An independent review has found that a man who died after being given a Covid-19 vaccination should not have received the jab. Jack Last, 27, from Stowmarket, Suffolk, died from a blood clot after receiving the AstraZeneca vaccine in 2021. The following year, an inquest found he died as a “direct result” of the inoculation.
The review, commissioned by the Suffolk and North East Essex Integrated Care Board, found admin errors meant Mr Last was wrongly offered the vaccine months before he should have been and that staff at his local hospital in Suffolk failed to spot how ill he was after he received the jab. The report concludes that “Jack’s death was a consequence of a combination of system shortcomings, human error and tragic unfortunate timing.”
Mr Last was invited to receive the Covid-19 vaccine in March 2021. At the time, the rollout of the vaccine in the UK was prioritising all adults aged 16 to 64 with underlying health conditions. The Suffolk GP Federation, a collective of surgeries in the county, was sent a large batch of the AstraZeneca vaccine with a short expiry date. The surgeries expanded the criteria to include those who were living with vulnerable people to ensure vaccines weren’t wasted.
However, an error in the medical records of one of Mr Last’s parents indicated they suffered from chronic obstructive pulmonary disease (COPD), a lung condition that causes breathing difficulties, which would have made them vulnerable. The telephone number on his medical records also suggested Mr Last was living with his parents and that he was therefore eligible for the vaccine.
He received a text message inviting him to book an appointment and was given the AstraZeneca (AZ) vaccine on 30 March, 2021. By the time he had received the jab, reports had already emerged in Europe of the AZ vaccine being linked in rare cases to blood clots.
Mr Last fell ill within a week of getting the vaccine. He went to his local A&E complaining of severe headaches having phoned NHS 111. His blood tests were abnormal and the consultant ordered a specialised scan to see if Mr Last had a vaccine-induced thrombosis (VITT) – an emerging condition at the time linked to the AZ vaccine. However, the radiologist did not have the technical expertise to perform such a scan, the report found. Instead, a regular CT scan was performed which identified a blood clot in his brain. This wasn’t spotted by the radiologist, whose report said he had no brain abnormalities.
It wasn’t until the following day that the specialist scan was performed. It correctly identified the blood clot, linked to the AZ vaccine. Shortly afterwards, Mr Last was transferred to specialist care at Addenbrooke’s Hospital in Cambridge. His treatment there, the report said, was “appropriate and of a high standard”. However, Jack died on 20 April, 2021. The 2022 inquest found he died from a blood clot as a direct result of his reaction to the AZ vaccine.
The report makes four recommendations, including ensuring that patients’ medical records are updated and accurate, and only include current, active telephone numbers
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