The NHS England website allowing over-45s to book their coronavirus vaccination initially crashed, moments after it was opened.

The website appeared to go down just after slots were made available. Users were met with the message: “The NHS website is currently experiencing technical difficulties. We are working to resolve these issues. Thank you for your patience.”

Shortly after the vaccine booking site was hit by the technical issues, vaccines minister Nadhim Zahawi tweeted that the problem had been “fixed”. It is understood that NHS Digital were able to get the website back up and running on Tuesday morning, with all issues being resolved and people able to book appointments.

Meanwhile, England was gearing up to offer its first doses of the Moderna jab, the third Covid-19 vaccine introduced in the national deployment.

On Tuesday, the vaccination will be available at 21 sites, including the Madejski Stadium in Reading and the Sheffield Arena. It will offer an alternative to the Oxford/AstraZeneca vaccine for under-30s, after concerns about a possible link to very rare blood clots. The Pfizer jab has already also been available.

England follows Wales and Scotland, which began using the Moderna vaccine last week. The Vaccines Taskforce has secured 17m doses of the Moderna vaccine for the UK.

Prof Stephen Powis, the medical director of NHS England, said having the Moderna vaccine marked another milestone in the national programme.

He said more sites would offer the Moderna vaccine as supplies arrived, urging people to get vaccinated when they were invited, as it is “our hope at the end of a year like no other”.

Quick Guide

Covid vaccine side-effects: what are they, who gets them and why?


What are the most common side-effects from the Covid vaccines?

According to Public Health England, most side-effects from the Covid vaccines – Pfizer/BioNTech and Oxford/AstraZeneca – are mild and short-lived. These include soreness where the jab was given, feeling tired or achy and headaches. Uncommon side-effects include having swollen lymph nodes.

Why do the common side-effects occur?

“The sore arm can be either due to the trauma of the needle in the muscle, or local inflammation in the muscle probably because of the chemicals in the injection,” said Prof Robert Read, head of clinical and experimental sciences within medicine at the University of Southampton and director of the NIHR Southampton Biomedical Research Centre.

“The other common side-effects – the muscle aches, flu-like illness and fatigue – are probably due to generalised activation of the immune system caused by the vaccine. What this means is that the white blood cells that are stimulated by the vaccine to make antibodies themselves have to secrete chemicals called cytokines, interferons and chemokines, which function to send messages from cell to cell to become activated.”

Are blood clots a side-effect of the vaccines?

The Oxford/AstraZeneca jab has been linked to a small but concerning number of reports of blood clots combined with low platelet counts (platelets are cell fragments in our blood that help it to clot).

These include a rare clot in the brain called cerebral venous sinus thrombosis (CVST). In an unvaccinated population, upper estimates suggest there may be 15 to 16 cases per million people per year.

The Medicines and Healthcare products Regulatory Agency (MHRA) said recipients of the Oxford/AstraZeneca jab should look out for new headaches, blurred vision, confusion or seizures that occur four days or more after vaccination. The MHRA also flagged shortness of breath, chest pain, abdominal pain, leg swelling and unusual skin bruising as reasons to seek medical advice.

Up to and including 31 March, the MHRA said it received 79 reports of cases of blood clots combined with low platelets, including 19 deaths, following more than 20m doses of the Oxford/AstraZeneca jab. That equates to about four cases for every million vaccinated individuals.

Two cases of blood clots with a low platelet count have also been reported among recipients of the Pfizer/BioNTech jab. The European Medicines Agency is also examining three cases of venous thromboembolism blood clots involving the Johnson & Johnson jab.

The MHRA says blood clots combined with low platelets can occur naturally in unvaccinated people as well as in those who have caught Covid, and that while evidence of a link with the Oxford/AstraZeneca vaccine has become stronger, more research is needed.

Nicola Davis Science correspondent

All over-50s and high-risk groups in the UK have been offered a coronavirus vaccine before the mid-April deadline set by the government, allowing the second phase of the deployment to younger cohorts to begin.

Boris Johnson hailed the passing of “another hugely significant milestone”.

However, there are fears of a slowdown in supply of vaccines and possible fall in confidence after a change in advice on who could get the Oxford/AstraZeneca jab.

With more than 32 million people having had a first dose and 7.6 million of those having received their second, the prime minister said “many thousands of lives” had been saved.

But there were concerns not everyone had been offered a jab they could access. Last month, the Guardian reported that a number of high-risk people had still not had their first vaccine.

People unable to leave their homes were meant to be visited by a mobile vaccination team, similar to the service offered to care home residents. But the Guardian understands that months on, a number of older and disabled people who are too unwell to leave their homes are still waiting, with some told to travel miles to a vaccine centre.

Public Health England released operational details about the Moderna jab on Monday, including information on the dose, the interval between first and second jab, the storage temperature and whether people who receive the jab would need to be monitored afterwards.

The vaccine needs to be stored at a temperature of -25C to -15C and once thawed can be stored at 2C to 8C for up to 30 days. The minimum interval between first and second dose of the Moderna vaccine is 28 days. Patients who receive the Moderna jab will need to wait at the vaccination centre and be observed for a period of 15 minutes after they receive the vaccine.

On Monday evening, and earlier than expected, Johnson announced the target had been reached. The Joint Committee on Vaccination and Immunisation (JCVI) – the body advising on which groups should be prioritised for a jab – is to publish its final advice later this week on who should be next in line.

Johnson suggested the current plan would continue, meaning people in their late 40s would be offered a vaccine next. The JCVI’s interim plan published earlier in the year said the rollout should continue down the adult age groups.

Sir Simon Stevens, the chief executive of the NHS in England, said: “Vaccinating 19 out of 20 people aged 50 and over is an incredible milestone. Thanks to our NHS nurses, doctors, pharmacists, operational managers and thousands of other staff and volunteers, the NHS Covid vaccination programme is without a doubt the most successful in our history.”

This content first appear on the guardian

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