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Read this thread with interest. 53, asthmatic from early childhood. Hospitalised twice while at Uni. Switched to Symbicort 12 years ago which made a massive difference to management. Rarely take Ventolin. Asthma check every year at GP. So fairly sure they know I'm on the good side of mgt (peak flow is okay, BP is low, weight is fine, pretty fit generally, etc)
I tell you all this because yesterday I received a text offering me a vaccine next week. I live in Herefordshire which has a very ageing population, so I was very surprised. Checked with my surgery to make sure it wasn't spam, and they told me they're offering it to anyone on their books who is flagged with any kind of chronic respiratory disease regardless of management.
Don't want to get anyones hopes up, but thought it was worth sharing.
Sounds like leaving it to individual GP practices or groups is leading to a multitude of different interpretations of fairly vague guidance. Some extremely mild asthmatics will be offered jabs from now on, while some who, like me, probably has a course of systemic steroids once a year or so, are maxed out on dosage of three drugs, and were asked to shield last year, are still waiting to find out...
Just another NHS postcode lottery.
Yeah that's a rubbish situation for you Martin. I didn't hesitate to get booked in once I'd spoken to the surgery. I did ask if was the same for all of Herefordshire, but they could only speak for their practice.
Also when I booked in there were LOTS of slots on Weds, Thur and Fri.
I'm pretty sanguine about it TBH. Even once I get one, my wife is a mildish asthmatic (in her 40s) and I won't be able to change behaviour until she is jabbed nearer the summer. Just seems like another case of pisspoor messaging. There are millions of asthmatics out there who will be wondering what's going on.
Thanks @sofaman. Apparently I should have already had my invite, then.
Pretty narrow pool of potential group 6 patients. Asthmatics without isolated history of severe or prolonged exacerbation won't be prioritised. Also possible that there will be plenty with equally bad episodes who were managed successfully in primary care without the need for either admission or so many consecutive steroid courses. Is that a normal prescribing pattern for severe episodes?
My mate's wife and son have been given a date for vaccination - both have asthma, although the son has 'grown out of it'.
The other thing that concerns me about the Asthma UK info is that it hasn't necessarily been disseminated to GPs - what status does it have? Doesn't matter what clarification they've been given, if it is not communicated to those placing patients into priority groups, nothing will change.
The other thing that concerns me about the Asthma UK info is that it hasn’t necessarily been disseminated to GPs – what status does it have? Doesn’t matter what clarification they’ve been given, if it is not communicated to those placing patients into priority groups, nothing will change.
Their message today just reflects the jcvi green book guidance really, ie systemic drugs and hospital visit.
The 'hospitilization' bit is pretty vague however. How long ago does the hospitilization have to have been?
Alex seems to have well controlled asthma yet 30 years ago went to hospital, which makes him eligible for vaccination. Yet folk I know have flare ups at slightest cold, on multiple drugs, yet haven't ever been hospitalized, so don't qualify. That's obviously ridiculous.
Then you have fossy's example, where someone, presumably young, and has grown out of their asthma gets a jab.
Alex seems to have well controlled asthma yet 30 years ago went to hospital, which makes him eligible for vaccination. Yet folk I know have flare ups at slightest cold, on multiple drugs, yet haven’t ever been hospitalized, so don’t qualify. That’s obviously ridiculous.
I would completely agree. Surely it'd be better to look at last 3-5 years! Although having done a bit of work on NHS data integration, I'm not convinced all my prior data would have survived multiple NHS system transitions... I've neer mentioned those episodes to my current practice.
https://twitter.com/asthmauk/status/1360545639113912320
This seems slightly different though. I've not seen 'shielding letter = jab' expressed so clearly before. Also the '3 courses of steroids in 3 months' seems to be a definition of 'regular systemic steroids' we've not had before.
I was hospitalised for pneumonia/asthma about 10 years ago. My wife was hospitalised when she was a child with it. Does that count as an asthma exacerbation?
Also, when they say 'shielding letter', do they mean recently? I had one in the first lockdown, another saying I was clinically extremely vulnerable in the second, but nothing this time around.
Also, when they say ‘shielding letter’, do they mean recently? I had one in the first lockdown, another saying I was clinically extremely vulnerable in the second, but nothing this time around.
I fail to see how they could possibly argue that you aren't eligible if you've had a shielding letter at some point.
All nhs sites still saying non severe asthma is a risk factor, they really need to change that asap. It's one of the reasons everyone is so pissed off, many saw the guidance and voluntarily shielded, and up until days ago had assumed they were part of group 6. The government even published an 'easy read guide on vaccination' start of Jan, which specifically said that inhaled steroids was the inclusion criteria. Expectations have been set so people see this as a massive uturn
The data used for defining criteria is based on deaths. I've always been pretty confident I ain't going to die with covid so whilst reassuring to hear, what we really want to know is what is the additional risk to asthma sufferers of more severe disease, and how will it affect our asthma post covid.
It stands to reason that if you have compromised lungs to begin with, a disease which can permanently reduce lung function ain't good for asthmatics, and lots of people saying their asthma is far worse after covid ( including a fella on main thread). Likewise studies show that long covid is more prevalent in asthma sufferers.
Lots of disappointed asthma sufferers today, although i had seen this coming for a while so not remotely surprised.
I fail to see how they could possibly argue that you aren’t eligible if you’ve had a shielding letter at some point.
Well, the NHS booking site for jabs invites applications from 'clinically extremely vulnerable', which is the phrase used in the shielding letter first time around. So I went through the process this afternoon, but it punted me back out saying I didn't qualify. So perhaps the goalposts have been shoved along a bit.
I guess I'll have to bother my GP about it after all.
I'm getting my jab tomorrow. I was very surprised to get the message (46yo, fairly fit and healthy with mild asthma that's well controlled with Clenil and Ventolin). My in-laws with various health conditions only got theirs last week. I'm in London.
So perhaps the goalposts have been shoved along a bit.
Are you talking about group 4 or group 6 eligibility?
If we are talking asthma here, yes the goalposts have moved, but surely not to the extent that someone who was told to shield previously is now not going to get a jab in group 6..? Id be on to the gp first thing Monday if I was you.
I'm miles off shielding level, so not in same boat as you at all.
I’m getting my jab tomorrow. I was very surprised to get the message (46yo, fairly fit and healthy with mild asthma that’s well controlled with Clenil and Ventolin). My in-laws with various health conditions only got theirs last week. I’m in London.
So basically exactly the same as me (although id say mine is moderate based on peak flow, same drugs though), yet I'll be waiting until 2nd half of year most probably.
And people question why some asthmatics are slightly pissed off by the whole thing!
If we are talking asthma here, yes the goalposts have moved, but surely not to the extent that someone who was told to shield previously is now not going to get a jab in group 6..?
As you point out, the differences between group 6 and group 4 are pretty minimal. Both definitions are very much at the very severe end of the asthma scale. I was put in the shielding category primarily because of the high dosages I was on rather than any hospitalisations/steroid blitzes, and if that has been jettisoned as a marker of severity, I could be in the waiting room with the moderates and milds.
I certainly don't meet the 'revised' clinical definitions for group 4, so I'm surprised to see the statement that everyone who has been asked to shield should qualify. My view is that this is some Department of Health chat which will be walked back fairly rapidly next week.
I have asthma and as I (now) work in NHS was lucky enough to have had my jab mid January. I also had a positive antibody test and believe I had Covid last March. I have recurrent episodes of unusually tight chest and hurts when I work hard (and asthma normally well controlled), initially roughly every 4-5 weeks after (believed) initial virus. Beginning of Jan getting increased chess tightness/soreness and has chest X-ray 2 weeks ago. Luckily clear, and GP has increased my steroid dose. I'm convinced my asthma has been affected by Covid, or it's some aspect of long Covid.
I’m convinced my asthma has been affected by Covid
Tons of people are saying the same thing, and it's not really surprising given nature of covid is it
Chat now is of asthma uk lobbying to get asthmatics vaccinated at the start of the 2nd phase, based on evidence of more severe illness and long covid. Given they seem pretty useless I'm not holding my breath ( pun intended) that they'll get anywhere with that.
I’m convinced my asthma has been affected by Covid
I'm increasingly convinced I had Covid back in September, just after the kids went back to school. One day of mild symptoms, but my asthma has not been as well controlled since, and was really bad over Christmas. @Clink - I was prescribed Montelukast after the latest episode, and it appears to have made a difference. Might be worth asking to give it a try if you're struggling. Coincidentally, Montelukast has been touted as a possible 'long Covid' drug, not just for asthma.
@Clink – I was prescribed Montelukast after the latest episode, and it appears to have made a difference. Might be worth asking to give it a try if you’re struggling.
Thanks for that, if it doesn’t improve I’ll ask my GP.
Some extremely mild asthmatics will be offered jabs from now on, while some who, like me, probably has a course of systemic steroids once a year [...]are still waiting to find out…
Most surgeries are using the following determinations on their population searches
1. Has diagnosis of asthma -YES
2. Has been prescribed asthma medication in the last 12 months -YES
3. Aged between 16-64 -YES
You're in group 6
The other thing that concerns me about the Asthma UK info is that it hasn’t necessarily been disseminated to GPs – what status does it have?
None
Just gave a skim read of the study which defined the criteria for the priority groups, and how they came up with the fact that asthmatics are apparently at no greater risk of death, and as far as I can tell there is a fairly large flaw.
Asthmatics seem to have been grouped as one population, rather than being defined by severity. The study shows death rates amongst those who got covid and have asthma. But stands to reason that this would be massively skewed towards those asthmatics with a very mild form of the disease who have therefore not been taking the same precautions to avoid contracting it.
All the guys like Martin who were initially told to shield (And the data is from first wave so that's important to note) would be taking social distancing far more seriously, and as such more severe forms of asthma would be underrepresented.
seems to have well controlled asthma yet 30 years ago went to hospital, which makes him eligible for vaccination.
It doesn't work like that. The difference for when you get a call is more likely to be how quickly the vaccination site is getting through the priority groups above group 6, and the availability of vaccine. Where I work, we've paused as we're already through groups 1-5. we're having to wait for other sites near us to catch up. In other parts of the country where the elderly population is larger, are still working their way through those groups.
Just gave a skim read of the study which defined the criteria for the priority groups, and how they came up with the fact that asthmatics are apparently at no greater risk of death, and as far as I can tell there is a fairly large flaw.
Asthmatics seem to have been grouped as one population, rather than being defined by severity. The study shows death rates amongst those who got covid and have asthma. But stands to reason that this would be massively skewed towards those asthmatics with a very mild form of the disease who have therefore not been taking the same precautions to avoid contracting it.
All the guys like Martin who were initially told to shield (And the data is from first wave so that’s important to note) would be taking social distancing far more seriously, and as such more severe forms of asthma would be underrepresented.
This is true. I've been in fewer than five shops since last February and am still washing all my food deliveries...and may have caught it anyway!
You would hope that they would manage to find a way to analyse the data to avoid this kind of confounding.
It doesn’t work like that. The difference for when you get a call is more likely to be how quickly the vaccination site is getting through the priority groups above group 6, and the availability of vaccine.
I don't think that's the case. I wont be getting an invite in group 6 regardless of how quickly my local site get through the groups as i dont meet the criteria now the goalposts have been changed.
Asthma uk are giving out very clear criteria for group 6 which has come after extensive clarification from government. If you have had steroid tables 3 times in 3 months, or have 'ever' had a hospital admission you make it into group 6. Anyone else will be vaccinated after the first 9 groups.
Someone even queried if this included childhood admission many years ago and asthma uk responded yes.
I don’t think that’s the case. [...] i dont meet the criteria now the goalposts have been changed.
We haven't changed our criteria for Group 6, and we've not been asked to change them. In our PCN we're inviting folks as I've described above, and I know of large amounts of GP practices that are using the same searches we are. If you were a pt at our surgery, (and like Alex) you'd be getting a text.
TBH though, we're getting through this pretty quickly, it'll only be a matter of weeks before you'll meet the criteria for group 9 anyway. so it'll probs not make a massive difference either way.
Asthma uk are giving out very clear criteria for group 6 which has come after extensive clarification from government.
TBH, I don't care what Asthma UK are saying...Or what the Govt have clarified...We downloaded our searches as a package weeks ago, (when we started the vaccine programme)
Got my jab this morning, but actually I don't think I got it due to my asthma. I think it's more likely because I'm registered as a carer for my daughter. Sorry for getting up the hopes of other asthmatics!
I'm 49 with sports induced asthma and I've had my covid invite this morning. I'm booked in for my first jab on Wednesday. Midlands based.
So why the inconsistency then? Why am I being told I'm definitely not getting in group 6, and likewise why are loads of other people with asthma way worse than me getting told the same thing?
And if you were in our shoes, what can we do about it?
And then we have this..
https://twitter.com/RobT049/status/1360703434417135618?s=19
Edit..no idea if that screenshot is genuine tbf
So why the inconsistency then? Why am I being told I’m definitely not getting in group 6
Because: Humans. As a PCN we've all agreed to use the same imported searches (Ours are from Ardens, the group that provides searches for EMIS and System One which are our in house systems for pat management), so there's consistency. I know other GP practices who're aren't using the same searches, or it's some-ones job in the Practice to do the searches manually. so there's always going to be inconsistencies.
And if you were in our shoes, what can we do about it?
we have a list of folk who have asked for a call should there be any spaces. Perhaps your surgery has something similar? As for that tweet, we've also had to cancel clinics through lack of staff (esp on a Sunday) we don't look through the list an cancel folks if they have Asthma
My 24 year old daughter got hers in Chester this week. She has mild seasonal asthma but has been prescribed medication for it within the last year so I guess that's how she qualified. I'm 60 with no health issues and I've got my vaccination appointment next week. Guess they are smashing through the lists in our area.
My 24 year old daughter got hers in Chester this week. She has mild seasonal asthma but has been prescribed medication for it within the last year so I guess that’s how she qualified. I’m 60 with no health issues and I’ve got my vaccination appointment next week.
I'm very envious of this sort of thing. I've got asthma but I'm 65 so moving asthmatics to group 6 makes no difference to me, but our PCN says:
We will be moving to priority group 5, 65-70 years old, as soon as vaccination slots are available to us.
We are expecting vaccine supplies to fall nationally in the coming weeks so are not able to provide any further information on when this will be
Mrs R has a condition more serious than asthma but doesn't know if she's in group 6 or 7 - it's not just asthmatics that have unclear guidance - so I'm assuming I may get a vaccine by the end of March and she's assuming April. Got to manage your expectations and all that...
we have a list of folk who have asked for a call should there be any spaces. Perhaps your surgery has something similar?
Worth a shot, need to call them about some blood tests next week so can ask then. Thanks.
@tpbiker - saw this and thought of you...
https://www.bbc.co.uk/news/health-56069455
Looks like my wife might be prioritised as she spent a week in hospital about 3/4 years ago due to an asthma attack.
Yep that reflects exactly what everyone found out at the weekend. Tbh it reflects what was always in the jcvi so not a surprise to me. But it was very surprising to alot of folks judging by the outrage on Twitter.
Whilst the data the decision has been based on (deaths) is fundamentally flawed for asthma (as it doesn't take into account severity and social distancing), the focus now should be on getting us all priority in the next phase. The government themselves have identified that the only medical condition associated with long covid are lung conditions including asthma, so hopefully they will take this into account, along side the key workers who I fully expect to also (rightly) get priority.
Just had the email which includes the official letter from nhs England advising only asthmatic patients with previous admissions or continuous oral steroids should be in group 6. Unlike nickc and lots of other practices we don’t use ardens for our searches so I expect someone at the medicines management team at our ccg will construct a search which will only invite these patients. However our clinical system (emis) is still telling me that patients with any regular meds for asthma are in group 6. So you can see why there is confusion. All caused by lack of clarity from the centre. Someone on R4 this morning trying spin that it was good news for all those millions of asthmatics under 50 who now are at the back of the queue.
They do like to make things difficult for us all!
Someone on R4 this morning trying spin that it was good news for all those millions of asthmatics under 50 who now are at the back of the queue
Asthma uk tried to put that spin on it to us to. It did not go down well with their supporters as you can imagine!
Frustrating, especially as from what I've seen loads of asthmatics no worse than me are getting the jab, but it is what it is. Certainly not the practices fault, clearly you guys are getting mixed messages as well.
Asthma UK have certainly dropped a bollock with their 'anyone asked to shield will get one' tweet over the weekend. Poor comms from them, they should have got it in writing before spouting off. But generally just poor comms overall from NHS England to both the public and practices, as usual.
One other issue is what qualifies as a hospital admission - normally there is some kind of trigger for a massive asthma exacerbation - a chest infection or allergic reaction. I was hospitalised for pneumonia about 10 years ago, does that count?
getting mixed messages
We get no messages other than what’s already been leaked to the press. Hence I found out this was an issue here on STW
At our regular meeting here our PCN clinical director saw no reason to exclude asthma suffers from Group 6. His reasoning was (to my mind) pretty sound, group 6 are those folk who’d normally get a flu jab in winter, it seems counter productive therefore to exclude them from a different respiratory disease just on the grounds of severity. We’ll continue to invite all asthma suffers in our PCN for a COVID vaccine. Any official instruction to change that better come in the next few days otherwise we’ll have jabbed them already!
I've just had my vaccination offer cancelled, i'm quite pleased as it means i am too young at this stage.
His reasoning was (to my mind) pretty sound, group 6 are those folk who’d normally get a flu jab in winter, it seems counter productive therefore to exclude them from a different respiratory disease
Exactly, although it looks like you guys are in the minority taking this approach....and I wonder how many asthmatics will be thinking why bother getting a flu jab next year if I'm apparently not severe enough to get a covid vaccination.
I’ve just had my vaccination offer cancelled, i’m quite pleased as it means i am too young
I've heard of a few folks this has happened to. I think if you've been offered one already it's pretty poor to be rescinding the invite.
Ffs..
Someone asks the vaccine minister why the change. He categorically states that if you have an inhaler you are in group 6..completely contradicting advice of last 24 hrs
This despite the likes of @docrobster receiving guidance to the contrary from nhs england only today
They really need to get their act in order here, the mix messages are completely unfair.
I've just booked in for a vaccination, had anyone else been offered one?
I'm 34, take steroid inhaler twice a day and was hospitalised when I was a small child a couple of times. Last asthma attack was 10 years ago now, since then I've followed the now wife's advice to actually take my inhaler.
I half expect to have been scammed or to be turned away at the door.
Oh based in Greater Manchester too.