Germany’s vaccine committee has advised giving the Oxford-AstraZeneca Covid-19 vaccine only to people aged 60 or above because of a risk of rare blood clots.

The German medicines regulator found 31 cases of a type of rare blood clot among the nearly 2.7 million people who had received the vaccine in Germany.

Canada earlier suspended use of the AstraZeneca jab in people under 55.

AstraZeneca said international regulators had found the benefits of its jab outweighed risks significantly.

It said it was continuing to analyse its database to understand “whether these very rare cases of blood clots associated with thrombocytopenia occur any more commonly than would be expected naturally in a population of millions of people”.

“We will continue to work with German authorities to address any questions they may have,” it added.

• The EU and UK medicine regulators both backed the vaccine after previous cautionary suspensions in Europe this month.

The European Medicines Agency (EMA) and the UK Medicines & Healthcare products Regulatory Agency stressed that the benefits of the AstraZeneca vaccine continued to outweigh the risk of side effects.

AstraZeneca’s product is one of the most widely used coronavirus vaccines in the West, and is meant to be supplied on a not-for-profit basis to the developing world.

The EU’s rollout of its vaccination programme has been dogged by delays because of delivery and production problems, and Germany is among several states now fearing a third wave of infections.

On Tuesday, Italy’s Prime Minister Mario Draghi and his wife, who are both 73, received their first doses of AstraZeneca in a display of confidence in the vaccine.

If you give a vaccine to millions of people you will of course see some cases of people falling seriously ill or even dying shortly afterwards. It does not mean the vaccine has caused the problem – it could have occurred naturally. What authorities have to work out is whether it is cause or coincidence.

They do this by monitoring adverse events after vaccination and see if they are above what you would normally expect. The type of blood clot that has been seen is very rare and so it is hard to know exactly how many cases you would normally expect to see. We do know it is more common in women and taking the pill increases the risk of it happening.

There is no evidence yet to prove the AstraZeneca vaccine increases the chances of these clots. But, even if it does, the next thing you have to take into account is whether Covid presents more of a danger.

Regulators in Europe and the UK are clear – given the current evidence – that use of the vaccine should continue in all ages.

Why the new advice?

Ahead of the vaccine committee (Stiko) announcement, the German cities of Berlin and Munich, and the region of Brandenburg, halted use of the vaccine in people below the age of 60.

“After several consultations, Stiko, with the help of external experts, decided by a majority to recommend the AstraZeneca Covid-19 vaccine only for persons aged 60 years and older on the basis of available data on the occurrence of rare but very severe thromboembolic side effects,” the committee said, as quoted by Reuters news agency.

“Regarding the question of administering the second vaccine dose to younger persons who have already received a first dose of the AstraZeneca Covid-19 vaccine, Stiko will issue a supplementary recommendation by the end of April.”

Germany was one of the European states which briefly suspended use of the AstraZeneca jab earlier this month pending an EMA review into the possible link to blood clots.

When the EMA declared the vaccine “safe and effective”, Germany and others resumed its use but investigations continued.

The German medicines regulator, the Paul Ehrlich Institute, has found 31 cases of cerebral sinus vein thrombosis (CSVT) among people who received AstraZeneca in Germany.https://emp.bbc.com/emp/SMPj/2.40.2/iframe.htmlmedia captionCovid vaccine safety: How does a vaccine get approved?

Almost all the cases are reportedly in younger and middle-aged women.

France already limits use of AstraZeneca to those aged over 55.

On Monday, Canada recommended immediately suspending the use of AstraZeneca in people aged below 55 following the reports of rare but potentially fatal blood clots in Europe, CBC reports.

There have been no reports of blood clots related to the jab in Canada itself, where 300,000 doses of AstraZeneca jabs have now been administered.

In the UK, five cases of CSVT – one of them fatal – have been recorded among 11 million people who received the vaccine.

Canada suspend use of AstraZeneca for under-55s

The pandemic has thrown into sharp relief the income and pension inequality women experience. Covid-19 kills more men than women, but the latter have taken a bigger economic hit. They have been more likely to be furloughed, and more likely to lose their jobs. They have taken on a disproportionate share of household tasks, childcare and home schooling. And the pandemic has worsened job prospects for older people, especially women.

Even without coronavirus, the UK economy relies on unpaid care, mostly by family and friends, both men and women. The charity Carers UK says that 12 per cent of the country’s population are informal carers. Of these, the majority — 58 per cent — are women and their peak age is 50-64. Some give up well-paid jobs to care for relatives full-time, while others juggle caring with unskilled, poorly paid work.

Carers’ income is pitiful: carers’ allowance pays £67.25 a week for those who provide more than 35 hours a week, far less than even universal credit, let alone the living wage for full-time work. So although carers receive national insurance credits, they are unable to build up the occupational pensions essential for a comfortable retirement. All too often, becoming a carer means the premature end of a woman’s well-paid career; for many, it means poverty in old age.

The UK government aims to keep younger women in the workforce by providing childcare. But there is no recognition of the need to keep older women in work through care for the elderly. Indeed, some proposals to “solve” the social care crisis envisage women taking on even more. A recent pamphlet from the think-tank Demos proposes that “families” should be primarily responsible for elderly care, and suggests that this could be a “career choice”. And, as the pandemic has shown, with demand for care at home growing, the greater burden has fallen on women.