FSRH press release: FSRH issues updated guidance on use of combined hormonal contraception, the Astra Zeneca COVID-19 vaccine and risk of blood clots

The Joint Committee on Vaccination and Immunisation (JCVI) has advised a preference for adults aged 30 to 39 without underlying health conditions that predispose them to severe COVID-19 infection to receive an alternative to the Oxford/AstraZeneca COVID-19 vaccine.

• Following this announcement, today we issue updated advice on safe and effective contraceptive care for users of combined hormonal contraception (the combined pill, the transdermal patch and the vaginal ring) in relation to the AstraZeneca COVID-19 vaccine and risk of blood clots.

• Our recommendation remains the same: based on current evidence and JCVI advice, we do not recommend that combined contraceptive users stop their contraception when they receive their first or second COVID-19 vaccine.

• Currently, there is no evidence that ongoing or very recent use of combined hormonal contraception affects risk of this specific type of blood clot with low platelets occurring after the first dose of the AstraZeneca COVID-19 vaccine.

Dr Sarah Hardman, Director of the Clinical Effectiveness Unit of the Faculty of Sexual and Reproductive Healthcare (FSRH), said:

“A few cases of a specific type of blood clot with low platelets have been reported after Astra Zeneca COVID-19 vaccination. The risk of this type of blood clot is very low. The JCVI recommendation follows a precautionary approach taking into account the current UK context.

“I have seen users of the combined contraceptive pill share concerns on social media about increased risk of getting blood clots after the Astra Zeneca COVID-19 vaccine because of their pill.

“There is a small increased risk of blood clots - but not this specific, rare type of clot with low platelets - whenever anyone uses the combined contraceptive pill, but this risk is much smaller than the risk of blood clots occurring in pregnancy. We don’t know that being on the combined contraceptive pill makes any difference at all to the risk of the rare type of blood clot with low platelets happening after the AstraZeneca COVID-19 vaccine.

“Being vaccinated protects against COVID-19 infection and the very serious health problems that it causes. The risk of being seriously ill with Covid-19 infection is much greater than any risk with the AstraZeneca vaccine and I encourage people to go for vaccination when it is offered.

“We do not recommend that combined contraceptive pill, patch or vaginal ring users stop their contraception when they receive their COVID-19 vaccination. It will not help and will put them at risk of unplanned pregnancy.

“However, if women are still concerned about the risk of blood clots in general, they can always consider switching to one of the other effective types of contraception that do not affect blood clotting risk.

“As a precaution, after their vaccine, people should look out for any symptoms of blood clots like persistent headaches, breathlessness, coughing up blood, swelling of a leg or severe abdominal pain.”

ENDS

For further information, please contact: Camila Azevedo, FSRH External Affairs Manager, at cazevedo@fsrh.org / 07379408587

Notes to Editors

• The updated FSRH guidance on the Astra Zeneca COVID-19 vaccine, combined hormonal contraception and blood clots can be found here
• The JCVI has advised a preference for adults aged 30 to 39 without underlying health conditions to receive an alternative to the Oxford/AstraZeneca vaccine – where available and only if this does not cause substantial delays in being vaccinated. This follows the decision on 7 April to offer a preference for adults aged under 30. You can read more about the JCVI announcement here.

About FSRH
The Faculty of Sexual and Reproductive Healthcare (FSRH) is the largest UK professional membership organisation working at the heart of sexual and reproductive health (SRH), supporting healthcare professionals to deliver high quality care. It works with its 15,000 members, to shape sexual reproductive health for all. It produces evidence-based clinical guidance, standards, training, qualifications and research into SRH. It also delivers conferences and publishes the journal BMJ Sexual & Reproductive Health in partnership with the BMJ.