The family of a solicitor who died from a blood clot on the brain after taking the AstraZeneca vaccine has urged the public to "keep saving lives" by continuing to take the jab.
Neil Astles, 59, was given his first dose on March 17 but died in hospital on Easter Sunday after suffering from 10 days of worsening headaches and loss of vision. Mr Astles, a married solicitor at Warrington Borough Council, is the first named person in the UK suspected to have died from side-effects linked to the Oxford jab.
On Wednesday night, his sister told The Telegraph that his family were "furious" but wanted the public to continue taking the AstraZeneca vaccine because "fewer people will die".
Dr Alison Astles said her brother had been "extraordinarily unlucky", and urged people who had received the vaccine to seek medical help if they experienced lasting headaches or sickness.
The family spoke as it was announced that healthy under-30s will now receive the Pfizer or Moderna vaccines instead of the AstraZeneca jab after regulators said there was a "strong possibility" that it had caused deadly blood clots.
The Medicines and Healthcare products Regulatory Agency (MHRA) said side-effects were "very rare" and were being detected "in an extremely small number of people". The European Medicines Agency said the benefits of the AstraZenca vaccine outweighed the risks.
Following the announcement, Boris Johnson said it was "very important for everybody to continue to get their top-up jab when you're asked to come forward for your turn".
However, the MHRA said the evidence was still "firming up" and more work was needed to be sure "beyond all doubt".
The joint committee on vaccination and immunisation (JCVI) recommended that 18 to 29-year-olds should be offered an alternative vaccine where available.
It emerged on Wednesday that, up to March 31, the MHRA had received 79 reports of blood clots accompanied by low blood platelet count, all in people who had their first dose of the vaccine, out of around 20 million doses given. Of the 79, a total of 19 have died, although it has not been established what the cause was in every case.
Mr Astles, from Warrington, died at Royal Liverpool University Hospital on April 4, almost three weeks after his first dose of the vaccine. His sister, the subject lead for pharmacy at the University of Huddersfield, said on Wednesday night it was important that people continued to receive the jab.
"Despite what has happened to our family, we strongly believe that everyone should go for their first and second doses of the AstraZeneca vaccine," she said. "Emotionally, we are completely and utterly furious. We are suffering. But there's nothing in our minds to be really furious about. My brother was just extraordinarily unlucky.
"If we all have the vaccine, a few of us might have a blood clot but the evidence is that fewer people will die. We trust the process, we trust the regulator, and despite what has happened to our family we don't want people to be scared off. That's the message we want to get across."
Dr Astles said her brother began to feel ill about a week after receiving his first dose of the AstraZeneca vaccine. He had been fit and healthy, ran regularly and had no history of blood clotting issues, but began to suffer from worsening headaches and loss of vision in his right eye.
"He had a headache which didn't go away and he felt a bit sick," she said. "But he carried on doing his work, went to the shops, driving around. And then on Friday night, his symptoms had become a great deal worse, and my other brother took him to A&E. At three o’clock the next morning, they transferred him over to the Royal Liverpool Hospital to ICU.
"There was a strong suspicion right from the very beginning that it was the Astra vaccine because of his very low platelet levels.
"So he had a clot and a subsequent bleed on his brain, which was compressing his brainstem. He was probably brain dead on Saturday afternoon, but he was declared dead at 22 minutes past five on Sunday evening, when they turned off his ventilator. We were all around him at that point. The clot just compressed his brainstem such that his breathing wouldn't function."
Dr Astles said her brother's diagnosis was "cerebral sinus thrombosis and subarachnoid haemorrhage" with "low platelets and extraordinarily high d-dimer", adding that the coroner had not yet reported the official cause of death.
"What appears to have happened is the vaccine has caused his immune system to turn against his body. And his body has reacted by forming a clot which then resulted in a subsequent bleed in his brain," she said.
Mr Astles' case is understood to have been discussed by the MHRA and the British Society of Haematology.
Dr Astles urged people who suffered headaches after taking the AstraZeneca jab to seek medical help, and said pharmacists should be on the lookout for the symptoms.
"My brother went to the pharmacy, but the pharmacist gave him some anti-sickness medicine," she said. "As a pharmacist myself, I very strongly want all pharmacists to be asking people presenting with headaches or sickness: have you had a Covid vaccine within the last three weeks?"
Regulators altered their position on the vaccine for under-30s on Wednesday following weeks of debate over whether the risk from blood clots from the vaccine outweighed those from catching Covid among younger people.
Prof Anthony Harnden, the deputy chairman of the JCVI, said: "We decided that that risk-benefit ratio doesn't really stack up when it comes to the very well under-30-year-olds. Therefore we decided ... as a precautionary approach, we would advise an alternative vaccine for that particular age group."
At a press conference on Wednesday afternoon, Prof Jonathan Van-Tam, the deputy chief medical officer, said a "course correction" was now needed to the vaccine rollout.
Watch: UK advises under-30s to use alternative to AstraZeneca
"We're talking in the context of extremely small numbers," he said. "This is a course correction ... but it's quite normal for physicians to alter their preferences over time.
"The UK vaccine programme has been the most enormous success. This is a massive beast that we are driving along at enormous pace and enormous success. And if you sail a massive liner across the Atlantic then it's not really reasonable that you aren't going to make at least one course correction on that voyage."
Dr Astles said she agreed "with everything Professor Jonathan Van-Tam said at the briefing".
The European Medicines Agency (EMA) on Wednesday added clotting to the list of side-effects of the AstraZeneca vaccine and said it was "plausible" that the jab was causing a rare auto-immune response.
Emer Cooke, the EMA executive director, said: "A very in-depth analysis has concluded that the reported cases of unusual blood clotting following vaccination should be listed as possible side effects of the vaccine."
A World Health Organisation (WHO) panel of experts also concluded that a causal link between the AstraZeneca vaccine and blood clots was "plausible" but "not confirmed" based on current information.
The MHRA's chief executive, Dr June Raine, said there was a "reasonably plausible" link between the AstraZeneca jab and rare blood clots.
"The evidence has accrued not only in numbers and kinds of cases but the pattern of those cases," she said. "So we feel it's a much more solid basis in our regulatory world to put in the side effect into our product information and that tells us it is a reasonably plausible link."
Italy will recommend the AstraZeneca vaccine only for people over 60, the country's top health adviser said on Wednesday night after the European regulator's briefing.
Mr Johnson insisted the AstraZeneca vaccine was "safe, effective and has already saved thousands of lives”.
"The vast majority of people should continue to take it," the Prime Minister said. "We will follow today's updated advice, which should allow people of all ages to continue to have full confidence in vaccines, helping us save lives and cautiously return towards normality.
"It is very important for everybody to continue to get your jab when you're asked to do it and get your second jab when you're asked to come forward for your turn."
The Prime Minister said the updated guidance would not impact the vaccination rollout, adding: "I don't see any reason at this stage at all to think we need to deviate from the road map. And we're also very secure about our supply."
People in Wales started receiving the Moderna vaccine on Wednesday morning and England, Scotland and Northern Ireland will receive supplies within the coming days.
The UK has bought 17 million doses of the Moderna vaccine – enough for 8.5 million people – and has ordered 40 million doses of the Pfizer jab.
The MHRA said those who had had their first dose of the AstraZeneca vaccine should still get their second dose. Only those who suffered a blood clot after the first dose should not get vaccinated.
Anyone with blood disorders that leave them at risk of clotting should discuss the benefits and risks of vaccination with their doctor before going for a jab.
Watch: Should I be worried about the AstraZeneca vaccine?