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

Posted 9 April 2021

Date: 09 Apr 2021

Type: FSRH Press Releases and Statements

Yesterday, the UK regulator of medicines and medical devices, the Medicines and Healthcare products Regulatory Agency (MHRA), issued new advice concluding a possible link between the COVID-19 Vaccine AstraZeneca and extremely rare, unlikely to occur blood clots. In response, we have issued guidance for healthcare professionals to provide safe and effective contraceptive care for users of combined hormonal contraception (the combined pill, the transdermal patch and the vaginal ring).

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

“People are at increased risk of thrombosis whenever they use combined hormonal contraception (CHC). Many people choose to accept that risk to get the benefits of combined hormonal contraception like lighter, predictable periods and improved acne, as well as effective protection against unplanned pregnancies. If they want to avoid increased risk of thrombosis, they can choose to use one of the other effective methods of contraception instead.

“A very few cases of a rare specific type of thrombosis have been reported after the Astra Zeneca COVID19 vaccine. We do not yet know for certain that these were caused by the vaccine. They are rare cases, and we do not know that being on combined hormonal contraception makes any difference at all to the risk of them happening.

“Having the COVID19 vaccine protects against COVID19 infection and the very serious health problems that it causes – including thrombosis and many others. If someone delays their vaccine, they stay at risk of those serious health problems for longer.

“Based on what we know, we recommend that people, including combined hormonal contraception users, attend for their COVID19 vaccination when it is offered, and do not delay it to wait for a specific type of vaccine.

“Combined hormonal contraception users should not stop using their contraceptive pill, patch or vaginal ring when they are called for vaccination – it will not help, and will put them at risk of pregnancy. Of course, if people want to switch to a different method of contraception because they do not want to be at increased risk of thrombosis in the future, they can do that.

“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.”


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

Notes to Editors

  • The new FSRH guidance on the Astra Zeneca COVID-19 vaccine, combined hormonal contraception and blood clots can be found here
  • The MHRA’s scientific review of UK reports of extremely rare and unlikely to occur specific blood clots with lowered platelets has concluded that the evidence of a link with COVID-19 Vaccine AstraZeneca is stronger but more work is still needed. The data suggest there is a slightly higher incidence reported in the younger adult age groups and the MHRA advises that this evolving evidence should be taken into account when considering the use of the vaccine. You can read more about the MHRA announcement here
  • The MHRA is now issuing updated guidance for healthcare professionals on how to minimise risks, as well as further advice on symptoms for vaccine recipients to look out for 4 or more days after vaccination
  • The Joint Committee on Vaccination and Immunisation (JCVI) have also published a statement following reports of an extremely rare adverse event after vaccination with the first dose of the AstraZeneca COVID-19 vaccine. This includes information on the use of the vaccine in those under 30.
  • JCVI has weighed the relative balance of benefits and risks and advise that the benefits of prompt vaccination with the AstraZeneca COVID-19 vaccine far outweigh the risk of adverse events for individuals 30 years of age and over and those who have underlying health conditions which put them at higher risk of severe COVID-19 disease. JCVI currently advises that it is preferable for adults aged <30 years without underlying health conditions that put them at higher risk of severe COVID-19 disease, to be offered an alternative COVID-19 vaccine, if available. People may make an informed choice to receive the AstraZeneca COVID-19 vaccine to receive earlier protection. The JCVI statement can be read 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.