weeks and months with i think some expectation. on the behalf of the country that perhaps he was nearing the end of his life a few weeks ago prince charles was allowed to go and see him prince charles being his son the future king of england was allowed to go see him in a hospital which you know is considered one of those things that is only done in the u.k. at the moment because of coronavirus restrictions if there is some fear that you know the person is about to die 18 foreign ambassadors to me in mar have issued a joint statement calling for the restoration of democracy it's in response to me and mars ambassador to the u.k. being ousted chose to our men was locked out of the embassy in london and removed from his post after criticizing fabrice to the u.k. says it's allowing him to stay to stay on temporarily and 3 is also pushed back its promise to hold an election it now says it will let the

country vote within 2 years previously it said it would carry them out within one of the latest round of talks to revive the landmark 2015 nuclear agreement between iran and world powers has ended in vienna all sides of agreed to resume negotiations in the exact same location next wednesday so far the u.s. and iran have been communicating in directly the nigerian army says 10 soldiers and an officer have been killed in an attack in central benue state they were deployed there to tackle local armed groups in the past 6 years hundreds of people have been killed in violence between farmers and cattle herders in the region. voting is underway in djibouti 73 year old. is seeking a 5th term in office he's been in power for 22 years main opposition parties have boycotted the vote the small horn of africa nation is strategically located one of

the world's busiest trading routes it's also home to several foreign military bases and it's been more loose order and fighting in northern ireland police fired water cannon to disperse protesters who threw rocks and petrol bombs anger about post brags that trade issues have worsened other frustrations the white house is joining the british and irish governments in calling for calm at least 55 police officers have been injured since the armrest began. a critical care doctor says a lack of oxygen and not drugs killed george floyd when he was pinned down by police martin tobin testified at the trial of derrick shove in a former officer accused of killing floyd. it's inside story now stay with us.

brad but still dangerous the european matter is his agency says the astra zeneca vaccine for covert 19 is linked to blood clots but it insists the benefits outweigh the risks so should people be wary it this is the inside story. hello welcome to the program. many countries have been relying on the senate vaccine to get them out of the coronavirus been demick crisis but there have been

problems from supply side effects european regulators say the vaccine can in cases cause blood clots the u.k.'s to turn out to young people who appear to be at more risk but both the u.k. and say they're still confident in the us to identical vaccines effectiveness and safety. there have been fewer than 80 cases reported in the u.k. despite more than 20000000 being given out but even so that's caused a reaction there reported cases of unusual blood clotting following vaccination with the astra zeneca vaccine should be listed as possible side effects of the vaccine based on the current available evidence specific risk factors such as age gender or

a previous medical history of clotting disorders have not been able to be confirmed as the rarest and repents are seen in all ages and in men and women the 1st possible connection between the astra zeneca vaccine and blood clotting was made in late february since then speculation research and reactions have been mixed many medical body has carried out investigations but failed to come up with a link between their job and clotting even. just heard before so the image didn't think the 2 were related but more than a dozen countries temporary suspended us of the vaccine austria 1st then france spain germany in europe and then indonesia thailand and democratic republic of congo now where the latest moves many countries are introducing age limits for the drug australia the philippines and the one full of e.u. countries are ordered astra zeneca jobs for people and

a certain age. oxford university which was behind the creation of the vaccine continues to stand by its work in a statement is a professor of pediatric infection and immunity is that safety has been our priority throughout the development of the vaccine at university of oxford in 2020 and we are reassure to see that safety monitoring continues and their close scrutiny of regulators and public health authorities as a vaccine is around the world the identification of rare cases of blood clots which might be associated with a vaccine shows that the safety system works and has also allowed the u.k. and the regulators to conclude that the benefits of vaccination continue to are to weigh the risks putting in measures to help mitigate any possible risk.

let's bring in our guests in cambridge chris smith is consultant viola just at cambridge university and posed as host of the naked scientists in london sign up isaac is lead on the art break of infectious diseases for the university college london zoo global citizenship program in barcelona geoffrey lazarus had of the health systems research group of the bus and owner institute for global health welcome to the program chris the finding by the european medicines agency now about the link between the. and the blood clots this should be really bad news for a company that has been battered by a series of setbacks. i think the chief executive officer pascal soriano has said the economy regrets going down the path of offering a vaccine which makes no profit fresh resentment which is the decision that they took this should be available at cost it was

a wonderful gesture it seems to be somewhat thrown back in their face yes it's tricky and obviously one is very concerned at the moment with the concept of vaccine hesitancy one of the crucial things about getting this over the line and getting the pandemic under control is that we have the support and trust of the general public and that translating into high uptake of vaccines which will suppress the spread of the virus and it will translate what would have otherwise been lethal infections into non-lethal infections with this kind of image problem that the vaccines currently laboring under but could be a problem going forward oksana with what do you think would be the immediate implications of the latest findings by the ema. so have said that the benefits outweigh the risks and actually they have not defined any age based recommendations but countries are choosing to do so. restricting

to about $55.00 brussels and. over 16 other countries as well so we do see that there is a very here in terms of the interpretation of what the european medicines agency has concluded as well as the u.k. body m.h.r. what we see as well is that we consider the overall benefits of the vaccine not just in terms of focusing on mortality rate but younger people can also be affected by things like that and there was a recent study in the lancet which show that one in 3 people actually went on within 6 months to receive either a neurological or psychological diagnosis and so we really do need to ensure that this vaccine rollout continues ok to avoid greater burden on the health care system jeffrey how do you explain the difference into the stations of both the says there

was a link and the u.k. regulates as host say that there needs to be more investigation before they stop that it's. it's difficult to explain you know how the other bodies came up with different findings but yes mention the european medicines agency has for the 2nd time said that this is a safe that with very rare side effects and it's common to have side effects with any baxi or any medicines it's completely safe to take it now that different european countries have defined different age groups is is their decision the important thing is that the astra zeneca vaccine gets used and if that your peers are going to use all they do is available to them and that's more doses for the rest of the world chris is it political in a way or another that the u.k. regulators are saying 1st of all as far as the causal relationship between the vaccine and the occurrence of the blood clots coming together with

a low platelets which are the main reason why we're seeing those fatalities is considered possible plausible however it has to be confirmed and for it to be confirmed this could take a body of work and research and data. a good right thinking about this is to look at the timeline over the life course and the risk profile so a person who is in their rights may have say a 10 percent or higher chance of succumbing to severe or lethal infection with coronavirus whereas someone who's 18 rather than 80 may have a one in a 1000000 chance of having a severe outcome if they catch coronavirus now if we map onto that the vaccine. the vaccine has a side effect or complication rate potentially about one in a 1000000 that's roughly the rate at which we're seeing these blood clots that might or might not be associated but let's assume they are one in

a 1000000 so if we vaccinated a 1000000 people we might therefore expect to have one person with the complications now if those are all 80 year olds for one person with the complications we've saved 10 percent or 100000 lives from coronavirus but if you contrast that with an 18 year old we've caused one person to have complications and we've prevented one person from having complications so that ratio of the risk versus the benefit is quite different when considered across the range of ages and it's that that has provoked the regulators to say we don't think there's a serious issue here and the fact that they've said if you've already had one dose of it carry on and have a 2nd dose even if you are in the 20 to 29 year age group but because we do have alternatives and until we get the data we don't want to hold up the vaccination process because vaccines really do matter and they do save lives therefore let's

offer the people who might be at a risk a different bank seem while we similar tony eastley continue for those other people for whom that respect a fair analysis is absolutely clear it's a safe very effective and life saving lack of if this is the problem. the. finding of itself is going definitely to create some problem among among the people who are definitely going to be more skeptical now and this is going to create huge problems for us president which was hoping that it's vaccine widely touted as affordable easier to administer likely to compete with pfizer and modern or that image itself shattered in a way or another. well i think that to flip flopping certainly hasn't helped originally he did see that the. older groups were not vaccinated to the fact that there is this idea or the feeling there wasn't enough data honest

and then that's now been rehearsing the other direction so i do think that what we this survey so hard you should that there is a dip in confidence what's also interesting is that due to the different strategies in preparing to roll out the u.k. had at 1st identified less cases because we focused on back meeting our older population 1st so whereas on the continent we saw that there were certain ied groups that work the elders in your originally wrote left off and people who were in frontline positions either in hospitals care workers will tended to be female so also some of the patterns that we are looking at now may just be a result of the vaccine rather than something more significant than that however there is let's not forget there are some countries in the world who have very little or no back means at all this stage in so i do think that certainly this is

something that can be overcome it is damaging but we know that it is the real and known dangers of coke that far outweigh any potential adverse impacts really because back there it fits the typical profile of geoffrey many countries us typing in just right off of the front of the findings were released of the same that it's about time to start looking for options but to care for the people under 30 it's very easy sent in practice this means that you have to with think your whole procedure as you whole swatches you think about alternatives by new medicine which is going to be extremely difficult particularly in the e.u. . so if you're interested into changing the vaccine strategy i'm not sure it's really that complicated it just means you're using your pies are more down our your johnson and johnson that scene for those younger age groups that are then asters

anika and you know like in spain where i am now they have limited esther's and i get used to those aged 60 to 64 so they'll use up the vaccines they have built in the finished the 2nd doses for that as you have only received one dose and then that will be more than scenes and for the rest of the well what i'm hoping is that we can turn this around and say given that the european medicines agency has said it's safe we can use this to accelerate next ation programs and other parts of the world which is extremely important in order to avoid variance of concerns as variants flourish leave risk that some of them may become resistant to the axioms chris when you have a you facing 400000000 doses of. the americans 300000000 in the past trying to. be ready for the eventuality of starting the fast track vaccination campaign what would be the reaction do you think among the decision makers now against the backdrop of the

findings of the ema. well i hope they'll look at the statistics and the statistics paint a very encouraging picture we're talking here about chance events occurring down at the level of less than one in a 1000000 to one in half a 1000000 that's really really low and when you put this up against the fact that the complication we're talking about affects about 5 people in a 1000000 per year just by chance anyway and if people take the oral contraceptive pill increases their likelihood of this happening to them by maybe 8 forward and no one bats an eyelid about that sort of thing i think that probably most of the people making decisions around this will be saying well actually statistically we're on a very short footing here because what we absolutely know is this is a very effective vaccine and the data we're seeing coming through now show in some cases 90 percent plus protection in the most vulnerable groups and it's also very

very cheap it's one of the cheapest vaccines on the market and actually has one of the longest track records because the construct that's being used to make this vaccine has been used for more than a decade and and in the fight in west africa against a boa that construct went into thousands and thousands of people so we've also got long term follow up so there are many reasons to be reassured by these findings not least that they're being investigated properly oxana when you have people who have been from day one skeptical about the whole idea about getting vaccinated against kovi as a safest way and you get this whole story about astra zeneca and the and the and the link between the vaccination of the blood clots do you have any concerns that this could unfortunately or fortunately push some people to start comparing between vaccines and say you know what with the ink that one could be more efficient safer than the other one well i think that there really have to

distinguish between people who are. anti actors who for the. pandemic writ be concerned or refuse vaccines and those who have some really legitimate questions based on the headlines that they're seeing in the media and i think chris really broke it down in a in a understandable way that you know there's just and one in a 1000000 chance of this occurring which is the putt the same as getting murdered or being hit by a car in the next month or so so if we think about it that way it's it definitely i think eases the concerns that people how i think what's crucial though is that the public's question's all about seeing on a day that that there is transparency and that scientists in the governments do address their public regularly so that that confidence that cost can be rebuilt and regained so i don't think that it is for this middle ground group who who just want

to understand what it is that the real risk is i think that that's something that health care professionals perms this doctors can have those conversations and change people's minds that any vaccine at this stage is going to protect themselves and their loved ones because they see that there's something great about limited transmission it's not just about yourself it's also about the people around just for this looks like a it mammoth task ahead in a cup but when it comes to the american market the f.d.a. is yet to authorize emergency use and with starting to hit with force from american officials saying that we might not use the astros' anika told by the end of the day . that's right and if they don't then they will use pfizer medan and johnson and johnson and like i said earlier that means more doses of astra zeneca for the rest of the world right now the vaccine is desperately needed across latin america in

parts of africa where they have very very low numbers that means the astra zeneca exene is more available and that's where that's where it should be distributed through the callbacks facility or through direct purchase so i'm not so worried about. in the u.s. right now with regards to tast or to the astra zeneca maxine i think people should get their 2nd dose. and then we have other options it's the countries that don't have those that are options because they don't have a cold chain to manage and pfizer down our because of the cost so as long as you know it gets used you know we were not facing you know severe problem with with astra zeneca the europeans were hoping from day one that they would have a comprehensive united approach when it comes to tackling covert 9 ting acquiring the same vaccine from astra zeneca and moving forward the germans are saying about that they are in talks with the russians for sputnik vaccine could this be an

indication of that we're seeing some cracks within the e.u. itself about dealing with us president and the new future. i think we've seen cracks in the e.u. right from the get go and i don't think that they have made themselves look particularly honorable or really bolster their reputation internationally i think quite the opposite in fact interesting that they're going down the route of the russian sputnik vaccine though because a hasn't been approved yet but we understand that the a.m.a. the european medicines agency looking at that banksy it's also very closely related to how astra zeneca has vaccine works it's a modified cold virus in fact it's a pair of cold viruses which are administered a few weeks apart it's also very similar to the johnson and johnson vaccine that's also still waiting for approval in the u.k. what unites all these different vaccines is they're all based on modified cold viruses which they used as trojan horses to smuggle into the body the corona virus coat message and therefore what is happening with astra zeneca is vaccine with this

rare complication albeit at very low levels it could also affect the johnson and johnson vaccine it could also affect the russian bank scene we haven't seen the data yet we haven't seen the follow up on millions of people who have had it like it had the astra zeneca vaccine and that may yet emerge so it may well be that so we see the same trend emerging with these other products subsequently we'll have to watch this space china where does this leave the it's grappling with a 3rd wave of covert 19 a spike in infectious death tolls that be lagging far behind when it terms of vaccinating lost sections of the society they have been grappling with ways to find new vaccines could this be the moment of reckoning as far as the europeans are concerned. well certainly the timing isn't great and some say there's a 3rd wave that is roland crossed the continent and there are more and more restrictions coming into place just as you can we start to lift. some of these

restrictions as early as next week so in this instance they do need to be accelerating the maximum roll out as quickly as possible as jeffrey has highlighted however did you have a selection of other types of vaccines that could also be using but i believe that they do you have to think about how to best leverage their existing public health infrastructure job skills or health workers and ensure that we get as many jobs and arms possible so that we don't. end up in a situation where we have a friend sharing it with bad variant. resulting in the fact not only confirmation a vaccination rates but also tracking these again these are all very particularly the latter more complicated to address in a given some of the issues that we've discussed and asked that but i think another point as well is that outside of the u.k. and outside of the e.u.

brazil for instance being one of the. cases that moment and that situation is not looking ok we need to do mountain take a local approach and we definitely you need to this is going to be my question to jeffrey about this is this whole thing has been an area for for us and for the science scientific community because they're dealing with the way it was something new there's been trying and testing you may vaccine some of them using old technology some of them using ultra modern technologies don't you think that this whole thing about us doesn't it has should be an approach and it's a for everyone to put into place a mechanism to monitor all the vaccines and look for any of us. both side effects that we might be overlooking right now absolutely so we have the codex facility there which is a global mechanism for distribute a vaccine is to to the poor low resource countries but we need like you said global

mechanism to oversee all the vaccines we also need that or similar mechanism to look at production because where we failed is in be able to produce enough doses of the vaccines that governments invested early in developing the backseat has been one of the great scientific breakthroughs for so many successful vaccines but they haven't invested the same level in the production and we know that that seems require dozens of components from the ages to vials of residence so on so we need an overview of like. when the availability of the different components and a massive global fargo vigilance of any possible side effects since we're seeing some in the in the u.k. but we need to make sure that we're seeing this the rest of the world crissy less than 20 seconds of his own why what would be your message to those ho better across and politicians doctors working in different parts of the world having to make that decision about sun allowing their own countries to continue using us resident are

not look at the data the risk profile is exceptionally good in the performance of a vaccine is very very high i have no conflict of interest i have no shares national democratic or not that's but i do of course have a share in being a doctor myself and treating patients who are suffering with this disease which we can prevent with this vaccine next backswing. thank you very much indeed i really appreciate your messages of the hope of this particular moment when people are eager to see light at the end of the tunnel chris smith oxana by sick and jeffrey lazarus thank you very much indeed for your contribution i thank you for watching you can see the program again any time by visiting our website c.n.n. dot com for further discussion go to our facebook page that's facebook dot com forward slash a.j. inside story you can also join the conversation on twitter handle is a j inside story from the house and the entire team here in doha by for now.

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