All first-time Covid vaccine appointments on the National Booking System for patients under the age of 30 will be automatically cancelled from tomorrow (9 April), NHS England (NHSE) has announced.

Pharmacy-led sites have been asked to cancel any appointments made for under-30’s booked on local systems.

This comes as part of updated vaccine guidance, sent yesterday (7 April) by NHSE to vaccine sites, which relates specifically to those aged under 30 who are in cohorts 1-9 of whom are due to have the AstraZeneca jab.

Individuals who have their vaccine appointments cancelled will be asked to contact their GP to 'discuss the benefits and risks of having the AZ or another vaccine' before they book another appointment.

‘If following a conversation with a clinician, an individual chooses to go ahead with the AZ vaccination, all vaccination sites should make this option available,’ the guidance also explained.

It added: ‘PCN-led Local Vaccination Services, working with system partners including hospital hubs, should rebook this individual in a clinic offering the Pfizer BioNTech vaccine over the coming four weeks. Guidance on how to access additional Pfizer BioNTech vaccine will follow shortly.’

Scheduled bookings for today were able to go ahead as planned, but clinics were advised to ‘prepare to have individual conversations about the risks and benefits of receiving the AZ vaccine should individuals arrive for their appointment.

‘This means all vaccination sites will need to put immediate measures in place to ensure that regulated healthcare professionals are available to support these conversations, using the materials provided by PHE,’ the guidance said.

Second doses of the AZ vaccine should continue to go ahead for all age groups except in specific circumstances when the vaccine should ‘only be considered when the potential benefit outweighs any potential risks,’ NHSE added.

This includes patients with a history of cerebral venous sinus thrombosis, acquired or hereditary thrombophilia, heparin-induced thrombocytopenia or antiphospholipid syndrome.

It also includes patients who have experienced major venous and arterial thrombosis occurring with thrombocytopenia following vaccination.

This update comes after a review by the UK drugs regulator found that by the end of March 79 people had suffered rare blood clots after having the AZ vaccination - 19 of whom had died.

Of the 19 who died, three were aged under 30. However, the regulator said that it is not known whether the blood clots were the cause in all of the cases.

In response, the UK government decided yesterday that all under-30s in the UK are to be offered an alternative Covid vaccine to the AZ jab as a precautionary measure.

At a press conference held yesterday (7 April) Professor Wei Shen, chair of the government's joint committee on vaccination and immunisation, said the decision to offer an alternative vaccine to the AZ vaccine is ‘just on the side of safety, rather than any particularly significant concern about the risk from the vaccine itself.'

Meanwhile, the EU's medicines regulator said that blood clots should be listed as a ‘very rare’ side effect of the AZ vaccine, but that the benefits of taking the vaccine continue to outweigh the risks.