Pakistan’s national health ministry has released guidelines for the AstraZeneca COVID-19 vaccine which say that people below 40 years should not get the shot.

The guidelines add that safety data for this age group is still pending.

The health ministry advises against the vaccine for anyone with:

---A history of severe allergic reaction to any vaccine component (polysorbate)

---Blood clotting episode after the first dose of the AstraZeneca vaccine

---Active gastrointestinal bleeding or seizures

--- A history of heparin-induced thrombocytopenia (low platelets) and thrombosis (clotting)

A history of a major blood clot and decrease in levels of platelets after receiving any COVID-19 vaccine

The decision follows reports in some countries of rare blood clotting events in people, especially those below 50 years, after receiving the vaccine.

Trust in AstraZeneca’s coronavirus vaccine also fell in many European countries.

The Global Advisory Committee on Vaccine Safety released a statement on the AstraZeneca-Oxford vaccine on April 16:

“A very rare new type of adverse event called Thrombosis with Thrombocytopenia Syndrome (TTS), involving unusual and severe blood clotting events associated with low platelet counts, has been reported after vaccination with COVID-19 Vaccines Vaxzevria and Covishield.”

Vaxzevria and Covishield are different brand names of the AstraZeneca shot.

“Based on latest available data, the risk of TTS with Vaxzevria and Covishield vaccines appears to be very low,” the statement adds.

UK data suggests the risk is approximately four cases per million adults (1 per 250 000), while the rate is approximately 1 per 100 000 in the European Union.

“Countries assessing the risk of TTS following COVID-19 vaccination should perform a benefit-risk analysis that takes into account local epidemiology (including incidence and mortality from COVID-19 disease), age groups targeted for vaccination and the availability of alternative vaccines.”

GACVS added that further research is needed to understand the age-related and sex-related risks of the AstraZeneca jab.

Who can receive the AstraZeneca vaccine

The national health ministry recommends the shot for:

---People over 40 years

---Those with diabetes, hypertension, heart disease and other stable chronic disorders

---Those with mild COVID-19 once the isolation period is complete

---Those with severe COVID-19 once they become stable

---Chronically immunosuppressed people, though efficacy may be lower

The AstraZeneca-Oxford vaccine has two doses which will be given 12 weeks apart.