If The Contraceptive Pill Is Safe For Under 30s, The AstraZeneca Vaccine Should Be Too
This week, the UK’s drugs regulator said people under 30 should be offered an alternative to the AstraZeneca coronavirus vaccine where possible because of ‘extremely small’ risks related to the jab.
The recommendation comes following 79 reports of blood clots accompanied by low blood platelet count out of the 20.2 million doses of the COVID-19 AstraZeneca vaccine that had been given in the UK by March 31. Of these cases, 19 people died, though the cause has not been established in every case.
Five of those who died had thrombosis, while the other 14 had cerebral venous sinus thrombosis (CVST), a specific type of clot that prevents blood from draining from the brain. Three of those who died were under the age of 30.
In a press release, the UK’s drugs regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), said a review had concluded that evidence of a link between the cases and the AstraZeneca vaccine is stronger but more work is still needed.
The risk of blood clots works out to about four in one million of those who receive the vaccine; which works out to one in 250,000, or 0.0004%. Following the review, the MHRA continued to stress the benefits of vaccination strongly outweigh the risks.
The risk of getting a blood clot with the combined contraceptive pill is, comparatively, much higher than the risk with the AstraZeneca vaccine – but it’s still considered safe for young women to use.
I began taking the combined contraceptive pill when I was 16 years old. Eight years on, it’s still the first thing I do each and every morning.
I’d like to think the doctor who prescribed me the pill discussed all the risks involved before I started it, though admittedly I can’t remember for sure. The risks are outlined in an information leaflet in the box, and while blood clots are discussed in detail, I had such little trouble getting the pill that I never really worried about it harming my health.
Millions of women and young girls will be able to relate to my experience, and there has seemingly never been much public attention surrounding the risks involved with the pill.
That changed, however, when reports emerged that the AstraZeneca vaccine had been linked to a handful of blood clots. It’s only a 0.0004% chance, but it was enough to get people talking.
Estimations by NHS GP Margaret McCartney, cited by Sky News, suggest the risk of getting a blood clot while on the combined oral contraceptive pill is about five per 10,000 women per year, or 0.05%, while WebMD puts the risk for getting clots at ‘about 0.3% to 1% over 10 years for a woman on the pill’.
In the US, the National Blood Clot Alliance estimates the risk of women who are taking birth control pills getting a blood clot is 0.1%.
The risk further appears to vary depending on the pill being used, with Levest stating that 30-40 women out of 100,000 may have a blood clot in a year on ‘a pill like Levest’, equating to 0.03–0.04%, while 9–12 out of every 10,000 women, or 0.09–0.12%, taking Millinette are at risk.
Though the exact percentage varies, one thing is clear: the risks of the AstraZeneca vaccine are much lower than those with the combined pill. However, with so much attention on the vaccine to help us escape the pandemic, that small, small risk prompted enough concern for the authorities to take action.
Speaking to UNILAD, pharmacist James O’Loan of Chemist4U explained the decision to recommend an alternative to AstraZeneca comes because the risk of serious illness or death from coronavirus is low in those under the age of 30. This means there is no point potentially putting young adults with no underlying health conditions at extra risk with the AstraZeneca vaccine when there is an alternative available.
The hesitation to give the AstraZeneca jab to under 30s may place doubt in the minds of people who are yet to have the vaccine, but as doctors have long deemed the contraceptive pill more than acceptable to give to people under 30, there should be no reason why people should allow the small risks to put them off getting what otherwise could be a lifesaving vaccine.
James explained that when it comes to the pill, the risk of blood clots is still rare, and the benefits far outweigh the risks that come with taking it. He also noted that people do have choices on the pill, with some posing a lower risk of blood clots such as the progestogen-only pill or ‘the mini pill’, or a low dose of the combined pill.
However, it seems that if a 0.0004% risk of blood clot really is enough of a risk to warrant the recommendation of an alternative option, then one would assume the risks that come with the combined pill are not acceptable either. If this was the case, health bodies need to address it.
Eleanor Lee, a 23-year-old journalist from Bedfordshire, was prescribed the contraceptive pill when she was 16 years old. She doesn’t recall being told about the risk of blood clots from her GP, but she was aware of the risks through conversations with her family and friends. Still, she didn’t think too much about it, and assumed the chances were rare.
More recently, Eleanor was given the AstraZeneca coronavirus vaccine. She told UNILAD she ‘wasn’t told of any blood clot risks’ when getting the vaccine, but had heard stories on news reports. In spite of this, she ‘wasn’t worried about going to get it’ and knew that she was ‘at more of a risk developing and getting ill from COVID-19 if [she] didn’t have the vaccine’.
When people started to draw further attention to the risk of blood clots with the vaccine, Eleanor felt angry they were being ‘reported with such priority’. She admitted it was a ‘tiny bit worrying’ to think she could be at a greater risk of a blood clot, but knew it was important for her to get the vaccine to help prevent her from getting coronavirus, and that ‘the risk of blood clots was even greater when [she] was on the pill.’
Even now that the MHRA has recommended an alternative to AstraZeneca for under 30s, Eleanor says she ‘would still go and get the vaccine’. She acknowledged that offering an alternative is good for those who may be particularly worried about receiving the AstraZeneca jab, but also pointed out that ‘offering an alternative adds to the scaremongering’, describing it as a ‘catch 22’.
Eleanor strongly believes that people should not be put off from getting the vaccine due to the reported risks, and stressed that the chances of catching coronavirus and becoming seriously ill, or even dying from the virus, are greater than the risk of developing a blood clot.
She added: ‘The figures are ridiculously tiny and don’t really waiver from the standard figures of blood clot developments without the vaccine. Girls and women have been put at a much higher risk of blood clots for YEARS now and no authority has stepped in to care or monitor, so this tiny risk is not worth risking your health over and skipping the vaccine.’
James acknowledged the decision to recommend alternatives to AstraZeneca may cause concern for some people, but he stressed that we should ‘trust the regulating bodies’, emphasising that ‘all vaccines that are now in use have been approved and deemed safe’.
Though blood clots may be a small risk of the AstraZeneca vaccine, James added that coronavirus ‘has far worse side effects and complications than any vaccine, including serious blood clots’.
Given how prevalent and transmittable this virus is, you’re more likely to get a blood clot from having the virus rather than having the vaccine. Although the cases of blood clots are worrying, the numbers are very small, and millions of people have been vaccinated without any ill effects or complications. Getting vaccinated can actually help to prevent blood clots or other serious complications from coronavirus.
James highlighted the importance of the vaccination in helping to stop the spread of the virus, to protect those who are most vulnerable and ease the strain on our NHS services, though it is worth noting that in the wake of the MHRA recommendations, many people under 30 who were scheduled to received the AstraZeneca vaccine have had their appointments cancelled – including people who are on the pill.
Many of those who have had their appointments cancelled have expressed their frustration at the situation, indicating there are people under 30 who are still more than happy to get the AstraZeneca vaccine, and that a 0.0004% risk should not warrant that choice to be taken away.
With the coronavirus vaccine playing such a vital part in the UK’s return to normal life, it seems nonsensical to limit the options that are available for a large portion of the country – especially if people are aware and informed of the risks.
Though we can appreciate the thought process behind the MHRA’s recommendation, if the combined contraceptive pill is deemed safe for people under the age of 30, as has been the case for years, then the AstraZeneca vaccine should be, too.
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