medicines agency. I am very delighted to have with me. Medicines agency. I am very delighted to have with me today the Executive Director of the European Medicines Agency, dr sabina strauss, the chair of the ema Safety Committee and the Vigilance Committee, and the head of analytics at ema, who can provide Additional Information about the review of the Scientific Evidence it was based on. Before we start, i want to explain how we plan to run this Press Briefing. Please note that your microphone is disabled by default for the duration of the Press Briefing. We will first hear short remarks from mrs cook and dr strauss, and after that, we will have half an hour of questions about. 0nce have half an hour of questions about. Once the question and answer session starts, please raise your hand in webex if you want to raise a question. Todays briefing is broadcast on youtube and through europe by satellite and the footage can be used free of charge by all media and you will find the respective links in the invite said earlier today. Without further delay, i am earlier today. Without further delay, iam now earlier today. Without further delay, i am now handing over to mrs cook, the Executive Director of ema. Thank you very much. Good afternoon, ladies thank you very much. Good afternoon, ladies and thank you very much. Good afternoon, ladies and gentlemen, and thank you forioining ladies and gentlemen, and thank you forjoining us again for this Press Briefing forjoining us again for this Press Briefing. First of all, i want to start briefing. First of all, i want to start by briefing. First of all, i want to start by stating that our Safety Committee, the Vigilance Committee of European Medicines Agency, confirmed that the benefits of the astrazeneca vaccine in preventing covid19 astrazeneca vaccine in preventing covid 19 overall outweigh the risks of side effects. Covid 19 is a very serious of side effects. Covid 19 is a very serious disease with high hospitalisation and death rates, and Every Hospitalisation and death rates, and every day, hospitalisation and death rates, and every day, covid is still causing thousands every day, covid is still causing thousands of deaths across the eu. This Vaccine Thousands of deaths across the eu. This vaccine has proven to be highly effective this vaccine has proven to be highly effective in this vaccine has proven to be highly effective in preventing severe disease effective in preventing severe disease and hospitalisation, and it is saving disease and hospitalisation, and it is saving lives. Vaccination is extremely is saving lives. Vaccination is extremely important in helping us in the fight extremely important in helping us in the fight against covid 19 and we need the fight against covid 19 and we need to the fight against covid 19 and we need to use the vaccines we have to protect need to use the vaccines we have to protect us need to use the vaccines we have to protect us from the devastating effects protect us from the devastating effects. After very in depth analysis, effects. After very in depth analysis, we have concluded that the reported analysis, we have concluded that the reported cases of unusual Blood Clotting reported cases of unusual Blood Clotting following vaccination with the astrazeneca vaccine should be listed the astrazeneca vaccine should be listed as the astrazeneca vaccine should be listed as possible side effects of the vaccine as we communicated last week, the vaccine as we communicated last week, we the vaccine as we communicated last week, we convened an ad hoc expert group, week, we convened an ad hoc expert group, composed of experts from a range group, composed of experts from a range of group, composed of experts from a range of medical specialities, including haematologists, neurologists, epidemiologists and virologists. Based on the current avaiiabte virologists. Based on the current Available Evidence, specific risk factors Available Evidence, specific risk factors like age, gender or previous Medicai Factors like age, gender or previous medical history of Clotting Disorders have not been able to be confirmed disorders have not been able to be confirmed as the rare events are seen confirmed as the rare events are seen in confirmed as the rare events are seen in all confirmed as the rare events are seen in all ages and in Men And Women seen in all ages and in Men And Women a seen in all ages and in Men And Women. A plausible explanation for these women. A plausible explanation for these rare women. A plausible explanation for these rare side events is an immune response these rare side events is an immune response to these rare side events is an immune response to the vaccine, leading to a Condition Response to the vaccine, leading to a condition similar to one scene sometimes in patients treated with heparin. Sometimes in patients treated with heparin, called heparin induced thrombocytopenia, and Sabine Straus will give thrombocytopenia, and Sabine Straus will give us thrombocytopenia, and Sabine Straus will give us more details from the assessment. Ema is working very closely assessment. Ema is working very closely with the National Competence authorities in all of the eu Member States authorities in all of the eu Member States and authorities in all of the eu Member States and the company to make sure the risi effectiveness and safety of all of the authorised covid 19 vaccines, and we the authorised covid 19 vaccines, and we wiii the authorised covid 19 vaccines, and we will issue further recommendations if necessary on the grounds recommendations if necessary on the grounds of recommendations if necessary on the grounds of science and robust evidence grounds of science and robust evidence. This case clearly demonstrates one of the challenges posed demonstrates one of the challenges posed by demonstrates one of the challenges posed by large scale Vaccination Campaigns. When millions of people receive campaigns. When millions of people receive these vaccines, very rare events receive these vaccines, very rare events can receive these vaccines, very rare events can occur that were not identified events can occur that were not identified during the Clinical Trials identified during the Clinical Trials. The role of farmer cove vigilance, trials. The role of farmer cove vigilance, the monitoring of these side effects, is to help us rapidly detect side effects, is to help us rapidly detect and analyse these risks and their impacts on the risk benefit profiie their impacts on the Risk Benefit Profile of their impacts on the Risk Benefit Profile of the vaccine. This case also profile of the vaccine. This case also shows profile of the vaccine. This case also shows us that the Vigilance System also shows us that the Vigilance System is also shows us that the Vigilance System is working. These very rare and unusual system is working. These very rare and unusual events have been picked up, identified, analysed and have allowed up, identified, analysed and have allowed us to come to science based recommendations to allow the safe and effective use of this vaccine. Emas and effective use of this vaccine. Emas scientific assessment will continue emas scientific assessment will continue to work on all recommendations around this vaccine. Any National Recommendations around this vaccine. Any National Decision on the optimal use in any National Decision on the optimal use in Vaccination Campaigns will also take use in Vaccination Campaigns will also take into account the pandemic situation also take into account the pandemic situation in also take into account the pandemic situation in any individual country, and other situation in any individual country, and other factors such as hospitalisation and availability of vaccines hospitalisation and availability of vaccines. So thank you very much for joining vaccines. So thank you very much for joining us vaccines. So thank you very much for joining us today and i am now very pleased joining us today and i am now very pleased to joining us today and i am now very pleased to hand over to the chair of the pharmacovigilance and Risk Assessment committee, dr Sabine Straus assessment committee, dr Sabine Straus, assessment committee, dr Sabine Straus. ,. ,. , straus. Just worth reiterating the ke line straus. Just worth reiterating the keyline from straus. Just worth reiterating the keyline from emer straus. Just worth reiterating the keyline from emer cooke straus. Just worth reiterating the keyline from emer cooke in keyline from emer cooke in amsterdam, the benefit of the astrazeneca vaccine outweighs the risks. That is from the European Medicines Agency. It is a highly effective vaccine, she said. It is saving lives. However, of course, she acknowledged there has been a few cases of unusual Blood Clotting and the ema says that should be listed as a possible side effect to the vaccine. She went on to say it is a rare event. It has happened in all ages and in both Men And Women, but she stressed right from the outset that the European Medicines Agency says the benefits of the astrazeneca vaccine outweigh the risks. We are staying with this News Briefing in amsterdam, the headquarters of the European Medicines Agency. We are of course keeping an eye on the Department Of Health because we are also going to hearin health because we are also going to hear in the uk from The Medicines and Health Care Regulatory agency and Health Care Regulatory agency and we will be hearing from professorJonathan Van Tam but for now, lets stay with the briefing from the European Medicines Agency. These cases were fatal. The cases came mainly from Reporting Systems of the European Economic area, and the uk. I can provide you all say with more recent figures. As of the 4th of april, 2021, the safety data base of the 4th of april, 2021, the safety database had received a total of 169 cases of cvs t, and 53 of splenetic Vein Thrombosis and at that moment, 40 Million People were vaccinated in the European Economic area and the uk. The more recent data did not change any of our recommendations. After extensive discussions within the committee and taking into account the findings of the expert group, our conclusion is that these Clotting Disorders are very rare side effects of the vaccine. This conclusion is based on the detailed clinical, mechanistic and epidemiological assessment including a distinct clinical pattern, immunologicalfindings and pattern, immunological findings and observation pattern, immunologicalfindings and observation of more reported cases than would be expected from the Background Rates of these unusual conditions. The currently available data did not allow us to identify a definite cause for these compilations. However, plausible explanations have been put forward, including an immune response that leads to a condition that seems similar to an atypical heparin induced thrombocytopenia. No specific risk factors could be identified based on the current data. The committee can therefore not recommend any specific measures to reduce the risk. Most of the cases occurred in individuals below the age of 60, and in women but because of the different ways the vaccine is being used in the different countries, the committee did not conclude that age and gender were clear risk factors for these very rare side effects. Importantly, further Research Analysis of this important issue will take place. The manufacturer, astrazeneca, will have to conduct studies and research which has been commissioned by the ema, to further investigate these reactions. The committee will continue to assess all evidence that becomes available on this issue while the Vaccination Campaigns continue. It is of great importance that Health Care Professionals and people coming for vaccination are aware of these risks and look out for possible signs or symptoms that usually occur in the first two weeks following vaccination. These include, for example, shortness of breath, chest pain, swelling in the leg, persistentabdominal breath, chest pain, swelling in the leg, persistent abdominal pain, neurological symptoms, including severe or persistent headache, or blurred vision, and skin bruising beyond the site of injection. Their Product Information will be updated to reflect these new findings and this will be added as an adverse drug reaction to the Product Information. It will also include warnings. I would like to thank all of my colleagues that have worked very, very hard around the clock, to provide a comprehensive review of all of the evidence that was available to the committee, and for the assessment which was both rapid and robust. The collaboration between colleagues from the National Competent authorities and the European Medicines Agency, as well as with the scientific experts, was extremely productive. This review shows that in europe, there is a strong pharmacoVigilance System that can promptly detect and analyse any adverse event, even the very rare ones, and take appropriate action and i would like to take the opportunity here to stress again the importance of reporting any suspected side effects. It is based on the reports from Health Care Professionals and from people vaccinated that we have been able to detect, assess and act in this rapid and robust way. I am pleased to leave the floor now to our moderator. Leave the floor now to our moderator. ,. ,. ,. , moderator. Many thanks and we are now opening moderator. Many thanks and we are now opening the moderator. Many thanks and we are now opening the floor moderator. Many thanks and we are now opening the floor for moderator. Many thanks and we are | now opening the floor for questions. Just to now opening the floor for questions. Just to reiterate now opening the floor for questions. Just to reiterate the now opening the floor for questions. Just to reiterate the key now opening the floor for questions. Just to reiterate the key points just to reiterate the key points from Sabine Straus before we hear the questions, saying that there are no specific risk factors that the ema could identify as to why a handful of people have gone on to develop that rare form of blood clot. They say they cannot identify the cause, it could be an immune response and we will talk more about that later, im sure, but there are no specific risk factors that can be identified, age and gender are not clear risk factors. To reiterate, the ema is saying the benefit of the astrazeneca vaccine still outweighs the risks. Lets hear some of the questions. The risks. Lets hear some of the questions the risks. Lets hear some of the iuestions. ,. ,. ,. , questions. Reports of young women with serious questions. Reports of young women with Serious Foetal questions. Reports of young women with Serious Foetal blood questions. Reports of young women with Serious Foetal blood clots, questions. Reports of young women with Serious Foetal blood clots, i with Serious Foetal blood clots, i wonder with Serious Foetal blood clots, i wonder if with Serious Foetal blood clots, i wonder if you with Serious Foetal blood clots, i wonder if you can with Serious Foetal blood clots, i wonder if you can expect with Serious Foetal blood clots, i wonder if you can expect to with Serious Foetal blood clots, i wonder if you can expect to me i with Serious Foetal blood clots, i. Wonder if you can expect to me why with Serious Foetal blood clots, i wonder if you can expect to me why i and other wonder if you can expect to me why i and other young wonder if you can expect to me why i and other young women wonder if you can expect to me why i and other young women like wonder if you can expect to me why i and other young women like me wonder if you can expect to me why i. And other young women like me should confidently and other young women like me should confidently receive and other young women like me should confidently receive the and other young women like me should confidently receive the oxford confidently receive the Oxford Astrazeneca confidently receive the Oxford Astrazeneca vaccine confidently receive the Oxford Astrazeneca vaccine if confidently receive the Oxford Astrazeneca vaccine if it confidently receive the Oxford Astrazeneca vaccine if it is confidently receive the Oxford Astrazeneca vaccine if it is offered to me astrazeneca vaccine if it is offered to me the astrazeneca vaccine if it is offered to me. The second astrazeneca vaccine if it is offered to me. The Second Question astrazeneca vaccine if it is offered to me. The Second Question i astrazeneca vaccine if it is offered | to me. The Second Question i want astrazeneca vaccine if it is offered i to me. The Second Question i want to ask is to me. The Second Question i want to ask is that to me. The Second Question i want to ask is that europe to me. The Second Question i want to ask is that europe remains to me. The Second Question i want to ask is that europe remains one to me. The Second Question i want to ask is that europe remains one of ask is that europe remains one of the most ask is that europe remains one of the most vaccine ask is that europe remains one of the most vaccine sceptical ask is that europe remains one of. The most vaccine sceptical continent in the the most vaccine sceptical continent in the world the most vaccine sceptical continent in the world. Will the most vaccine sceptical continent in the world. Will allowing the most vaccine sceptical continent in the world. Will allowing a in the world. Will allowing a vaccine in the world. Will allowing a vaccine that in the world. Will allowing a vaccine that does in the world. Will allowing a vaccine that does increase i in the world. Will allowing a. Vaccine that does increase the in the world. Will allowing a vaccine that does increase the risk of potentially vaccine that does increase the risk of potentially fatal vaccine that does increase the risk of potentially fatal Blood Vaccine that does increase the risk of potentially fatal blood clots, of potentially fatal blood clots, even of potentially fatal blood clots, even if of potentially fatal blood clots, even if they of potentially fatal blood clots, even if they are of potentially fatal blood clots, even if they are very of potentially fatal blood clots, even if they are very rare, of potentially fatal blood clots, even if they are very rare, if. Of potentially fatal blood clots, | even if they are very rare, if we allow even if they are very rare, if we allow that even if they are very rare, if we allow that to even if they are very rare, if we allow that to remain even if they are very rare, if we allow that to remain on even if they are very rare, if we allow that to remain on the even if they are very rare, if we allow that to remain on the market, will that allow that to remain on the market, will that have allow that to remain on the market, will that have an allow that to remain on the market, will that have an increasingly will that have an increasingly negative will that have an increasingly Negative Effect will that have an increasingly Negative Effect on will that have an increasingly Negative Effect on vaccine i will that have an increasingly Negative Effect on vaccine take up in the Negative Effect on vaccine take up in the continent . Negative effect on vaccine takeup in the continent . Negative effect on vaccine takeup in the continent . Thanks, probably best we split in the continent . Thanks, probably best we split the in the continent . Thanks, probably best we split the message in the continent . Thanks, probably best we split the message so in the continent . Thanks, probably i best we split the message so perhaps Sabine Straus can First Respond with the advice to young women and then we can go forward with emer cooke about the Vaccine Hesitancy . Thank ou ve about the Vaccine Hesitancy . Thank you very much. About the Vaccine Hesitancy . Thank you very much. It about the Vaccine Hesitancy . Thank you very much, it is about the Vaccine Hesitancy . Thank you very much, it is an about the Vaccine Hesitancy . Thank you very much, it is an important i you very much, it is an important question you very much, it is an important question and also a very difficult one question and also a very difficult one what question and also a very difficult one. What we have seen so far is that indeed, the risk seems to be predominantly in younger age, under 60, predominantly in younger age, under 60. But predominantly in younger age, under 60. But it predominantly in younger age, under 60, but it also occurs in the elderly 60, but it also occurs in the elderly and we have seen that it predominantly affects women. Some of that could predominantly affects women. Some of that could be explained by the way the vaccine is being used in the european the vaccine is being used in the European Union and in the European Economic European Union and in the European Economic area. What we do know is that covid 19 is a very serious disease that covid 19 is a very serious disease and we know that the Benefits Disease and we know that the benefits of the astrazeneca vaccine have been benefits of the astrazeneca vaccine have been established. It prevents covid have been established. It prevents Covid Disease and hospitalisation and it Covid Disease and hospitalisation and it prevents mortality. So in that respect, prac feels that the overall that respect, prac feels that the overall benefits outweigh the risks. We are overall benefits outweigh the risks. We are keeping an eye on this of course and we are waiting for the briefing to begin in london, so all of that to come. But just to update you if you are justjoining of that to come. But just to update you if you arejustjoining us, this is a briefing from the headquarters of the European Medicines Agency about those possible links between the Oxford Astrazeneca vaccine and a rare form of blood clot. As i say, the ema stressing that as far as their committee has decided, the benefit still outweighs the risks. This vaccine is saving lives, they said, right at the start of the News Briefing, and that they cannot identify the cause of the few blood pots that have of course happened. We cant identify any specific risk factors, but cases of unusual Blood Clotting will be listed as a possible side effect of the vaccine. We will keep an eye on this because we are expecting to hear from this because we are expecting to hearfrom professor this because we are expecting to hear from professorJonathan Van Tam in the coming minutes. Anna collinson is with me. Everything we are hearing out of amsterdam takes us to the heart of one of the issues as far as a lot of scientists and researchers are concerned which is Public Confidence. Of course, one does not want to minimise the terrible impact forfamilies does not want to minimise the terrible impact for families who have been through the very rare events they are talking about but it is still so unclear because the numbers are so small compared to the vast numbers of people that have had a vaccine. Edit vast numbers of people that have had a vaccine. , vast numbers of people that have had a vaccine. ,. , vast numbers of people that have had a vaccine. ,. , ,. , a vaccine. Of course and this is all about, a vaccine. Of course and this is all about. We a vaccine. Of course and this is all about, we have a vaccine. Of course and this is all about, we have been a vaccine. Of course and this is all about, we have been speaking a vaccine. Of course and this is all i about, we have been speaking about it a lot, havent we, the risk balance benefit risk benefit balance, trying to establish where that falls so the emas Safety Committee, known as prac, have delivered their findings and it comes a day after the ema leader made a comment in his own personal opinion, saying he believed there was a link between the Astrazeneca Jab and these very rare blood clots. He did go on to say that he believed that the benefits were still there, and people should still take up their vaccine but it was obviously worth monitoring and worth continuing looking into. As we have just heard, they have concluded, the committee today, that these unusual blood clots with low platelets should be listed as very rare side effects. Most cases, they say, occurred in women under 60, within two weeks of vaccination. One plausible explanation, they say, is this was an immune response. Lets this was an immune response. Lets no to the this was an immune response. Lets go to the department this was an immune response. Lets go to the department of this was an immune response. Lets go to the Department Of Health, where we arejust go to the Department Of Health, where we are just about to hear, it looks like we can see professor Jonathan Van Tam of course and we will hear the british response to this. The briefing is going to be led byJonathan Van Tam, alongside him, dr du maine, the Chief Executive of the mhra, and also, the chair of the committee of Human Medicines. And a representative from the jcvi. Medicines. And a representative from thejcvi. Im medicines. And a representative from the jcvl medicines. And a representative from thejcvi. �. ,. ,. ,. , from the jcvi. Im Jonathan Van Tam, deu from the jcvi. Im Jonathan Van Tam, deputy chief from the jcvi. Im Jonathan Van Tam, deputy chief medical from the jcvi. Im Jonathan Van Tam, deputy chief Medical Officer. From the jcvi. Im Jonathan Van Tam, deputy chief Medical Officer. And deputy chief Medical Officer. And this is a clinical and scientific briefing. I am join today on my right by the chair of the joint committee on vaccination and immunisation, thejcvi, to my immediate left by the Chief Executive officer of the mhra, and to my extreme left, by the chair of the commission on Human Medicines. Todays briefing is about the uk Vaccine Programme, and in particular, about the astrazeneca vaccine and we will explain as we go through about a change of course, a Course Correction, if you like, to the uk programme. Now, if you had said to me back in march 2020, and predicted how far we would have come so far with our Vaccine Programme, then i am not sure i would have believed that we would have got as far as we have. The uk Vaccine Programme has been the most enormous success indeed. And if you said to me that by march 2021, we would not have needed a Course Correction, that also would have amazed me stop so we must keep this in the context the enormous success of the enormous success we have achieved so far. Im going to stop there so far and allow professor raine to open the briefing by explaining her perspective from the mhra and where we are arriving at today. Thank perspective from the mhra and where we are arriving at today. We are arriving at today. Thank you. I will now update we are arriving at today. Thank you. I will now update on we are arriving at today. Thank you. I will now update on mhras we are arriving at today. Thank you. | i will now update on mhras rigorous scientific i will now update on mhras rigorous scientific review of Safety Reports of very scientific review of Safety Reports of very rare and specific blood clots of very rare and specific blood clots with of very rare and specific blood clots with low platelet count, Thrombocytopenia Associated with covid19 Thrombocytopenia Associated with Covid 19 Vaccine Astrazeneca. Over 20 million Covid 19 Vaccine Astrazeneca. Over 20 million doses of the a z vaccine have 20 million doses of the a z vaccine have been 20 million doses of the a z vaccine have been given in the uk, and we know have been given in the uk, and we know that have been given in the uk, and we know that vaccines are the best way to protect know that vaccines are the best way to protect people from covid 19 and have already saved thousands of lives have already saved thousands of lives and have already saved thousands of lives and in fact, around 6000, modelled lives and in fact, around 6000, modelled in the uk, by the end of february modelled in the uk, by the end of february. But no effective medicine or vaccine february. But no effective medicine or vaccine is february. But no effective medicine or vaccine is without risk. With vaccines, or vaccine is without risk. With vaccines, more complex than usual, because vaccines, more complex than usual, because the vaccines, more complex than usual, because the benefits can be to people because the benefits can be to people other than the individual taking people other than the individual taking the vaccine, while the clinical taking the vaccine, while the Clinical Trials of vaccines allow us to assess Clinical Trials of vaccines allow us to assess relatively common effects very rare to assess relatively common effects very rare effects are only detected when very rare effects are only detected when a very rare effects are only detected when a vaccine is used at scale on a large when a vaccine is used at scale on a large enough number of people and that is large enough number of people and that is why the uk has careful Monitoring Systems in place and these Monitoring Systems in place and these Monitoring Systems are now detecting these Monitoring Systems are now detecting a potential side effect of the Covid 19 Vaccine Astrazeneca, in an extremely small number of people. The evidence is firming up and our review the evidence is firming up and our review has the evidence is firming up and our review has concluded that while it is a Strong Review has concluded that while it is a strong possibility, more work is a strong possibility, more work is needed is a strong possibility, more work is needed to establish beyond all doubt is needed to establish beyond all doubt that the vaccine has caused these doubt that the vaccine has caused these side effects. Our role is to continually these side effects. Our role is to continually monitor safety during widespread use, to confirm that the vaccines widespread use, to confirm that the vaccines are widespread use, to confirm that the vaccines are performing as expected, to identify vaccines are performing as expected, to identify any very rare side effects. To identify any very rare side effects, and to ensure the benefits outweigh effects, and to ensure the benefits outweigh the risks. The publics safety outweigh the risks. The publics safety is outweigh the risks. The publics safety is at the forefront of our minds safety is at the forefront of our minds. Ourteams safety is at the forefront of our minds. Our teams of safety experts, scientists. Minds. Our teams of safety experts, scientists, clinicians and epidemiologists have investigated, reviewed epidemiologists have investigated, reviewed and evaluated thoroughly and scientifically all Safety Reports and scientifically all Safety Reports and our safety reviews are carried reports and our safety reviews are carried out reports and our safety reviews are carried out in tandem with the Vaccination Programme. We have gathered Vaccination Programme. We have gathered a Vaccination Programme. We have gathered a large amount of data on the safety gathered a large amount of data on the safety profile of the available vaccines the safety profile of the available vaccines and we have done a rigorous scientific vaccines and we have done a rigorous scientific review of all the available data with regards to suspected blood clots with low platelet count. The commission on human platelet count. The commission on Human Medicines Expert Working Group has also Human Medicines Expert Working Group has also met frequently and critically has also met frequently and critically assessed all the data, alongside our regulatory review, and this is alongside our regulatory review, and this is also alongside our regulatory review, and this is also included lay representatives and advice from leading representatives and advice from leading haematologists. Based on the current leading haematologists. Based on the current evidence, the benefits of the Covid 19 Vaccine Astrazeneca against the Covid 19 Vaccine Astrazeneca against covid 19 and its associated risks, against covid 19 and its associated risks, hospitalisation and death, continues risks, hospitalisation and death, continues to outweigh the risks for the vast continues to outweigh the risks for the vast majority of people. Our review the vast majority of people. Our review has the vast majority of people. Our review has reinforced that the risk of this review has reinforced that the risk of this rare review has reinforced that the risk of this rare suspected side effect remains of this rare suspected side effect remains extremely small. By the 31st of march, remains extremely small. By the 31st of march, over 20 million doses having of march, over 20 million doses having been given, we have had 79 case reports, up to and including that date, case reports, up to and including that date, the 31st of march. All 79 cases that date, the 31st of march. All 79 cases occurred after the first dose. Of these cases occurred after the first dose. Of these 79 cases occurred after the first dose. Of these 79 cases, 19 people have sadly of these 79 cases, 19 people have sadly died. These cases occurred in 51 women sadly died. These cases occurred in 51 women and 28 men aged from 18 79 years 51 women and 28 men aged from 18 79 years and 51 women and 28 men aged from 18 79 years. And from these reports, the risk of years. And from these reports, the risk of this years. And from these reports, the risk of this type of rare blood clot is about risk of this type of rare blood clot is about four people in a million who received the vaccine. Three out of the who received the vaccine. Three out of the i9 who received the vaccine. Three out of the 19 were under 30 years. 14 of the i9 of the 19 were under 30 years. 14 of the 19 were of the 19 were under 30 years. 14 of the 19 were of the cerebral venous sinus the 19 were of the cerebral venous sinus thrombosis with low platelets, and five sinus thrombosis with low platelets, and five were other kinds of thrombosis in major veins. The balance thrombosis in major veins. The balance of thrombosis in major veins. The balance of benefits and risks is very balance of benefits and risks is very favourable for older people. But it very favourable for older people. But it is very favourable for older people. But it is more finely balanced for the younger people. We at the mhra are advising that this evolving evidence are advising that this evolving evidence should be taken into account evidence should be taken into account when considering how the vaccine account when considering how the vaccine is account when considering how the vaccine is used. Today, we will be communicating information and advice to health communicating information and advice to Health Care Professionals on how to Health Care Professionals on how to minimise risks. This will provide a lot to minimise risks. This will provide a lot of to minimise risks. This will provide a lot of guidance, including how to report a lot of guidance, including how to report any a lot of guidance, including how to report any suspected cases. The information for Health Care Professionals will be updated and there professionals will be updated and there will also be information for there will also be information for the public, things to look out for, as we the public, things to look out for, as we continue to monitor this issue as we continue to monitor this issue. Anyone who has symptoms, four days after issue. Anyone who has symptoms, four days after vaccination or more, should days after vaccination or more, should seek prompt medical advice. A new onset should seek prompt medical advice. A new onset of a severe or persistent headache new onset of a severe or persistent headache or new onset of a severe or persistent headache or blurred vision. Shortness of breath, chest pain, leg swelling. Shortness of breath, chest pain, leg swelling, persistent abdominal pain, or indeed, swelling, persistent abdominal pain, or indeed, unusual skin bruising or pinpoint or indeed, unusual skin bruising or pinpoint spots beyond the injection site. Pinpoint spots beyond the injection site we pinpoint spots beyond the injection site. We will further outline the advice site. We will further outline the advice but i would like to underline that this advice but i would like to underline that this is advice but i would like to underline that this is extremely rare and with the proven that this is extremely rare and with the proven effectiveness against a disease the proven effectiveness against a disease that is still a huge risk to our population, the balance of benefits our population, the balance of benefits and risks of the vaccine is still very benefits and risks of the vaccine is still very favourable for the vast majority still very favourable for the vast majority of people. So, professor pirmohamed, overto majority of people. So, professor pirmohamed, over to you. Majority of people. So, professor pirmohamed, over to you. Thank you. I worked pirmohamed, over to you. Thank you. I worked with pirmohamed, over to you. Thank you. I worked with the pirmohamed, over to you. Thank you. I worked with the commission pirmohamed, over to you. Thank you. I worked with the commission on i worked with the commission on Human Medicines and the Expert Working Group separately to thoroughly review all of the cases coming in with the Oxford Astrazeneca vaccine in the uk. We have taken into account a wide range of data sources. We have looked at information about usage of the vaccine in various age groups and updated incidence rates and benefit risk comparisons for different populations by age and gender. Over the last couple of weeks, the two committees have spent almost 24 hour in committee reviewing these reports. Each report has been carefully scrutinised by the mhra and by the members of the working group and further information has been obtained where necessary. We have also had independent adjudication of these cases by an expert haematologist, and we worked with another group of haematologists to develop the Case Definition of these events, to make sure that the cases were identified throughout the uk and reported via the yellow card scheme. Based on the currently available data, the commission is advising the following, first, that pregnant women should continue to discuss with their Health Care Professional whether the benefits of having the vaccine outweigh the risks for them. Number having the vaccine outweigh the risks forthem. Numbertwo, people with a history of blood disorders, that increase the risk of clotting, should only have the covid 19 astrazeneca vaccine where the benefits outweigh any potential risks. Numberthree, anyone benefits outweigh any potential risks. Number three, anyone who experiences cerebrally or other major blood clots occurring together with low levels of platelets after the first vaccine of covid 19 astrazeneca should not have their second dose. We will be continually monitoring further reports as they come in and continually monitoring other aspects to identify risk factors so that we can refine the advice that we give. Are present, the data on people who have had two macro doses are limited because these events are rare and comparatively small number of second doses have been given. Therefore it is not possible to draw a conclusion about how frequently blood clots with a low platelet count happened following a second dose of the vaccine, but this will be monitored closely by the mhra and by the sea hm as part of the ongoing review. Just to put it into context, these events are extremely rare, as at june has already mentioned, they want to put into context in relation to covid 19 itself. It is important to covid 19 itself. It is important to remember that covid 19 itself causes a clotting and lower platelets and i have eight paper that was recently published. Clots on the lungs occur in 7. 8 of people who have covid 19. Dvt, clots in the legs, occur 11. 2 who have had a covid 19 and of those people who have been infected with sars cove two, getting covid 19 and ending up in icu, 22 will have some form of clot. Covid 19 also causes strokes in about 1. 6 and up to 30 of people who develop covid 19 will get thrombocytopenia which is lowering of the platelet count and that is in the context of a risk of clots and lower platelet is much higher with covid 19 than these extremely rare events which are occurring with the vaccine. So to finish, the chm has a that the race between vaccine and blood clots in its repro and other veins is getting firmer, but absolute proof will need extensive scientific work. Based on the currently Available Evidence and the benefit risk remains favourable for the vast majority, but asjoon said, is more finely balanced for the younger people and we are advising that this evolving evidence should be taken into account when considering the use of the vaccine. Asjune said. I will hand back to professor van tam. As june said. I will hand back to professor vantam. As june said. I will hand back to professor vantam. Thank you. You have now heard professor vantam. Thank you. You have now heard from professor vantam. Thank you. You have now heard from the professor vantam. Thank you. You have now heard from the regulatory| have now heard from the regulatory experts and in a moment i will turn to the new advice from thejcvi, but before we do that, i would like to put into context in a visual way what the data are telling us in terms of benefits and risks. If i could have the first slide, please. So, this slide, and i will go through the first one slowly, shows you, in a blue type to the left of the slide, the potential benefits from covid 19 vaccination and on the orange part to the right, the potential harms. You can see that as you go down the side from top to bottom, those benefits and potential harms are arranged by age band. The way these data have been arrayed in terms of intensive care admissions prevented via vaccine on the left and serious harm is potentially due to the vaccine on the right. And i thank colleagues at the winter and centre for risk and evidence communication at Cambridge University for help with getting this slide together. This first slide is set, as you can see from the title, in a scenario of low exposure and in actual fact, the rates of disease assumed in this scenario are lower than those we currently have in the uk at the moment. And you can see that if you look at the 20 to 29 age band, then the potential benefits amount to 0. 8 icu admissions averted compared with serious harms of a potentially 1. 1. But as you go up through the age groups, the amount of serious harm declines, but the amount of benefit in terms of averted icu admissions becomes much more pronounced. These are arrayed over a 16 week period. We do not expect vaccine to last for 16 weeks. We very confidently expect that it 16 weeks. We very confidently expect thatitis 16 weeks. We very confidently expect that it is going to be many, many months of protection from a vaccine and the reason for using 16 weeks is it because that is atypical pandemic wave, that is the duration of it. But you can see at a very low exposure and risk, lower than we have in the uk at the moment, the risk benefit is relatively finely balanced in those Younger Age Groups, but it becomes very overwhelming in favour of vaccine as you go up the ages. If we go on to the next slide, please. This is now a medium risk scenario and it is set at 60 cases per 100,000. That is marginally higher than the uk average at the moment, but it is lower than at some of the remaining hotspots in the uk. And you can see that when the disease is around us more, when there is more exposure, then the benefits, the potential benefits, start to stack up, but the potential serious harms remain static of course. This is still over a 16 week period and you can see that the data become more overwhelming in terms of vaccine benefit. Finally, lets move to a high exposure risk and this one, next slide, please, is set typically at where we get to in terms of a pandemic wave. This is set at the height of the second pandemic wave that we went through in the last few months and i think is reflective of the kind of scenario we want to avoid in the forthcoming autumn and winter if we possibly can. But here, when there is a lot of covid 19 circulation and the population, you can see even in the 20 to 29 group, the potential benefits in terms of intensive care admissions averted is very much higher than the serious harms due to vaccine. And that is why the regulators have concluded, as they have, about risk benefit for the astrazeneca vaccine. So i hope that has placed it all into a bit of context for everybody. I recognise it has been a detailed scientific discussion at so far, but hopefully those figures bring it to life and at this point im going to hand over for thejcvi advice. At this point im going to hand over for the jcvi advice. For the jcvi advice. Thank you. The ch for the jcvi advice. Thank you. The jcvi has been for the jcvi advice. Thank you. The jcvi has been meeting for the jcvi advice. Thank you. The jcvi has been meeting of for the jcvi advice. Thank you. The jcvi has been meeting of the for the jcvi advice. Thank you. The jcvi has been meeting of the last l jcvi has been meeting of the last two weeks and we have independently reviewed the safety evidence and the benefit evidence given to us from mhra and Public Health england. That includes some of the kinds of data that you have seen earlier on the slide. We are well aware of the high level of protection that covid 19 vaccines provide, particularly against serious disease that is hospitalisation, icu admission and dying from covid 19. Against that must be balanced the uncertain occurrence of an extremely rare and adverse event which may be associated with vaccination. Acting really in the interest of safety and the benefit, jcvi feel there are three points of advice we would like to put across. The first is that information given to individuals being offered vaccination and information given to Health Professionals should be appropriately updated to reflect the latest considerations and deliberations byjcvi and by mhra. The second point, is that those who have received their first dose of astrazeneca vaccine should consider to be offered the second dose of astrazeneca vaccine according to the set schedule. And the final bit of advice is that adults who are aged 18 to 29 years old who do not have an Underlying Health condition that puts them at higher risk from serious covid 19 disease should be offered an alternative covid 19 vaccine in preference to the astrazeneca vaccine were at such an alternative vaccine is available. And perhaps it is useful to state what is not advised as well. We are not advising a stop to any vaccination for any individual in any age group. We are advising a preference for one vaccine over another vaccine for a particular age group, really out of the utmost caution rather than because we have any serious safety concerns. This will obviously have some implications in terms of operation and deployment of vaccines and i will just and deployment of vaccines and i willjust end back tojonathan to set those out for us. Willjust end back to jonathan to set those out for us. Willjust end back to jonathan to set those out for us. Thank you, wei shen. Im set those out for us. Thank you, wei shen lm going set those out for us. Thank you, wei shen. Im going to set those out for us. Thank you, wei shen. Im going to round set those out for us. Thank you, wei shen. Im going to round off set those out for us. Thank you, wei shen. Im going to round off the shen. Im going to round off the last part of this briefing now. People out there listening to this will say what does this mean for me and what should i now do . Let me begin with the deployment piece. This is a change in clinical advice for the under 30s. It will require some changes in the way that the National Health service operationalise is the Vaccine Programme, but i have spoken to my colleagues in the nhs in some detail this morning and i am assured that actually, because of our supply situation in relation to alternative vaccines, the effect on the timing of our Overall Programme should be zero or negligible. That of course is contingent upon getting the supplies that we expected to get of the alternative vaccines which are the alternative vaccines which are the Pfizer Vaccine currently in use and the returner vaccine which we hope to bring into use in mid april. That is the what does it mean for me. As to what should i do, these be reassured that two sets of independent experts on the regulatory side, the mhra and the chm, and on the clinical advice side, thejcvi, are all over this and i can testify to the many, many hours of work they have been putting into getting this advice to you in the last week or so. Really almost working without a break and my thanks to the members of those various committees and organisations who have worked honestly at night and day behind the scenes to get to this point. This is a Course Correction, there is no question about that, but it is in a sense, in medicine, quite normalfor physicians to alter their preferences for how patients are treated over time. It has happened with vaccines only a few years ago. Up with vaccines only a few years ago. Up until a few years ago, the adviser to the elderly in flu vaccines was at get your vaccine and then the jcvi vaccines was at get your vaccine and then thejcvi then changed its advice and said our preference is now first the agitated vaccine for the elderly. So changes in preference for vaccine business as usual and this is a Course Correction, but this is a massive beast that we are driving along at enormous pace with enormous success, this Vaccine Programme, and if you assail a massive liner across the atlantic, it is not really reasonable that you are not going to have to make at least one Course Correction during that voyage. I frame this very much in those terms. The nhs has a message that we will get the right vaccine to you in the right time according to the newjcvi advice. There might be a small delay sometimes. There might be a slightly greater distance that some people are asked to travel. But the nhs is all over this and understands the challenge of making the advice from the jcvi are challenge of making the advice from thejcvi are truly operational in a smooth way. Im going to sum up their by saying this is a course change. It is based on a clinical preference, based on a newly emerging data. It will be kept under very careful review. Please remember that the benefits of vaccine accrue over a very long period of time. We are fairly confident it is months and months, whereas the event of a vaccination is a brief moment. Vaccines continue to be the way out for the uk. They continue to be the way in which we can get our lives back to normal and our economy opened up again in the shortest time possible. Thank you very much for listening and we will now take some questions. I think the first questions. I think the first question is from fergus walsh at the bbc. , ~ question is from fergus walsh at the sac. ~ ,. , question is from fergus walsh at the bbc. , ~ ,. , question is from fergus walsh at the sac. ~ , y. , bbc. Thank you very much indeed. Can i ask two questions . Bbc. Thank you very much indeed. Can i ask two questions . Are bbc. Thank you very much indeed. Can i ask two questions . Are you bbc. Thank you very much indeed. Can i ask two questions . Are you worried l i ask two questions . Are you worried that this i ask two questions . Are you worried that this change i ask two questions . Are you worried that this change of i ask two questions . Are you worried that this change of course i ask two questions . Are you worried that this change of course might that this change of course might damage that this change of course might damage vaccine that this change of course might damage Vaccine Confidence, damage Vaccine Confidence, especially damage Vaccine Confidence, especially in damage Vaccine Confidence, especially in the damage Vaccine Confidence, especially in the young . Damage Vaccine Confidence, i especially in the young . And damage Vaccine Confidence, especially in the young . And cant you just especially in the young . And cant you just be especially in the young . And cant you just be specific especially in the young . And cant you just be specific on especially in the young . And cant you just be specific on the especially in the young . And cant you just be specific on the risk . I especially in the young . And cantl you just be specific on the risk . Can you you just be specific on the risk . Can you be you just be specific on the risk . Can you be possessed you just be specific on the risk . Can you be possessed specific . You just be specific on the risk . | can you be possessed specific . Are the risks can you be possessed specific . Are the risks to can you be possessed specific . Are the risks to the can you be possessed specific . Are the risks to the under can you be possessed specific . Are the risks to the under 30s the risks to the under 30s significantly the risks to the under 30s significantly higher the risks to the under 30s significantly higher than l the risks to the under 30s significantly higher than Older Age Groups . Significantly higher than older age irou s . , ~ significantly higher than older age mus . , ~ ,. , significantly higher than older age irous . , ~ , groups . Thank you. On the first oint, i groups . Thank you. On the first point. Iwill groups . Thank you. On the first point, i will answer groups . Thank you. On the first point, i will answer that groups . Thank you. On the first | point, i will answer that question and say that clearly this is a course change was that we do not want it to result in a loss of Vaccine Confidence. I hope i have reassured you that these are carefully considered decisions and it remains vitally important that people who are called back for the second dose comfort and it remains vitally important that all adults in the uk come forward for vaccination when they offered fitted. Second dose, for it. On the second point i will refer to wei shen. It is dose, for it. On the second point i will refer to wei shen. Will refer to wei shen. It is not siml will refer to wei shen. It is not simply the will refer to wei shen. It is not simply the musketeer will refer to wei shen. It is not simply the musketeer an will refer to wei shen. It is not simply the musketeer an individual, there is a slight degradation in the risk occurring in younger people to other people, but it is really the benefit risk a balance which is most important here. The benefit from vaccination is, as we know, very high in order people and decreases as age goes down, because the risk from covid 19 goes down with age. But there is still a benefit to younger people from being vaccinated and overall, that benefit is still in favour of being vaccinated. It happens that when we have an alternative vaccine, we feel, on balance, it would be preferable to offer the very youngest people who have no other Health Conditions the alternative vaccine instead of the astrazeneca vaccine, reallyjust on the side of a safety rather than because of any particular significant concern about risk from the vaccine itself. The vaccine itself. Thank you. Fer us, the vaccine itself. Thank you. Fergus. L the vaccine itself. Thank you. Fergus, i would the vaccine itself. Thank you. Fergus, i would just the vaccine itself. Thank you. Fergus, i would just add the vaccine itself. Thank you. Fergus, i would just add that| the vaccine itself. Thank you. Fergus, i would just add that the slides i showed to you were based on icu admissions and did not take into account the additional benefits of vaccine in terms of preventing long covid, which we know is quite a significant problem after this illness. The costs of the illness itself and the costs of potentially passing on the infection to family and friends. Thank you. Tom clark, itv. ,. , ~. , and friends. Thank you. Tom clark, itv. Hello, thank you. Can i come back to the itv. Hello, thank you. Can i come back to the vaccine itv. Hello, thank you. Can i come back to the Vaccine Confidence back to the Vaccine Confidence question . Back to the Vaccine Confidence question . You back to the Vaccine Confidence question . You have back to the Vaccine Confidence question . You have obviously| back to the Vaccine Confidence question . You have obviously laid out clearly question . You have obviously laid out clearly what question . You have obviously laid out clearly what the question . You have obviously laid out clearly what the risk benefit l out clearly what the Risk Benefit Profile out clearly what the Risk Benefit Profile art out clearly what the Risk Benefit Profile art to out clearly what the Risk Benefit Profile art to reassure out clearly what the Risk Benefit Profile art to reassure people i out clearly what the risk benefit. Profile art to reassure people what the risks profile art to reassure people what the risks they profile art to reassure people what the risks they are profile art to reassure people what the risks they are facing profile art to reassure people what the risks they are facing are, the risks they are facing are, however. The risks they are facing are, however, what the risks they are facing are, however, what would the risks they are facing are, however, what would you the risks they are facing are, however, what would you advise that someone however, what would you advise that someone who however, what would you advise that someone who is however, what would you advise that someone who is so however, what would you advise that someone who is so 31 however, what would you advise that someone who is so 31 years however, what would you advise that someone who is so 31 years of however, what would you advise that someone who is so 31 years of age, i however, what would you advise thatj someone who is so 31 years of age, a family someone who is so 31 years of age, a family member, someone who is so 31 years of age, a family member, loved someone who is so 31 years of age, a family member, loved one, someone who is so 31 years of age, a family member, loved one, i someone who is so 31 years of age, a family member, loved one, ido someone who is so 31 years of age, a family member, loved one, i do not. 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Take the astrazeneca vaccine, you tell them take the astrazeneca vaccine, you tell them in take the astrazeneca vaccine, you tell them in terms take the astrazeneca vaccine, you tell them in terms of take the astrazeneca vaccine, you tell them in terms of the take the astrazeneca vaccine, you tell them in terms of the risks take the astrazeneca vaccine, youl tell them in terms of the risks they might tell them in terms of the risks they might be tell them in terms of the risks they might be taking . Tell them in terms of the risks they might be taking . That tell them in terms of the risks they might be taking . Tell them in terms of the risks they might be taking . That is a very good iuestion might be taking . That is a very good question and might be taking . That is a very good question and in might be taking . That is a very good question and in fact might be taking . That is a very good question and in fact we might be taking . That is a very good question and in fact we were might be taking . That is a very good question and in fact we were just question and in fact we were just discussing at that earlier, because we know somebody whose daughter is around 30,31, we know somebody whose daughter is around 30, 31, and it is a very relevant and important question. One of the really fundamental things about the Vaccine Programme is that it is shown to be fair and transparent. That is precisely why we want to have this briefing now to demonstrate what the risks and the benefits are so that everybody is informed before they come for the vaccination. And we have set up quite clearly what the benefits are against the risks and why we have made a decision about the 30 year old who is healthy and otherwise well. For somebody who is 31 and 32, i think they have it to make their own decision as to what they want to do about vaccination. 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And what questions the high risk of clots in Younger Age Groups . And what questions does that raise age groups . And what questions does that raise the age groups . And what questions does that raise the paediatric age groups . And what questions does that raise the paediatric vaccine that raise the paediatric vaccine campaigns . That raise the paediatric vaccine campaigns . L that raise the paediatric vaccine campaigns . That raise the paediatric vaccine campaigns . That raise the paediatric vaccine cam iiains . ,. , campaigns . I wonder whether in at the moment. Campaigns . I wonder whether in at the moment, someone campaigns . I wonder whether in at the moment, someone will campaigns . I wonder whether in at the moment, someone will to i campaigns . I wonder whether in at| the moment, someone will to come back and just discuss the risk signal from the back and just discuss the risk signalfrom the ages in back and just discuss the risk signal from the ages in terms of thrombocytopenia and blood clots, but in terms of moving into paediatric vaccination, jcvi has not made any Firm Decision yet on when to move into vaccination for children. The Clinical Trials are still ongoing regarding the safety of vaccines in children, so no decision made on that point yet. Thank you, wei shen. Atomic, in passing the baton back to professor pirmohamed on the numbers, i will on this passing through me as it were, say the jcvis this passing through me as it were, say thejcvis decision to give advice for the under 30s was taken fully cognizant of the fact that there advice would therefore apply above the age of 30 to 31 year olds and that was part of the consideration. We are talking here in the context of extremely small numbers, by age, and that makes the data very difficult to interpret, but im sure sir pirmohamed will elaborate much better on this. Thank ou. There elaborate much better on this. Thank you there is elaborate much better on this. Thank you there is a elaborate much better on this. Thank you. There is a slightly elaborate much better on this. Thank you. There is a slightly higher elaborate much better on this. Thank you. There is a slightly higher risk in the you. There is a slightly higher risk in the Younger Age Group compared to the older in the Younger Age Group compared to the Older Age Group and as has been already the Older Age Group and as has been already said, we do need to look at the relative already said, we do need to look at the relative benefits versus the risks the relative benefits versus the risks in the relative benefits versus the risks in different age groups. The reason risks in different age groups. The reason why risks in different age groups. The reason why it is a higher risk in the Younger Age Group is not clear. As i the Younger Age Group is not clear. As i said the Younger Age Group is not clear. As i said earlier, we need to undertake much more scientific work to understand why the link between the vaccine and the Younger Age Group the vaccine and the Younger Age Group is the vaccine and the Younger Age Group is occurring. That will help us in group is occurring. That will help us in the group is occurring. That will help us in the future to be able to then refine us in the future to be able to then refine the us in the future to be able to then refine the advice we give in terms of product refine the advice we give in terms of Product Information. Further work needs of Product Information. Further work needs to of Product Information. Further work needs to be of Product Information. Further work needs to be done on all of that. With needs to be done on all of that. With regard to children, the trial has been with regard to children, the trial has been caused by the data safety monitoring board has been caused, for an monitoring board has been caused, for an abundance of caution is that we know for an abundance of caution is that we know children are at much lower risk of we know children are at much lower risk of these we know children are at much lower risk of these clots, so as we accumulate more data over the next few weeks. Accumulate more data over the next few weeks, the nhra, and the expert working few weeks, the nhra, and the Expert Working Groups, will be liaising with the working groups, will be liaising with the trial at oxford to be able to determine whether the trial can start again to determine whether the trial can start again based on the data that is available. Start again based on the data that is available is available. Thank you, tom. On children, i is available. Thank you, tom. On children, iwill is available. Thank you, tom. On children, i willjust is available. Thank you, tom. On children, i willjust add is available. Thank you, tom. On children, i willjust add that i is available. Thank you, tom. On | children, i willjust add that there are multiple manufacturers with different types of vaccines, all that working to do trials in children and so this is not the only show in town in terms of trying to establish whether a vaccine can be authorised and suitable for children. That is an unfolding story we will have to leave it for another day. And other atomic now, tom from sky. Day. And other atomic now, tom from s. ~ day. And other atomic now, tom from sky. Thank you, you presented this as a choice sky. Thank you, you presented this as a choice between sky. Thank you, you presented this as a choice between astrazeneca i as a choice between astrazeneca vaccine as a choice between astrazeneca vaccine and as a choice between astrazeneca vaccine and having as a choice between astrazeneca vaccine and having covid, as a choice between astrazeneca vaccine and having covid, but. As a choice between astrazeneca i vaccine and having covid, but that is not vaccine and having covid, but that is not true vaccine and having covid, but that is not true at vaccine and having covid, but that is not true at any vaccine and having covid, but that is not true at any age. Vaccine and having covid, but that is not true at any age. If vaccine and having covid, but that is not true at any age. If you is not true at any age. If you recognise is not true at any age. If you recognise the is not true at any age. If you recognise the young is not true at any age. If you recognise the young could i is not true at any age. If youi recognise the young could be is not true at any age. If you recognise the young could be given an alternative recognise the young could be given an alternative vaccine, recognise the young could be given an alternative vaccine, why recognise the young could be given an alternative vaccine, why not i recognise the young could be given an alternative vaccine, why not the| an alternative vaccine, why not the middleaged an alternative vaccine, why not the middle aged too . An alternative vaccine, why not the middle aged too . Can an alternative vaccine, why not the middle aged too . Can i an alternative vaccine, why not the middle aged too . Can i also an alternative vaccine, why not the middle aged too . Can i also ask, i an alternative vaccine, why not the| middle aged too . Can i also ask, in europe middle aged too . Can i also ask, in europe and middle aged too . Can i also ask, in europe and canada, middle aged too . Can i also ask, in europe and canada, there middle aged too . Can i also ask, in europe and canada, there are europe and canada, there are countries europe and canada, there are countries that europe and canada, there are countries that have europe and canada, there are countries that have decided. Europe and canada, there are i countries that have decided not to ive countries that have decided not to give the countries that have decided not to give the astrazeneca countries that have decided not to give the astrazeneca vaccine i countries that have decided not to give the astrazeneca vaccine to i give the astrazeneca vaccine to anyone give the astrazeneca vaccine to anyone under give the astrazeneca vaccine to anyone under the give the astrazeneca vaccine to anyone under the age give the astrazeneca vaccine to anyone under the age of give the astrazeneca vaccine to anyone under the age of 55 give the astrazeneca vaccine to anyone under the age of 55 or. Give the astrazeneca vaccine to i anyone under the age of 55 or 60. Are they anyone under the age of 55 or 60. Are they being anyone under the age of 55 or 60. Are they being too anyone under the age of 55 or 60. Are they being too cautious . I anyone under the age of 55 or 60. Are they being too cautious . Would ou like to are they being too cautious . Would you like to begin are they being too cautious . Would you like to begin on are they being too cautious . Would you like to begin on that, are they being too cautious . Would you like to begin on that, wei i are they being too cautious7m you like to begin on that, wei shen . Thank you. Every country has to make their own decision regarding what is best for their own population and that takes into account the kind of disease that we have in our country, the size of the wave, the risk of a next wave occurring, the amount of vaccines we have, how well the vaccines we have, how well the Vaccine Programme is being delivered, and obviously the values of our own people, whether we want to accept the vaccine or not. So i believe every country will in the end have to make their own decision regarding the risk and benefit. Just as an example, it is sad to see but true in some countries life expect to see is not as good as it is in the uk and some may live to a mean age of about 50. For them, their Life Expectancy will mean their risk benefit in terms of when to draw the line against a particular vaccine, and it may be any of the vaccines that are available, will be different from another country where Life Expectancy may be different. So it is taking all of these things into account. We have come to a decision that in the uk, given our vaccine availability, and must apply, the kind of pandemic we are having, the variant we have had, all of these together, we felt that the correct judgment of these together, we felt that the correctjudgment was of these together, we felt that the correct judgment was that of these together, we felt that the correctjudgment was that it is around the 30 year threshold where there are younger people who do not have any Health Conditions where we would offer the alternative vaccine rather than saying everybody in the country should be offered an alternative vaccine, because really, this is an extremely rare adverse event. We do not know for sure it is related to one vaccine or not yet. It may also be relevant to some other vaccine. It may also be relevant to some othervaccine. It it may also be relevant to some other vaccine. It may not even be related to a vaccine, it may be related to a vaccine, it may be related to a vaccine, it may be related to covid itself. We are just unsure and the advice we are giving is really based very much on protecting the population and working on a principle that the safety is our biggest concern. 50. Safety is our biggest concern. So, thank you. Safety is our biggest concern. So, thank you. Wei safety is our biggest concern. So, thank you, wei shen. I will reinforce the point about context. Wei shen has kind of stolen the example about a low income country where sadly life its like to see is not the same as the uk. Life expectancy. The context of risk and benefit will be different in every situation. The jcvi benefit will be different in every situation. Thejcvi was entirely free to make its own advice and recommendation to us as it saw fit, that has always been the way with jcvi. They are always independent and can say and do as they wish. That having been said, if you look at some of my slides and if you look for example at the high exposure risk category, then the idea of withholding a vaccine where potential harm for example in the 40 to 49 group is 0. 5 harms per 100,000 people versus 51. 5 intensive care admissions advert it, and that is not taking into account hospitalisations, long covid and spreading to others, then the notion that he would clip a vaccine at that point is it pretty absurd really, and so it is very much an independent decision, but i think it has been taken in an extremely rational way. Has been taken in an extremely rationalway. No, it isnt. It absolutely wasnt. As i have explained to you all, the programme should not be delayed because of this change in course. Everything should stay on course. Thank you. Right, we will now turn to the sun. Good afternoon, thanks for taking my question good afternoon, thanks for taking my question both good afternoon, thanks for taking my question. Both doctor good afternoon, thanks for taking my question. Both doctorjune good afternoon, thanks for taking my question. Both doctorjune raine i good afternoon, thanks for taking my question. Both doctorjune raine andj question. Both doctorjune raine and pirmohamed question. Both doctorjune raine and pirmohamed talked question. Both doctorjune raine and pirmohamed talked about question. Both doctorjune raine and pirmohamed talked about the question. Both doctorjune raine and pirmohamed talked about the link i pirmohamed talked about the link between pirmohamed talked about the link between the pirmohamed talked about the link between the vaccine pirmohamed talked about the link between the vaccine and pirmohamed talked about the link between the vaccine and blood i pirmohamed talked about the link i between the vaccine and blood clots. They both between the vaccine and blood clots. They both said between the vaccine and blood clots. 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And a second i question, we are expecting the one shot question, we are expecting the one shotiab question, we are expecting the one shotiab to question, we are expecting the one shot jab to arrive question, we are expecting the one shot jab to arrive in question, we are expecting the one shot jab to arrive in the question, we are expecting the one shot jab to arrive in the summer. 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As it potentially good news would prioritise alternative jabs. | as it potentially good news story younger as it potentially good news story younger people as it potentially good news story younger people who as it potentially good news story younger people who may as it potentially good news story younger people who may get as it potentially good news story younger people who may get the as it potentially good news story younger people who may get the short ab younger people who may get the short jab and younger people who may get the short jab and are younger people who may get the short jab and are more younger people who may get the short jab and are more likely younger people who may get the short jab and are more likely to younger people who may get the short jab and are more likely to get jab and are more likely to get international jab and are more likely to get International Vaccine jab and are more likely to get. International vaccine passports jab and are more likely to get International Vaccine passports and id International Vaccine passports and go on International Vaccine passports and go on holiDay International vaccine passports and go on holiday sooner International Vaccine passports and go on holiday sooner because International Vaccine passports and go on holiday sooner because they| International Vaccine passports and i go on holiday sooner because they do not need go on holiday sooner because they do not need to go on holiday sooner because they do not need to wait go on holiday sooner because they do not need to wait for go on holiday sooner because they do not need to wait for that go on holiday sooner because they do not need to wait for that 12 go on holiday sooner because they do not need to wait for that 12 week not need to wait for that 12 week second not need to wait for that 12 week second jab . Thank you, i will pass the first part of the question to the regulatory colleagues, not sure who wants to go there. The regulatory colleagues, not sure who wants to go there. Regulatory colleagues, not sure who wants to go there. The evidence has accrued, wants to go there. The evidence has accrued. Not wants to go there. The evidence has accrued, not only wants to go there. The evidence has accrued, not only in wants to go there. The evidence has accrued, not only in numbers wants to go there. The evidence has accrued, not only in numbers and i accrued, not only in numbers and kinds of cases but the pattern of those cases, so we feel it is a much more solid basis in our regulatory world to put in the side effect into our Product Information. That tells us it is a reasonably plausible link. But there needs to be much more work on the Scientific Understanding of this new constellation of symptoms to give us that feeling of the proof that you would expect and that work will go on at pace and i would like to hand to sir Munir Pirmohamed to tell you about that. The to sir Munir Pirmohamed to tell you about that. , to sir Munir Pirmohamed to tell you about that. ,. About that. The early evidence su nests about that. The early evidence suggests that about that. The early evidence suggests that this about that. The early evidence | suggests that this constellation about that. The early evidence suggests that this constellation of symptoms is caused by an immune response symptoms is caused by an immune response against platelets which allows response against platelets which allows the platelets to then lead to clotting allows the platelets to then lead to clotting in different parts of the body clotting in different parts of the body. But what we dont have, clearly, body. But what we dont have, clearly, is body. But what we dont have, clearly, is the link between the vaccine clearly, is the link between the vaccine and how the immune response becomes vaccine and how the immune response becomes activated against the platelets and that is where the scientific platelets and that is where the scientific work needs to go on, to identify scientific work needs to go on, to identify what that link is, so we can then identify what that link is, so we can then develop ways and strategies to be able can then develop ways and strategies to be able to overcome this adverse event to be able to overcome this adverse event for to be able to overcome this adverse event for the future. Event for the future. Thank you. Now, on event for the future. Thank you. Now. On your event for the future. Thank you. Now, on your second event for the future. Thank you. Now, on your second part event for the future. Thank you. Now, on your second part of event for the future. Thank you. I now, on your second part of the question, nick, about other vaccines and in particular, the jansen vaccine, in terms of the immediately available alternatives, the immediately available alternative right now, already in deployment in the uk, is the Pfizer Vaccine. We do expect to have quantities of moderna beginning to be deployed from mid april in england and those will be the two in the next few weeks, as it were. It is Common Knowledge and Public Information that the uk has placed orders with jansen. We dont yet have certainty on the timing of delivery but that vaccine could become available over the summer and is indeed a one dose schedule. Therefore, it must be in the frame, if you like, or in the mix for solutions for vaccine requirements going forward, and indeed, for the young people you referred to. But that has always been part of the uk strategy, to have multiple horses in the race so that we would always be in a good position if we needed flexibility to be able to exercise it. But my final cautionary point for you is that this is a vanishingly rare but sadly quite serious adverse event but it is vanishingly rare. And you cant pick these kind of things up until you have literally deployed tens of millions of doses of vaccine. And therefore, for the vaccine is not yet deployed in large numbers Around The World, we have to wait and see if we are going to see or not similar signals. And therefore, it again reinforces the message that it is important to have many horses in this race. Thank you, tom whipple at the times, next. Qt} this race. Thank you, tom whipple at the times, next. The times, next. 90 very much. In terms of the the times, next. 90 very much. In terms of the mechanism the times, next. 90 very much. In terms of the mechanism the times, next. 90 very much. In terms of the mechanism thank| the times, next. 90 very much. In. Terms of the mechanism thank you terms of the mechanism thank you very much, terms of the mechanism thank you very much, in terms of the mechanism thank you very much, in terms terms of the mechanism thank you very much, in terms of terms of the mechanism thank you very much, in terms of the very much, in terms of the mechanism. Very much, in terms of the mechanism, can very much, in terms of the mechanism, can you very much, in terms of the i mechanism, can you explain very much, in terms of the mechanism, can you explain more of your theories mechanism, can you explain more of your theories about mechanism, can you explain more of your theories about how mechanism, can you explain more of your theories about how this mechanism, can you explain more of your theories about how this might l your theories about how this might be triggered, your theories about how this might be triggered, particularly your theories about how this might be triggered, particularly as your theories about how this might be triggered, particularly as we be triggered, particularly as we have be triggered, particularly as we have several be triggered, particularly as we have several other be triggered, particularly as we have several other virus be triggered, particularly as we have several other virus vector| have several other virus vector vaccine have several other virus vector vaccine is have several other virus vector vaccine is likely have several other virus vector vaccine is likelyjohnson have several other virus vector vaccine is likelyjohnson have several other virus vector vaccine is likelyjohnson johnson and the vaccine is likelyjohnson johnson and the sputnik, vaccine is likelyjohnson johnson and the sputnik, that vaccine is likelyjohnson johnson and the sputnik, that presumablyi vaccine is likelyjohnson johnson i and the sputnik, that presumably the mechanism and the sputnik, that presumably the mechanism that and the sputnik, that presumably the mechanism that causes and the sputnik, that presumably the mechanism that causes this and the sputnik, that presumably the mechanism that causes this in and the sputnik, that presumably the mechanism that causes this in the mechanism that causes this in the astrazeneca mechanism that causes this in the astrazeneca could mechanism that causes this in the astrazeneca could be mechanism that causes this in the astrazeneca could be likely mechanism that causes this in the astrazeneca could be likely to mechanism that causes this in the astrazeneca could be likely to doi mechanism that causes this in the l astrazeneca could be likely to do so in them astrazeneca could be likely to do so in them as astrazeneca could be likely to do so in them as well. Astrazeneca could be likely to do so in them as well. And astrazeneca could be likely to do so in them as well. And a astrazeneca could be likely to do so in them as well. And a second in them as well. And a Second Question. In them as well. And a Second Question. If in them as well. And a Second Question, if we in them as well. And a Second Question, if we know in them as well. And a Second Question, if we know this in them as well. And a Second Question, if we know this is i in them as well. And a Second Question, if we know this is al question, if we know this is a possible question, if we know this is a possible side question, if we know this is a possible side effect, question, if we know this is a possible side effect, are i question, if we know this is al possible side effect, are there question, if we know this is a possible side effect, are there ways to then possible side effect, are there ways to then mitigate possible side effect, are there ways to then mitigate it possible side effect, are there ways to then mitigate it and possible side effect, are there ways to then mitigate it and help possible side effect, are there ways to then mitigate it and help peoplei to then mitigate it and help people who might to then mitigate it and help people who might have to then mitigate it and help people who might have it . To then mitigate it and help people who might have it . To then mitigate it and help people who might have it . Thank you, tom, a very mechanism who might have it . Thank you, tom, a very mechanism based who might have it . Thank you, tom, a very mechanism based question i who might have it . Thank you, tom, a very mechanism based question so i i very mechanism based question so i will pass that straight to sir Munir Pirmohamed. Will pass that straight to sir Munir Pirmohamed will pass that straight to sir Munir Pirmohamed. Thank you. The early evidence is pirmohamed. Thank you. The early evidence is suggesting pirmohamed. Thank you. The early evidence is suggesting that pirmohamed. Thank you. The early evidence is suggesting that there l pirmohamed. Thank you. The early| evidence is suggesting that there is an immune evidence is suggesting that there is an immune response which is occurring an immune response which is occurring in relation to whatever the event occurring in relation to whatever the event is, it may be the vaccine or previous the event is, it may be the vaccine or previous Covid Infection, for e response example, but the way that immune response then targets the platelets and why response then targets the platelets and why it targets the platelets in the very and why it targets the platelets in the very small number of individuals, we are not clear about and further individuals, we are not clear about and further work is ongoing at the moment and further work is ongoing at the moment i and further work is ongoing at the moment. I think it is really important to understand the mechanisms because it might provide us with mechanisms because it might provide us with ways of being able to prevent us with ways of being able to prevent this in the future, for example. Prevent this in the future, for example, if we were able to identify the mechanisms, we would be able to refine the mechanisms, we would be able to refine the the mechanisms, we would be able to refine the advice that is given so we can refine the advice that is given so we can identify risk factors, for example. We can identify risk factors, for example, and then try to prevent it in individuals with those risk factors in individuals with those risk factors it in individuals with those risk factors. It may also allows to then the able factors. It may also allows to then the able to factors. It may also allows to then the able to think about modifying the able to think about modifying the vaccines so they dont because this particular adverse event in the future this particular adverse event in the future you this particular adverse event in the future. You mentioned the adenoviral vector future. You mentioned the adenoviral vector and future. You mentioned the adenoviral vector and yes there are several vaccines vector and yes there are several vaccines with this adenoviral vectors vaccines with this adenoviral vectors but we dont know if it is related vectors but we dont know if it is related to vectors but we dont know if it is related to this or Something Else at the moment. Again, that is part of the moment. Again, that is part of the scientific work we need to undertake. The scientific work we need to undertake the scientific work we need to undertake. ,. ,. , undertake. Thank you. We will now move to the undertake. Thank you. We will now move to the daily undertake. Thank you. We will now move to the daily express. Undertake. Thank you. We will now move to the daily express. Good i move to the daily express. Good afternoon move to the daily express. Good afternoon. The move to the daily express. Good afternoon. The majority move to the daily express. Good afternoon. The majority of move to the daily express. Good afternoon. The majority of cases i afternoon. The majority of cases that have afternoon. The majority of cases that have been afternoon. The majority of cases that have been reported afternoon. The majority of cases that have been reported were i afternoon. The majority of cases that have been reported were in| that have been reported were in women, that have been reported were in women, with that have been reported were in women, with a that have been reported were in women, with a smaller that have been reported were in women, with a smaller numberi that have been reported were in i women, with a smaller number in that have been reported were in women, with a smaller number in men. As you women, with a smaller number in men. As you have women, with a smaller number in men. As you have said. Women, with a smaller number in men. As you have said, there women, with a smaller number in men. As you have said, there is women, with a smaller number in men. As you have said, there is not women, with a smaller number in men. As you have said, there is not a women, with a smaller number in men. As you have said, there is not a lot as you have said, there is not a lot of data as you have said, there is not a lot of data because as you have said, there is not a lot of data because it as you have said, there is not a lot of data because it is as you have said, there is not a lot of data because it is a as you have said, there is not a lot of data because it is a rare as you have said, there is not a lot of data because it is a rare but i of data because it is a rare but thinking of data because it is a rare but thinking about of data because it is a rare but thinking about the of data because it is a rare but thinking about the potential i thinking about the potential mechanisms thinking about the potential mechanisms that thinking about the potential mechanisms that you thinking about the potential mechanisms that you mentioned, are there mechanisms that you mentioned, are there any mechanisms that you mentioned, are there any possible mechanisms that you mentioned, are there any possible biological there any possible biological reasons there any possible biological reasons why there any possible biological reasons why women there any possible biological reasons why women might l there any possible biologicali reasons why women might be there any possible biological i reasons why women might be at there any possible biological reasons why women might be at higher risk than reasons why women might be at higher risk than men reasons why women might be at higher risk than men or reasons why women might be at higher risk than men or is reasons why women might be at higher risk than men or is it reasons why women might be at higher risk than men or is it too reasons why women might be at higher risk than men or is it too early reasons why women might be at higher risk than men or is it too early to risk than men or is it too early to say . Risk than men or is it too early to say . Secondly, risk than men or is it too early to say . Secondly, if risk than men or is it too early to say . Secondly, if i risk than men or is it too early to say . Secondly, if i make risk than men or is it too early to say . Secondly, if i make a risk than men or is it too early to| say . Secondly, if i make a yellow card scheme say . Secondly, if i make a yellow card scheme collect say . Secondly, if i make a yellow card scheme collect data say . Secondly, if i make a yellow card scheme collect data and i say . Secondly, if i make a yellow card scheme collect data and all. Card scheme collect data and all kinds card scheme collect data and all kinds of card scheme collect data and all kinds of possible card scheme collect data and all kinds of possible adverse card scheme collect data and all. Kinds of possible adverse effects. Are there kinds of possible adverse effects. Are there any kinds of possible adverse effects. Are there any others kinds of possible adverse effects. Are there any others where kinds of possible adverse effects. Are there any others where you. Kinds of possible adverse effects. I are there any others where you have seen any are there any others where you have seen any evidence are there any others where you have seen any evidence of are there any others where you have seen any evidence of increased are there any others where you have seen any evidence of increased risk. Seen any evidence of increased risk or is this seen any evidence of increased risk or is this the seen any evidence of increased risk or is this the only seen any evidence of increased risk or is this the only one . Seen any evidence of increased risk or is this the only one . Or is this the only one . Thank you. I am or is this the only one . Thank you. I am going or is this the only one . Thank you. I am going to or is this the only one . Thank you. I am going to ask or is this the only one . Thank you. I am going to ask sir or is this the only one . Thank you. I am going to ask sir munir i am going to ask sir Munir Pirmohamed, first of all for the question about women and then to the yellow cards to june question about women and then to the yellow cards tojune raine. {iii question about women and then to the yellow cards to june raine. Yellow cards to june raine. Of the 79 cases, yellow cards to june raine. Of the 79 cases. 51 yellow cards to june raine. Of the 79 cases, 51 were yellow cards to june raine. Of the 79 cases, 51 were in yellow cards to june raine. Of the 79 cases, 51 were in women i yellow cards to june raine. Of the 79 cases, 51 were in women and l yellow cards to june raine. Of the l 79 cases, 51 were in women and 28 were 79 cases, 51 were in women and 28 were in 79 cases, 51 were in women and 28 were in men 79 cases, 51 were in women and 28 were in men. The numbers are quite small were in men. The numbers are quite small that were in men. The numbers are quite small. That may reflect, actually, who is small. That may reflect, actually, who is getting the vaccine because many who is getting the vaccine because many of who is getting the vaccine because many of the health care workers, for example. Many of the health care workers, for example, are women. But if you look at the example, are women. But if you look at the incidence rate according to the number of vaccines administered, theres the number of vaccines administered, theres actually no difference between Men And Women. So we will need to between Men And Women. So we will need to continue to monitor this and see whether there is a gender predilection to developing this particular adverse event but at the moment, particular adverse event but at the moment, we dont have any evidence to say moment, we dont have any evidence to say either moment, we dont have any evidence to say either men or women are more likely to say either men or women are more likely to to say either men or women are more likely to get to say either men or women are more likely to get this. Gn to say either men or women are more likely to get this likely to get this. On the yellow card scheme likely to get this. On the yellow card scheme come likely to get this. On the yellow card scheme come every i likely to get this. On the yellow card scheme come every week, i likely to get this. On the yellow i card scheme come every week, we publish all the reports in summary form, but also, the report on a thursday talks about any trends that have come up. Sol thursday talks about any trends that have come up. So i really cant do any better than encouraging people to read it but also, to encourage everyone to report to us. Every report matters and every report will be carefully looked at. Thank you. Thank you, hannah. So that brings us to the end of the questions posed by the media today. I would like to conclude at this point by thanking my colleagues for their time and more importantly than their time today, for the immense amount of hours of effort they and their assistants have put in behind the scenes to get us to this point. I want to emphasise to everybody that covid 19 remains a serious illness, that unfortunately, as professor chris whitty has said, it is something we are going to have to live within the long term. The vaccine is likely to be and will continue to be extremely important in this country in getting life back to normal. We are managing this very carefully. I hope you have seen real evidence today of authentic experts looking after your interests, doing the very best they can. It is a Course Correction but nevertheless, it is full speed ahead with the uk Vaccine Programme, so that we can get life back to normal. Thank you. This briefing is concluded. Jonathan van tam, englands deputy chief Medical Officer, bringing to an end that briefing, focusing very specifically on the Oxford Astrazeneca vaccine. The headline is that the vaccines benefits hugely outweigh the risks, but there is what professorJonathan Van Tam called a Course Correction because of a link to a very small number of blood clots from people who have had the vaccine, the under 30s, it is now recommended they should get one of the other two proved vaccines in the uk. Listening to that briefing as our Health Correspondent Anna Collinson. The overall message is quite nuanced, how have they come to this decision . This decision . Well, it has been intense days this decision . Well, it has been intense days of this decision . Well, it has been intense days of work, this decision . Well, it has been intense days of work, both i this decision . Well, it has been intense days of work, both for i this decision . Well, it has been i intense days of work, both for the uk regulator but we have also been having a similar briefing from the european regulator, and they have been pouring through cases, potential cases linked to the astrazeneca vaccine, looking for these very rare types of blood clots. What they have said is that there is now mounting evidence that there is now mounting evidence that there is now mounting evidence that there is a link, getting firmer, how they describe it, they say they need more work to look into that area because they are not entirely sure what is particularly causing these very rare blood clots but it appears to be the case that those blood clots are forming along with these low levels of platelets. They gave us some more information, up until now, we have not had any idea of gender breakdown or age breakdowns when it has come to this, whereas from germany, we have been getting that information. At the mhra are saying is that up to the 31st of march, more than 20 million doses of the Astrazeneca Jab were given in the Astrazeneca Jab were given in the uk. 79 Blood Clot Cases were detected and there were 19 deaths. ProfessorJonathan Van Tam, the deputy chief Medical Officer for england, described these cases as vanishingly rare but serious. It is broken down into 51 women and 28 men aged between 18 and 79. But as we kept hearing during a Press Briefing, and i am sure we will hear from the Prime Minister boris johnson, gps, when you go to your surgery, these cases are extremely rare. The overall risk of these cases is approximately said to be four people in a million who received the vaccine. And the benefits are seen as very favourable. But what they have conceded is that it is more finely balanced, the benefit, when it comes to younger people. There is obviously the risk of things like long covid so basically the findings they have come to me that people aged under 30 should be offered an alternative covid jab is possible and those people dont necessarily include, if you are 29 and you have a Certain Health condition, you would not necessarily fall into that category. They are also saying that it is the utmost caution, they are not saying it is a rule, it absolutely has to happen but they are being ultra cautious. To absolutely has to happen but they are being ultracautious. Are being ultracautious. To be clear, are being ultracautious. To be clear. This are being ultracautious. To be clear, this is are being ultracautious. To be clear, this is a are being ultracautious. To be clear, this is a fine are being ultracautious. To be clear, this is a fine calculation, i are being ultracautious. To be i clear, this is a fine calculation, a statistical calculation if you like because we were shown a slide that showed that for younger people, the under 30 age group, the risks of getting covid and getting it seriously are so small, that they are slightly outweighed by this tiny risk of getting a blood clot and thatis risk of getting a blood clot and that is why the change in advice. Absolutely, that is what this whole thing is about, about trying to balance the benefit versus the risk. Trying to do the best thing possible. As i mentioned, four people ini million who have the astrazeneca vaccine, according to these figures from the mhra, may get this very rare type of blood clot. If you compare that to the risk of covid, if the million 40 year olds catch covid, 1000 could die and if you go up in age groups, the numbers just increase so if you are in the Older Age Groups, getting the vaccine makes sense but as you work down the age groups, the chances of getting dying all of getting seriously or dying from covid decrease. I thought it was interesting, they talked about women, the idea if you are a 30 year old woman, they seem to be particularly affected and those are findings that the mhra have concluded and also the ema, they also found there are a higher number of cases amongst women but there is a theory, that was mentioned in the briefing that maybe more women are getting the vaccine because they may be doing certainjobs like getting the vaccine because they may be doing certain jobs like working on the front line so that might be the case but what is an interesting statistic is a point made by the european regulator that if we treat 10,000 women with combined hormonal contraceptive for a year, we will see four excess blood clots. That gives a benchmark of another medicine which is given to a healthy population and gives you an idea again of the scale of the risk and that kind of balancing between risk and benefit. , that kind of balancing between risk and benefit and benefit. Really interesting, thank you and benefit. Really interesting, thank you we and benefit. Really interesting, thank you. We just and benefit. Really interesting, thank you. We just want and benefit. Really interesting, thank you. We just want to i and benefit. Really interesting, l thank you. We just want to bring and benefit. Really interesting, i thank you. We just want to bring you a tweet that has been put out by the vaccine minister, nadeem is a harley, who says. The regulation and oversight works well, in other words. The regulation and oversight works well, in otherwords. Quoting the pie minister, he says they will follow the advice and they are confident in meeting their targets which is important because they are saying this is not going to throw the timetable of course. Lots to discuss now. Lets speak now to david spiegelhalter, professor of statistics at Cambridge University. Good afternoon. Lots of statistics here, which have led to what is a quite nuanced message. What they are trying to say to the population presumably is that the astrazeneca vaccine is perfectly safe but it is just for certain age groups a certain age group, that the risk to a tiny extent outweighs the risk to a tiny extent outweighs the benefit, is that how you would read it . It the benefit, is that how you would read it . ,. , read it . It really is quite a complex read it . It really is quite a complex message read it . It really is quite a complex message and i i read it . It really is quite a i complex message and i should read it . It really is quite a complex message and i should say that our team at cambridge helped to design those slides thatJonathan Van Tam was using this afternoon. We were trying to illustrate this really quite complex trade off that is going on and as he explained, the issueis is going on and as he explained, the issue is that, you know, covid is a disease that really hits the elderly more and so the benefit of the vaccination does come down as you get into the younger groups of the population and frankly, a lot of the benefit of vaccinating young people is to stop transmission and to benefit the whole of society, as june raine pointed out. But it looks like with this harm, this particular combination of very unpleasant side effects, it does hit younger people more and so you have got the younger people who are getting less benefit and more harms, and at some point, you are going to cross a threshold which says, actually, you would be better to give them Something Else. But would be better to give them Something Else. Would be better to give them somethin else. �. ,. , Something Else. But does it actually affect young Something Else. But does it actually affect young people Something Else. But does it actually affect young people more . Something else. But does it actually affect young people more . Of Something Else. But does it actually affect young people more . Of the i affect young people more . Of the figures that we were given, 51 out of 79 cases of blood clots, we know that 19 people sadly died, but of those 19, three were under 30. Yes. Those 19, three were under 30. Yes, but the vaccine those 19, three were under 30. Yes, but the vaccine has those 19, three were under 30. Yes, but the vaccine has not those 19, three were under 30. Is but the vaccine has not been given to so many under 30 year olds so that three actually represents quite a lot. In fact, among the 20 29 Year Olds on the slides that were shown, it was estimated the risk was more than one in 100,000, whereas in 6069 more than one in 100,000, whereas in 60 69 year olds, it is estimated to be about one in 500,000. A considerable difference in the risk between the different age groups. 50 between the different age groups. So can you put the risks into context for us . ,. Can you put the risks into context forus . , , for us . This is tricky because vaccines for us . This is tricky because vaccines are for us . This is tricky because vaccines are read for us . This is tricky because vaccines are read special. I for us . This is tricky because | vaccines are read special. You for us . This is tricky because vaccines are read special. You could say the risks of taking other drugs, other treatments, there is always risks but those are taken when you are ill and a vaccine is taken when you are healthy. I thought the comparison with the oral contraceptive was very valuable that your correspondent made earlier because that is something young people take voluntarily and that does have side effects that you have to look out for. One thing i would say is that the risk for somebody in their 20s or 30s dying in any kind of accident every month is about one in 100,000. That is roughly the chance of getting this side effect if you take this vaccine. That kind of puts it in perspective, this is a risk that we all face in our everyday lives. Risk that we all face in our everyday lives. Risk that we all face in our eve da lives. , , everyday lives. The trouble is, you can make that everyday lives. The trouble is, you can make that comparison everyday lives. The trouble is, you can make that comparison but i everyday lives. The trouble is, you | can make that comparison but that everyday lives. The trouble is, you i can make that comparison but that is not necessarily going to reassure somebody. Not necessarily going to reassure somebody not necessarily going to reassure somebod. ,. ,. , ~ somebody. No, no, and i think the crucial thing somebody. No, no, and i think the crucial thing is somebody. No, no, and i think the crucial thing is what somebody. No, no, and i think the crucial thing is what was somebody. No, no, and i think the crucial thing is what was shown i somebody. No, no, and i think the crucial thing is what was shown on | crucial thing is what was shown on the slides is the risk benefit balance. This vaccine is extraordinarily effective and you know, it would be tragic if this led to distrust of this vaccine, even worse if it was for vaccines in generalfor worse if it was for vaccines in general for covid because worse if it was for vaccines in generalfor covid because it has been shown to be amazingly effective. It has saved thousands of lives already, and so, on average, it isjust lives already, and so, on average, it is just fantastic that there is no argument about the overall benefit. It isjust no argument about the overall benefit. It is just for this specific group of younger people, who, frankly, dont benefit that much from being vaccinated in terms of their own health. Ilrrulitli much from being vaccinated in terms of their own health. Of their own health. With the development of their own health. With the development of of their own health. With the development of all of their own health. With the development of all new i of their own health. With the i development of all new vaccines, is this a process that always goes on behind the scenes . The difference this time around is that it is all happening on prime time tv. Im this time around is that it is all happening on primetime tv. Im very interested you happening on primetime tv. Im very interested you did happening on primetime tv. Im very interested you did not happening on primetime tv. Im very interested you did not know happening on primetime tv. Im very interested you did not know the i happening on primetime tv. Im very interested you did not know the term | interested you did not know the term pharmacovigilance. Some of us. That is me tiled it pharmacovigilance. Some of us. That is me tiled that is me tiled it ust rips off the tongue h that is me tiled it ust rips off the tongue fori that is me tiled itjust rips off the tongue for some that is me tiled itjust rips off the tongue for some of that is me tiled itjust rips off the tongue for some of us i that is me tiled itjust rips off. The tongue for some of us which shows you that this kind of work is going on all the time but usually over a much of the period, drugs take longer to develop and then they are not usuallyjust immediately given to tens of millions of people over a few months. I mean, this is quite extraordinary, what is going on and asjonathan burn tam said, Jonathan Van Tam said, it is not surprising there will be some Course Correction that will happen. I think we have been lulled by the extraordinary success of both the vaccines and the roll out. Lulled into thinking that this is, you know, these are just things we should all be taking and that is great and we can get our freedom back. But actually, you know, this is the kind of mass medical intervention that is bound to lead to additional complications. Ilien; to additional complications. Very aood to to additional complications. Very good to talk to additional complications. Very good to talk to to additional complications. Very good to talk to you. To additional complications. Very good to talk to you. Thank you for joining us. We have had a tweet from the Prime Minister as a result of that Press Conference, who says, we will get on with rolling out the vaccines. The crucial thing on this is to listen to what the scientists and the doctors say. I dont think anything we have seen leads me to suppose that we will need to change the road map out of lockdown. It is pretty clear the decline in deaths, hospitalisations, is being helped by the vaccine roll out. So a steady as she goes message from the Prime Minister. Lets just recap. The uk medicines watchdog says the benefits of the Oxford Astrazeneca vaccine continue to outweigh any risks for the vast majority of people. However, due to a very small number of blood clots in younger people, those under the age of 30 will be offered the pfizer or Moderna Vaccine instead. A review carried out by the mhra found that by the end of march, of the 20 Million People who have received the Astrazeneca Jab, 79 people in the uk suffered rare blood clots after vaccination, 19 of whom died. The regulator said this was not proof the jab had caused the clots, but that the link was getting firmer. Speaking in the last hour, the Chief Executive of the mhra june raine gave more details about those who had been affected by the rare blood clots. Based on the current evidence, the benefits of the Covid 19 Vaccine Astrazeneca against covid 19 and its associated risks, hospitalisation and death, continues to outweigh the risks for the vast majority of people. Our review has reinforced that the risk of this rare suspected side effect remains extremely small. By the 31st of march, over 20 million doses having been given, we have had 79 case reports, up to and including that date, the 31st of march. All 79 cases occurred after the first dose. Of these 79 cases, 19 people have sadly died. These cases occurred in 51 women and 28 men aged from 18 79 years. And from these reports, the risk of this type of rare blood clot is about four people in a million who received the vaccine. Three out of the 19 were under 30 years. 14 of the 19 were of the cerebral venous sinus thrombosis with low platelets, and five were other kinds of thrombosis in major veins. The balance of benefits and risks is very favourable for older people. But it is more finely balanced for the younger people. We at the mhra are advising that this evolving evidence should be taken into account when considering how the vaccine is used. Today, we will be communicating information and advice to Health Care Professionals on how to minimise risks. This will provide a lot of guidance, including how to report any suspected cases. The information for Health Care Professionals will be updated and there will also be information for the public, things to look out for, as we continue to monitor this issue. Anyone who has symptoms, four days after vaccination or more, should seek prompt medical advice. A new onset of a severe or persistent headache or blurred vision. Shortness of breath, chest pain, leg swelling, persistent abdominal pain, or indeed, unusual skin bruising or pinpoint spots beyond the injection site. Professor wei shen lim, chairman of Thejoint Committee On Vaccination and immunisation, said the recommendation to prefer other vaccines to astrazeneca for the under 30s was out of the utmost caution rather than because of any serious safety concerns. Acting really in the interest of safety and for public benefit, jcvi feel that there are three points of advice that we would like to put across. The first is that information given to individuals who are being offered vaccination and information given to Health Professionals should be appropriately updated to reflect the latest considerations and deliberations byjcvi and by mhra. The second point is that those who have received their first dose of astrazeneca vaccine should continue to be offered the second dose of astrazeneca vaccine according to the set schedule. And the final bit of advice is that adults who are aged 18 to 29 years old who do not have an Underlying Health condition that puts them at higher risk from serious covid i9 disease should be offered an alternative covid i9 vaccine in preference to the astrazeneca vaccine where such an alternative vaccine is available. And perhaps it is useful to state what is not advised as well. We are not advising a stop to any vaccination for any individual in any age group. We are advising a preference for one vaccine over another vaccine for a particular age group, really out of the utmost caution rather than because we have any serious safety concerns. Englands deputy chief Medical Officer professorJonathan Van Tam said it was important to remember the success of the Vaccination Programme so far. If you had said to me back in march 2020, and predicted how far we would have come so far with our Vaccine Programme, then i am not sure i would have believed that we would have got as far as we have. The uk Vaccine Programme has been the most enormous success indeed. And if youd said to me that by march 2021, we would not have needed a Course Correction, that also would have amazed me. So we must keep this in the context of the enormous success we have achieved so far. Lots of public reaction, as you can imagine, from government ministers, this from Health Secretary matt hancock, who says. He goes on to stipulate again what the vaccines minister, nadim zahawi, said. He goes on also to say thanks to the excellent regulators and his clinical advisers. Just before the Press Conference here in the uk, the European Medicines Agency also held a Press Briefing following a safety review into the astrazeneca vaccine. Its Executive Director, emer cooke, said that the benefits of the Astrazeneca Jab outweigh the risks of side effects. First of all, i want to start by stating that our Safety Committee, the pharmacovigilance and Risk Assessment committee of European Medicines Agency, has confirmed that the benefits of the astrazeneca vaccine in preventing covid 19 overall outweigh the risks of side effects. Covid 19 is a very serious disease with high hospitalisation and death rates, and every day, covid is still causing thousands of deaths across the eu. This vaccine has proven to be highly effective in preventing severe disease and hospitalisation, and it is saving lives. Vaccination is extremely important in helping us in the fight against covid 19 and we need to use the vaccines we have to protect us from the devastating effects. The prac, after very in depth analysis, has concluded that the reported cases of unusual Blood Clotting following vaccination with the astrazeneca vaccine should be listed as possible side effects effects of the vaccine. We have just had the latest coronavirus figures for the last 2a hours and the uk has recorded 45 deaths within 28 days of a positive covid i9 tests gait test on wednesday. Last week, we recorded 43. In wednesday. Last week, we recorded a3. In terms of new cases, the uk has recorded 2763 new cases today and that compares with a052 at the same time last week. So and that compares with a052 at the same time last week. 50 down by about 1300 on last week. We can speak now to the conservative mp and former Health Secretaryjeremy hunt, who now chairs the Commons Health and social care committee. Thanks so much forjoining us. You have been listening to the briefing this afternoon, what did you make of what you heard . What you heard . Good afternoon, i thouuht what you heard . Good afternoon, i thought what what you heard . Good afternoon, i thought what was what you heard . Good afternoon, i thought what was interesting what you heard . Good afternoon, i thought what was interesting is what you heard . Good afternoon, i i thought what was interesting is what we did not hear, eitherfrom thought what was interesting is what we did not hear, either from the european drugs regulator or our own, the mhra. Neither said the Oxford Astrazeneca vaccine is unsafe for anyone. They both continued to say it is a totally safe vaccine, but what you need in a pandemic is to make sure that there remains trust between the authorities and the public, so people continue to comply with advice, so quite rightly they are being very transparent about the new risks emerging and what that does balancing the benefits for younger people. D0 does balancing the benefits for younger people does balancing the benefits for younger people. Do you think it dense confidence . Younger people. Do you think it dense confidence . I younger people. Do you think it dense confidence . I do younger people. Do you think it dense confidence . I do not younger people. Do you think it. Dense confidence . I do not think younger people. Do you think it dense confidence . I do not think so, obviously everyone dense confidence . I do not think so, obviously everyone is dense confidence . I do not think so, obviously everyone is worrying dense confidence . I do not think so, j obviously everyone is worrying about that today, but there is a big difference between what happened here and in Continental Europe a few weeks ago, because at that they raised questions before we had questions about Oxford Astrazeneca are not dented confidence in their vaccine roll out at the early stage. Here in the uk. It is nine times lower than in france, so people can see hard evidence that these vaccines really work. So i think people would take this in their stride. �. ,. , people would take this in their stride. �. ,. , people would take this in their stride. � ,. , stride. But the vaccines have been rolled out as stride. But the vaccines have been rolled out as we stride. But the vaccines have been rolled out as we note stride. But the vaccines have been rolled out as we note to stride. But the vaccines have been rolled out as we note to people i stride. But the vaccines have been l rolled out as we note to people over the age of 50 and above and it is younger people that we are worried about and that is where the potential for a about and that is where the potentialfor a dent about and that is where the potential for a dent in confidence over the oxford jab is their well, the way you avoid that dent in confidence is it to be completely honest about the confidence is it to be completely honest about the risks, but i think eole honest about the risks, but i think people know honest about the risks, but i think people know there honest about the risks, but i think people know there are honest about the risks, but i think people know there are no honest about the risks, but i think l people know there are no medicines that are completely safe, no medicines that do not have side effects and to have something that willjust have an impact on it four people in every million is really very low, so i think people will take this advice sensibly and understand the most important thing is to get as many people vaccinated as quickly as possible. What is to get as many people vaccinated as quickly as possible. As quickly as possible. What would ou sa to as quickly as possible. What would you say to somebody as quickly as possible. What would you say to somebody who as quickly as possible. What would you say to somebody who is as quickly as possible. What would you say to somebody who is 31 as quickly as possible. What would you say to somebody who is 31 for| you say to somebody who is 31 for example who is it still being offered the Astrazeneca Jab . You example who is it still being offered the Astrazeneca Jab . Offered the astrazeneca ab . You are safer having offered the astrazeneca ab . You are safer having this h offered the astrazeneca ab . You are safer having this jab offered the Astrazeneca Jab . You are safer having this jab than offered the Astrazeneca Jab . You are safer having this jab than not safer having this jab than not having it. You are less likely to die if you have this jab. The uk regulator, the mhra, has saved thousands of lives by making really important calls at every stage of this pandemic, first regulator in the world to approve a vaccine and the world to approve a vaccine and the decision to space the doses, these guys know what they are talking about. If you want to be safe, have this vaccine. Do talking about. If you want to be safe, have this vaccine. Safe, have this vaccine. Do you think of the safe, have this vaccine. Do you think of the government safe, have this vaccine. Do you | think of the government should safe, have this vaccine. Do you think of the government should now embark on an exercise of trying to explain quite clearly what the Scientific Evidence has shown . My understanding is if you are young, the risk of you becoming seriously ill from covid is a very which is why the risk of developing one of these very rare blood clots that goes up slightly in relation to the very small risk of covid and that is the balance. Very small risk of covid and that is the balance the balance. That is exactly right. It is because the balance. That is exactly right. It is because of the balance. That is exactly right. It is because of the the balance. That is exactly right. It is because of the fact the balance. That is exactly right. It is because of the fact that it is because of the fact that although people are more likely to suffer serious symptoms from covid, that the balance of advantages overwhelmingly favour having these vaccines for older people. I think if we did not have alternative vaccines, we would still be telling younger people that you are much safer having a vaccine against a covid than not, and if Oxford Astrazeneca is the only one available, that if they one you should have, it is the safest thing for you to do. But if those under 30 there is an alternative available, you cannot reduce the risk of those at side effects even more. I think thatis at side effects even more. I think that is howl at side effects even more. I think that is how i read the situation. You can reduce the risk. De that is howl read the situation. You can reduce the risk. You can reduce the risk. De that eole you can reduce the risk. De that people might you can reduce the risk. De that people might say you can reduce the risk. De that people might say if you can reduce the risk. De that people might say if it you can reduce the risk. De that people might say if it is you can reduce the risk. De that people might say if it is only people might say if it is only astrazeneca that is available, i do not want it, if they are under 30 . I think they would be making a mistake if they did that, because in reality, all of us, whatever age we are, are massively safer having a jab than not having a jab. The risk of not accepting a jab when you are offered one is that you expose yourself to the risk of covid and there are risks at all age groups from covid and that is why the most important thing is to follow the advice given by the nhs. We important thing is to follow the advice given by the nhs. We have had advice given by the nhs. We have had a series of tweets advice given by the nhs. We have had a series of tweets from advice given by the nhs. We have had a series of tweets from the advice given by the nhs. We have had a series of tweets from the vaccines i a series of tweets from the vaccines minister and the Health Secretary saying that nothing about the announcement today suggest the government will be put off course in terms of its timetable for the vaccine. Are you confident of that too . I vaccine. Are you confident of that too . , vaccine. Are you confident of that too . , , ~ too . I am broadly, yes. I think we have had incredible too . I am broadly, yes. I think we have had incredible public too . I am broadly, yes. I think we have had incredible public support for this Vaccine Programme, the government was expecting 75 take up and it is more like 90 and i think more than 99 of people going for that second jabs, so i think that will continue, but anything that would have dented confidence is if we had not had total transparency about the new advice coming forward and we have had that transparency this afternoon and we are offering alternatives to people under the age of 30, so i think most people will take this advice in their stride. Just a related issue, vaccine passports, very much in the air. What do you think about domestic vaccine passports, are you in favour . In vaccine passports, are you in favour . ,. ,. , vaccine passports, are you in favour . ,. , ,. ,. , favour . In any ordinary situation, if ou are favour . In any ordinary situation, if you are told favour . In any ordinary situation, if you are told he favour . In any ordinary situation, if you are told he would favour . In any ordinary situation, if you are told he would have favour . In any ordinary situation, if you are told he would have to l if you are told he would have to show something from your private medical Health Record in order to get into a pub or to go to a football match, people would say thatis football match, people would say that is utterly abhorrent, but this is not a normal situation, it is a pandemic. I think we may end up not having to have these vaccine passports because we can get the daily cases a solo that the risk becomes naturally durable. Daily cases so low. But if the only way to get to someone in to a football match is to show evidence that they are not likely to be a danger to other people, i think on balance most people would say that is perfectly reasonable. Most people would say that is perfectly reasonable. Thank you so much, perfectly reasonable. Thank you so much. Jeremy perfectly reasonable. Thank you so much, jeremy hunt, perfectly reasonable. Thank you so much, jeremy hunt, the perfectly reasonable. Thank you so much, jeremy hunt, the chair perfectly reasonable. Thank you so much, jeremy hunt, the chair of. Perfectly reasonable. Thank you so l much, jeremy hunt, the chair of the Health Select committee. Now on bbc news its time for your questions answered. Youve been sending in your questions on vaccines, and to answer your queries im joined now by dr samara afzal, a gp at Netherton Health centre in dudley, and danny altmann, professor of immunology at imperial college, london. Good afternoon to you both. We have had lots and lots of questions as a result of the Press Conference this afternoon and a lot of them are going over the same things, a couple of issues that are particularly worrying people, travelling people. Let me start with gail who asks if you have had no side effect after the first jab, you have had no side effect after the firstjab, does that you have had no side effect after the first jab, does that suggest the second jab will also result in no side effect . Second jab will also result in no side effect . ,. , side effect . Good afternoon. We have seen everyone side effect . Good afternoon. We have seen everyone respond side effect . Good afternoon. We have seen everyone respond to side effect . Good afternoon. We have seen everyone respond to different i seen everyone respond to different data vaccines, some people have had absolutely no side effects from the first but when they get their second booster dose they developed a stronger response and do get a fever, aches and pains, headache. On the other hand, i have seen people who have had nothing the second time, but the first time they developed a fever. So it is difficult to predict what will happen, but in my experience, it is usually that the second time you tend to get slightly stronger side effects. � ,. , tend to get slightly stronger side effects. � , ~ , tend to get slightly stronger side effects. � ~ ,. , tend to get slightly stronger side effects. � ~ ,. ,. , effects. Are you likely to get more of a side effect effects. Are you likely to get more of a side effect with effects. Are you likely to get more of a side effect with one effects. Are you likely to get more of a side effect with one of effects. Are you likely to get more of a side effect with one of the of a side effect with one of the vaccines over the other or is there no proof of that . I vaccines over the other or is there no proof of that . No proof of that . I think there is no proof of that . I think there is no roof no proof of that . I think there is no proof of no proof of that . I think there is no proof of that. No proof of that . I think there is no proof of that. There no proof of that . I think there is no proof of that. There are no proof of that . I think there is no proof of that. There are lots l no proof of that . I think there is | no proof of that. There are lots of anecdotal no proof of that. There are lots of anecdotal reports swelling around that astrazeneca is more punchy on the first that astrazeneca is more punchy on the first one adviser on the second, but in the first one adviser on the second, but in general, we should not over e. But in general, we should not over egg it. But in general, we should not over egg it. But but in general, we should not over egg it, but it is a mark of the vaccines egg it, but it is a mark of the vaccines activate your immune a lot, which vaccines activate your immune a lot, which is vaccines activate your immune a lot, which is why vaccines activate your immune a lot, which is why you feel rubbish for a day or which is why you feel rubbish for a day or two. Which is why you feel rubbish for a day or two, so it is a sign that something day or two, so it is a sign that something is happening, much as it is horrible something is happening, much as it is horrible when youre going through is horrible when youre going through it. Is horrible when youre going through it is horrible when youre going throuuhit. ,. , through it. Does having the response mean ou through it. Does having the response mean you are through it. Does having the response mean you are having through it. Does having the response mean you are having a through it. Does having the response mean you are having a stronger mean you are having a stronger immune response . Is it a positive response potentially . Let immune response . Is it a positive response potentially . Immune response . Is it a positive response potentially . Let me nip in on that, the response potentially . Let me nip in on that, the term response potentially . Let me nip in on that, the term is response potentially . Let me nip in on that, the term is react response potentially . Let me nip in on that, the term is react to response potentially . Let me nip in on that, the term is react to janet, | on that, the term is react to janet, a big on that, the term is react to janet, a big reaction, and people come back and say a big reaction, and people come back and say i a big reaction, and people come back and say i did a big reaction, and people come back and say i did not feel rubbish, but it is not and say i did not feel rubbish, but it is not so and say i did not feel rubbish, but it is not so literal, you could feel heavily it is not so literal, you could feel heavily 0k it is not so literal, you could feel heavily ok i still have a good response heavily ok i still have a good response was to blush my group feel perfectly response was to blush my group feel perfectly ok. Response was to blush my group feel perfectly 0k perfectly 0k. What does it mean for those under perfectly 0k. What does it mean for those under 30 perfectly 0k. What does it mean for those under 30 who perfectly 0k. What does it mean for those under 30 who have perfectly 0k. What does it mean for those under 30 who have had perfectly 0k. What does it mean for those under 30 who have had their. Those under 30 who have had their firstjab of those under 30 who have had their first jab of astrazeneca, those under 30 who have had their firstjab of astrazeneca, will they still get the second . First jab of astrazeneca, will they still get the second . Still get the second . There is no need to panic still get the second . There is no need to panic and still get the second . There is no need to panic and it still get the second . There is no need to panic and it is still get the second . There is no | need to panic and it is accounting for risk versus benefit was that we are not in a position where many in the 30s will have had the Astrazeneca Jab, but those who have had it, unless they have had a problem with the vaccine or a cot, the advice still is to continue to have a second one. We are not at the stage where we are mixing and matching vaccines yet. Research is still being done and i do not know what the vaccine will be in a few weeks time, but at the moment, unless they have had a serious adverse reaction to the vaccine, they will continue to have at their second vaccine with astrazeneca. Yes, i think professor wei shen from thejcvi did take those who have had their first dose should have their second dose, that was pretty clear at this afternoon. Thank you so much. Fassett altmann, christopher asksis much. Fassett altmann, christopher asks is it only astrazeneca that has the side effect of blood clots . Professor altmann. The the sideeffect of blood clots . Professor altmann. Professor altmann. The limits of protection professor altmann. The limits of protection for professor altmann. The limits of protection for any professor altmann. The limits of protection for any of professor altmann. The limits of protection for any of these, professor altmann. The limits of protection for any of these, you | protection for any of these, you need protection for any of these, you need to protection for any of these, you need to look at tens of millions of places need to look at tens of millions of places to need to look at tens of millions of places to pick up the signal in the adverse places to pick up the signal in the adverse event reporting put up so far we adverse event reporting put up so far we have only picked up this signal far we have only picked up this signal for far we have only picked up this signal for astrazeneca and if you remember at signal for astrazeneca and if you rememberat the signal for astrazeneca and if you remember at the beginning of the programme we picked up a different signal programme we picked up a different signal Fair Programme we picked up a different signal fair anaphylactic responses for pfizer signal fair anaphylactic responses for pfizer and these are all the kind for pfizer and these are all the kind of for pfizer and these are all the kind of things you only pick up when you are kind of things you only pick up when you are doing tens of millions of doses you are doing tens of millions of doses so you are doing tens of millions of doses. So these are all very rare events doses. So these are all very rare events where some are more astrazeneca and some are more pfizer. Astrazeneca and some are more pfizer. ~. , ~ astrazeneca and some are more pfizer. ,. , pfizer. Were talking a little earlier about pfizer. Were talking a little earlier about other pfizer. Were talking a little earlier about other mass i pfizer. Were talking a little earlier about other mass Vaccination Programmes like the flu vaccine for example. Does not have a side effect . ,. ,. , effect . Does that have side effects . We effect . Does that have side effects . We are effect . Does that have side effects . We are familiar effect . Does that have side effects . We are familiar with i effects . We are familiar with feeling effects . We are familiar with feeling rubbish on the day of vaccination and there are many different vaccination and there are many different flu vaccines in different seasons different flu vaccines in different seasons against different flu variants seasons against different flu variants under some have had adverse event variants under some have had adverse event profile is. I think the thing i would event profile is. I think the thing i would say in terms of people getting i would say in terms of people getting some context and perspective today is getting some context and perspective today is anyone who has been in a hospital today is anyone who has been in a hospital or today is anyone who has been in a hospital or doctors surgery will have hospital or doctors surgery will have seen hospital or doctors surgery will have seenjunior Doctors Hospital or doctors surgery will have seen Junior Doctors are marching have seen Junior Doctors are marching around with that little manual, marching around with that little manual, the formulary of all the drugs manual, the formulary of all the drugs they ever prescribed, and every drugs they ever prescribed, and every single page is filled with the possible every single page is filled with the possible adverse events for any given possible adverse events for any given drug you are ever given and drugs given drug you are ever given and drugs that given drug you are ever given and drugs that have been licensed have an adverse drugs that have been licensed have an adverse event profile. We know it and recognise it and mitigate for it and recognise it and mitigate for it and live and recognise it and mitigate for it and live with it. And and recognise it and mitigate for it and live with it. And live with it. And you are suggesting and live with it. And you are suggesting this and live with it. And you are suggesting this is and live with it. And you are suggesting this is no and live with it. And you are i suggesting this is no different . And live with it. And you are suggesting this is no different . It is a serious for people who have it and unspeakably rare and the second you know and unspeakably rare and the second you know how to look out for it, you can look you know how to look out for it, you can look out you know how to look out for it, you can look out for it and deal with it when can look out for it and deal with it when you can look out for it and deal with it when you see it and that is the world when you see it and that is the world that when you see it and that is the world that we are used to living and for all world that we are used to living and for all drugs. World that we are used to living and for all drugs for all drugs. 0k, thank you. Paul from oxfordshire for all drugs. 0k, thank you. Paul from oxfordshire asks for all drugs. 0k, thank you. Paul from oxfordshire asks why for all drugs. 0k, thank you. Paul| from oxfordshire asks why people for all drugs. 0k, thank you. Paul from oxfordshire asks why people are not tested for covid when they are about to get vaccinated . He says this could explain a clotting if there is a correlation between having had covid when being vaccinated and the rest of it reaction such as clots. It is one of those theories that has been doing the rounds. Yes . Doctor afzal. I the rounds. Yes . Doctorafzal. I think it would be the logistical issues, when we vaccinate we do ask if they have had covid in the last month and if they have we do not give them the vaccine. But for logistics, if they do not have symptoms, they should not be coming in and they should have a test anyway, but sometimes you get vaccines a few days notice and it is the logistics of trying to get all those patients tested and that would be hurting the Vaccination Programme. Lateralflow be hurting the Vaccination Programme. Lateral flow testing be hurting the Vaccination Programme. Lateralflow testing is around but it is not 100 sensitive and it is difficult to say whether some of these patients have a covid and have the vaccine and have developed these complications, so i do not think that will come in or i dont think for logistical reasons we will be able to test everyone before having the vaccine. But if somebody before having the vaccine. But if somebody knows before having the vaccine. But if somebody knows they before having the vaccine. But if somebody knows they have before having the vaccine. But if somebody knows they have already had covid, would there be a sense in screening people first . I suppose you are saying we do not know if that link is correct. You are saying we do not know if that link is correct. Yes, we do not know. That link is correct. Yes, we do not know but that link is correct. Yes, we do not know but if that link is correct. Yes, we do not know. But if they that link is correct. Yes, we do not know. But if they have that link is correct. Yes, we do not know. But if they have had that link is correct. Yes, we do not know. But if they have had covid i know. But if they have had covid within the last 28 days they would not have the vaccine anyway. Truths; not have the vaccine anyway. Why not . Because not have the vaccine anyway. Why not . Because we not have the vaccine anyway. Why not . Because we do not have the vaccine anyway. Why not . Because we do not not have the vaccine anyway. Why not . Because we do not know not have the vaccine anyway. Why not . Because we do not know in i not have the vaccine anyway. Why not . Because we do not know in terms ofthe not . Because we do not know in terms of the effects, not . Because we do not know in terms of the effects, what not . Because we do not know in terms of the effects, what the not . Because we do not know in terms of the effects, what the immune of the effects, what the Immune System is already doing, how it is acting, so it is a more precautionary measure. I do not think there is Much Research on people having had the vaccine after contracting covid apart from what will come in the nearfuture because of having the vaccine and then later discovering you had covid, so for that reason it is a precaution in place. That reason it is a precaution in lace. ,. , , that reason it is a precaution in lace. ,. ,. , , place. Sue from lincolnshire is askint place. Sue from lincolnshire is asking how place. Sue from lincolnshire is asking how long place. Sue from lincolnshire is asking how long after place. Sue from lincolnshire is asking how long after having i place. Sue from lincolnshire is i asking how long after having the vaccine with a blood clot, if you develop one, show . How long after your vacation can you stop worrying about whether you will get a blood clot or not . I think that must mean vaccination, i beg your pardon. Like most people. Vaccination, i beg your pardon. Like most people. I vaccination, i beg your pardon. Like most people, i have been studying the papers and case reports, particularly things like the case series particularly things like the case series from germany and austria, and it is a series from germany and austria, and it is a very series from germany and austria, and it is a very small number of cases, but the it is a very small number of cases, but the typical pattern is that these but the typical pattern is that these are events that are popping up after the these are events that are popping up after the first of vaccine dose and spotted after the first of vaccine dose and spotted during the first seven to ia days spotted during the first seven to ia days so spotted during the first seven to ia days. So that is the kind of window are keeping an eye on things. So are keeping an eye on things. Sc fairly are keeping an eye on things. Fairly early are keeping an eye on things. Sr fairly early on. I have a question here from richard who is asking are all the cases are from the first dose . Any from the second . In the case series dose . Any from the second . In the case series i dose . Any from the second . In the case series i have dose . Any from the second . In the case series i have seen dose . Any from the second . In the case series i have seen are case series i have seen are published, they are all first dose, but i published, they are all first dose, but i do published, they are all first dose, but i do not know the details on every but i do not know the details on every single one of the 79 or so we have every single one of the 79 or so we have over every single one of the 79 or so we have over the whole of the continent of europe have over the whole of the continent of europe so far, so i could not tell you of europe so far, so i could not tell you about all of those. All riaht, tell you about all of those. Fill right, thank you. James from northumberland asks does this type of clot occur in people who have not had the vaccine and if so, how often . Is this something you have seen . ,. ,. , often . Is this something you have seen . , seen . Yes, this clot does happen, but it is thought seen . Yes, this clot does happen, but it is thought the seen . Yes, this clot does happen, but it is thought the risks seen . Yes, this clot does happen, but it is thought the risks at seen . Yes, this clot does happen, but it is thought the risks at the i but it is thought the risks at the moment, they are saying four in i million, is probably slightly higher than what you would see in a baseline population, so although it is there, the risk has been said that it is there, the risk has been said thatitis is there, the risk has been said that it is slightly higher with the astrazeneca vaccine. That it is slightly higher with the astrazeneca vaccine. Right, 0k, thank you astrazeneca vaccine. Right, 0k, thank you. Stephen astrazeneca vaccine. Right, 0k, thank you. Stephen asks astrazeneca vaccine. Right, 0k, thank you. Stephen asks if astrazeneca vaccine. Right, 0k, thank you. Stephen asks if you | astrazeneca vaccine. Right, 0k, thank you. Stephen asks if you have a low platelet count, is it safe to have the astrazeneca vaccine . 50. I have the astrazeneca vaccine . So, i think we are have the astrazeneca vaccine . So, i think we are entering have the astrazeneca vaccine . So, i think we are entering a have the astrazeneca vaccine . So, i think we are entering a phase where there think we are entering a phase where there will think we are entering a phase where there will be. I have seen already some there will be. I have seen already some quite there will be. I have seen already some quite detailed haematology guidelines going out that will look at all guidelines going out that will look at all of guidelines going out that will look at all of this, but you have to have your at all of this, but you have to have your individual discussion with your gp, but your individual discussion with your gp, but samara may correct me if im wrong, gp, but samara may correct me if im wrong, but gp, but samara may correct me if im wrong, but at gp, but samara may correct me if im wrong, but at the i think that is not on wrong, but at the i think that is not on the wrong, but at the i think that is not on the list of things that would make not on the list of things that would make it not on the list of things that would make it be not on the list of things that would make it be regarded as unsafe. Samara . Make it be regarded as unsafe. Samara . We make it be regarded as unsafe. Samara . ~. , � make it be regarded as unsafe. Samara . � ,. , samara . We havent seen patients who have not samara . We havent seen patients who have got other samara . We havent seen patients who have got other conditions samara . We havent seen patients who have got other conditions when samara . We havent seen patients who have got other conditions when they. Have got other conditions when they have got other conditions when they have a low platelet and we have been giving them astrazeneca vaccine providing it is not at a critically low level, but of course, with the new guidance, and bleeding disorders, whether they will be told they cannot have the astrazeneca vaccine, orshould they cannot have the astrazeneca vaccine, or should not, than with low platelets, in theory that can be a pleading issue, sol low platelets, in theory that can be a pleading issue, so i do not know whether that will come in, but there will be more detailed guidance in the coming days from the haematologist. A bleeding issue. And show you say from individual consent should talk to their gp . Absolutely and if they do have specific issues they can ask for advice from haematologists that the patients are under. Trier . R advice from haematologists that the patients are under. Patients are under. Very good to talk to you patients are under. Very good to talk to you both, patients are under. Very good to talk to you both, thank patients are under. Very good to talk to you both, thank you patients are under. Very good to talk to you both, thank you so i patients are under. Very good to talk to you both, thank you so much. You are watching bbc news. People diagnosed with covid i9 appear to be at greater risk of developing psychological and neurological conditions, including depression, psychosis and stroke. A study by Oxford University examined the Health Records of more than half a million patients in the United States and found almost all the main Brain Illnesses were more common in people whod caught the virus. Heres our Health Reporter rachel schraer. Coronavirus breaks into our cells and multiplies wherever in the body it finds itself. Thats why it causes such a wide range of symptoms from the lungs, to the gut, to the brain. The team at the university of oxford looked over half a million looked at over half a million Patient Records in the us to see if conditions affecting the brain were more common in those whod had covid. They looked at ia conditions including anxiety, depression and psychosis, stroke, brain haemorrhage, and dementia. All of these conditions were seen more often in people whod had a Covid Infection in the previous six months. But these conditions all have very different causes. It could be that in some people, the virus actually gets into the brain and causes some damage. It could be the way your body is reacting to the virus, produces a sort of immune or inflammatory response that, again, contributes to the problems. And for other people, it may simply be a psychological effect, if you like, of the stress that having covid and thinking what might happen to you next is the important factor. The study couldnt prove the virus itself was definitely causing the changes, but patients recovering from covid were more likely than similar people whod had flu or another infection to develop a psychological or neurological condition. And the sicker coronavirus patients had been, the more likely they were to develop these complications. Rachel schraer, bbc news. Brazil has recorded more than a,000 coronavirus deaths in 2a hours a grim record for the country. The Public Health system has been overwhelmed by a surge in the number of cases since the beginning of the year, as paul adams reports. Sobbing. Overcrowded hospitals, a Health System on the brink of collapse, and a population living in fear. Covids spotlight has ranged across the globe and now has brazil locked in its harsh glare. For the first time, the country has recorded more than a,000 covid related deaths in just 2a hours. Brazils death toll now stands at around 337,000 second only to the United States. Still behind both the us and britain in terms of death per capita, but a contagious new variant is fuelling the latest surge the death toll in march twice as high as the previous month. I think brazil now is not only the epicentre of the pandemic worldwide, its a threat to the entire effort of the International Community to control the pandemic on the planet. If brazil is not under control, the planet is not going to be under control its not going to be safe because we are brewing variants, new variants every week. The countrys defiant president , jair bolsonaro, continues to oppose a lockdown. Damaging the economy, he says, would be worse than the virus itself. Without citing evidence, hes linked Quarantine Measures with obesity and depression. Hes even tried to reverse restrictions imposed by local authorities. What we are facing here in brazil, what we have here, it is a sad situation that is the consequence of the lack of coordination in the federal level by the national government. We have here, it is president bolsonaro confronting governors and mayors. The government is under pressure. It knows the world is watching with a critical eye. The countrys new Foreign Minister says theres a balance to be struck. Translation this is urgent, and president bolsonaro has l instructed me to face this mission. I emphasise the urgency of health, the urgency of the economy, and the urgency of sustainable development. Scenes like this are undermining confidence in the government. The president says 2021 will be the year of vaccinations, but fewer than 10 of brazilians have had their firstjab. Some say much more drastic action is needed. Paul adams, bbc news. People living in cities have been urged to think twice before buying suvs which are meant for the countryside. The Motoring Organisation the rac says drivers should choose vehicles which are less polluting, when they dont Need To Plough across rivers or fields on their way to the shops. Research suggests most Sports Utility Vehicles are now bought by people who live in urban areas, particularly london. Roger harrabin reports. Axa wheel drive cars are officially called suvs, Sports Utility Vehicles. To people who hate their bulk on city streets, there is a less respectful title chelsea tractors. New Research Shows that most of them are indeed bought in kensington and chelsea, Hammersmith And Fulham and westminster, london boroughs where wealthy residents can afford the prices. It is a far cry from the origins of the chelsea tractor, the Humble Workhorse land rover, loved by farmers, Country Dwellers and the military. Their appeal has spread into the towns. Two thirds of these cars are being sold to People Living in cities where there are no opportunities to drive off road. So actually, our call is not so much to consumers to think twice. What we are asking for is for these vehicles to stop being advertised in the uk. It is part of a trend towards bigger cars that has kept Carbon Emissions from transport unacceptably high. The classic mini, for instance, was 3. 05 metres long. The new version mini is 3. 82 metres long. Compare the huge mercedes gls. It is 5. 21 metres. And beasts like this are too big for a conventional parking space. If suv drivers were a country, they would be seventh in the world for Carbon Emissions. People choose different cars for different reasons. It might be style. It might be safety. It might be seating position. Indeed, it might be size. If people have got a big family, they want a bigger car. If they want to tow things, they might need a bigger car. But not all suvs are big and dirty. Some of the cleanest cars are now coming in the style of suvs. That means electric suvs, although they are only part of the solution. They waste energy, dragging tonnes of steel with heavy batteries through city streets, like this electric hummer, based on an American Army truck. It is a beast. Banning advertising for suvs would help, campaigners say, just as adverts for smoking are banned. It wont work, motoring groups warn. They say people buy suvs for all of the space inside and because they are good to drive. Roger harrabin, bbc news. Now its time for a look at the weather with nick miller. Hello. And more clout around than many of us have seen of the past couple of days. Despite the cloud, most places looking dry, just a few snow showers are peppering the north and north east of scotland. Rain edging and it was a Northern Ireland as we get into this evening, temperatures still very much rooted into single figures. Summit less cold air moving in from the antiquity cloud and rain into Northern Ireland, into Western Scotland, parts of wales and the western side of england overnight. Towards the south and far east, here is where there are still some clear spells, still a fast going into tomorrow, just not as cold as it has been over the last few nights. A frost. Tomorrow soaking wet into north west scotland, patchy rain elsewhere for Northern Ireland, england and wales. Westerly winds are introducing less cold air, damages for some back into single figures. That will not last very long because again by the weekend. This is bbc news, im reeta chakrabarti. The headlines. People under the age of 30 in the uk are to be offered an alternative to the Astrazeneca Covid vaccine, because of evidence linking it to extremely rare blood clots in a very small number of cases. This is of course change. It is based on a clinical preference based on newly emerging data. It will be kept under very careful review of. The eu drug regulator also updated its guidance, concluding that unusual blood clots should be listed as a very rare side effect. Both the european and uk regulators agree that the benefits of the Astrazeneca Jab heavily outweigh the risks. Also tonight. The uk now has its third Coronavirus Vaccine. The first doses of the Moderna Vaccine have been given