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Norwegian experts say blood clots were caused by the AstraZeneca Covid vaccine

239 points by yread 6y ago

draw_down 6y ago
Is it really so crazy to think that these vaccines which were (necessarily) rushed to production might have problems? The solution is not to just shut our eyes and say “well COVID is worse”. We have to understand the risks to administer the right vaccine to people with risk factors, and so we know how to treat the conditions that result.
- afavour 6y ago
  I don't think anyone is shutting their eyes to the risk. COVID is worse and a lot more people out there have risk factors associated with COVID than have risk factors associated with the AZ vaccine. We can do both here: investigate these reports while continuing to fight back COVID.
  - lwjwrehljkewr 6y ago
    I bless you my son into the church of the Branch Covidian.
  - draw_down 6y ago
    I don’t agree, I see a ton of discourse of the variety “if you eat hotdogs don’t worry what’s in the vaccine”, the point being it’s foolish to worry about the vaccine risks. Besides that this particular clotting issue has been repeatedly denied, which is why the researchers here are saying emphatically that the vaccine is the cause. Some country, I think Germany, slowed deployment of this vaccine for this reason and got a lot of heat because again, there can’t be anything wrong with the vaccines. COVID will kill you, vaccines will save you, and if you think different you get to sit in the corner.
- vintagemodel 6y ago
  There seems to be some working medication that helps people who have gotten covid: https://vdmeta.com/ https://vdmeta.com/ and https://ivmmeta.com/ https://ivmmeta.com/ (I'm not working in the fields of medicine, statistics or virology.)
imdsm 6y ago
I think a lot of folks are making the mistake of realising that inaction is action. To not vaccinate is an action, and one that carries its own risks.
- simonh 6y ago
  not realising.
vibrio 6y ago
Based on all the information provided in this article, this article is premature to publish. The headline is accurate, as 'experts say', but lack of any independent support of data supporting the claim, makes this dubious (at best) to publish at this point.
- ppf 6y ago
  If only the same standard were applied to all statements about Covid.
  - CWuestefeld 6y ago
    Or, really, everything in the news.
    - germinalphrase 6y ago
      But... then... there would be less news.
      - thitcanh 6y ago
        Wouldn’t it be nice
      - dekhn 6y ago
        nobody wants to read the "Journal of Unsurprising Results Consistent With Evidence"
        staticautomatic 6y ago
        I do.
      - acje 6y ago
        Is the quality degradation in news some variant of tragedy of the commons?
  - ohhhhhh 6y ago
simonh 6y ago
Interesting, and very concerning if it's true. I was given my first shot of the AZ vaccine on Monday afternoon, so I was aware of the reports of blood clots at the time although only in outline. I just don't understand how come the same reaction hasn't been seen in the millions of people vaccinated with AZ outside Norway (edit - it has been, thanks for the info, none of the articles I've come across properly explained this). Regardless I don't regret going ahead and getting the jab even for a second. Even if this turns out to be perfectly accurate, it seems to me the risk from the virus is dramatically greater. In fact while I don't want to trivialise what happened to these people, it's awful, I think the biggest concern for me is the millions of people who are not getting vaccinated or have delayed vaccinations due to these concerns, the thousands of them that will end up contracting Covid-19, and the hundreds of them that will end up dead. This is a real-life example of the runaway railcar switch dilemma. The train car is heading towards a crowd of millions of people and will plough through the middle of them killing many hundreds, or you can throw the switch and divert the railcar so it hits a handful of people prone to the blood clot reaction. A horrible situation to be in. Oh well, I made the choice for myself which group I want to join*. * Yes, a terrible analogy, but it's the best I could come up with during my lunch break.
- jansan 6y ago
  > I just don't understand how come the same reaction hasn't been seen in the millions of people vaccinated with AZ outside Norway. Dude, it has been seen outside Norway, and the observations are exactly the same, at least here in Germany. A certain group of people, maybe in combination with a certain type of drug they are taking, seem to be at risk for a very specific thrombosis in combination with a very low blood platelet count. There is some detective work necessary now to identify this group, so they can be excluded from AZ vaccinations, and then go on with the vaccination. That's what needs to be done now, and as fast as possible.
  - simonh 6y ago
    Thanks you, that's very helpful. None of the articles I've come across on this have explained the context outside Norway, including the one linked in this thread.
boomskats 6y ago
> “We have the reason. Nothing but the vaccine can explain why these individuals had this immune response”, he states. Do these two sentences not _directly_ contradict each other?
- deleted 6y ago
  [deleted]
- clankyclanker 6y ago
  They do not. Rewritten for concision: > “We have the reason: only the vaccine could have caused this immune response”
raverbashing 6y ago
Sensationalist and misleading title Yes, it's the vaccine "that caused it". In a 1 in a million case. In the same way you can die eating a donut and choking on it. The real news is that it might have involved a platelet targeting immune reaction. Guess what else causes clotting problems (in much higher frequency)? Covid
- hvidgaard 6y ago
  3 have had the immune response in about 120.000 vaccinated with AstraZeneca. That's too small a sample to really conclude anything, but as far as Norway is concerned it might be a 1:40000 risk.
  - chii 6y ago
    but norway has to consider whether they just got _really_ unlucky, and saw these numbers, when some countries like the UK hasn't. Or the UK has, but they are either unreported, or the different demographic group is not showing up with the same numbers so uncomparable. It's a hard thing to tease out.
    - hvidgaard 6y ago
      I agree, as I said it's too small a sample to really say anything. If we include the numbers from Denmark it's 4 in 250.000. Still not good if we need to use it on a large scale, and certainly not if we need to use it again and again.
    - Daho0n 6y ago
      Norway's number is only from healthy health workers. The UK number is not.
mynegation 6y ago
Is there any history of such reactions to vaccines in the past?
- kkoncevicius 6y ago
  Most well known is probably narcolepsy induced by Pandermix flu vaccine. [1] But in my understanding any vaccine can have side effects. When my kids get vaccinated I always have to sign a paper stating that I understand the risks of possible seizures, blood cloths, sudden death, etc. Even thou I understand that risks are very small it's always hard to read and sign something like that. [1]: https://www.sciencemag.org/news/2015/07/why-pandemic-flu-shot-caused-narcolepsy https://www.sciencemag.org/news/2015/07/why-pandemic-flu-sho...
  - swader999 6y ago
    The car ride to get the vaccine is the bigger risk in their day.
dekhn 6y ago
There is absolutely not enough evidence from this particular doctor to justify the claim. It's irresponsible to publish this.
- dsnr 6y ago
  > In collaboration with experts in the field from the University Hospital of North Norway HF, we have found specific antibodies against blood platelets that can cause these reactions[...] So the evidence is definitely not from only „this particular doctor“, but from a group of experts on the matter.
  - DoingIsLearning 6y ago
    > we found specific antibodies against blood platelets So are they claiming that this is actually due to the vaccine formulation itself, i.e. does this finding exclude the initial hypothesis of a Quality issue or a specific 'bad batch' of the vaccine?
    - dekhn 6y ago
      the news article doesn't say; it attributes a quote to the doctor saying "it's the vaccine" but it's unclear whether that means "bad batch". Personally, if 3 health workers all go to the same hospital in a remote region complaining of clots, it's more likely that something local happened (as you say, QA, or any number of other sources).
      - kwhitefoot 6y ago
        The article is a very poor quality summary. The articles in VG are much better. I put a quote from one and a translation elsewhere on this HN page.
        dekhn 6y ago
        I've read all of them so far and I still think the professor was being irresponsible in his wording and the press is being dumb for amplifying it.
auiya 6y ago
Astra Zeneca says it's less than 40 cases in 17 million. Are those numbers accurate? That seems like quite a small population affected.
- rambojazz 6y ago
  I think the argument for suspending the vaccine was that the number was still significantly higher than the expected value, despite being very low.
  - cranekam 6y ago
    40 out of 17 million is 0.0002%. Surely 0.0002% of any cohort go on to develop blood clots? I'd certainly pick those odds over being unvaccinated.
    - marvin 6y ago
      If the risk turns out to be 1 in 50.000, which would be on the conservative side if the observations from Norway are correct, it's not a clear-cut question in a country with low incidence of Covid. Especially if other vaccines are available with a small delay. The British tool for calculating covid risk puts risk of death as 1 in 500.000 for a healthy 25-year old, and risk of hospital admission as 1 in 13.000. Must also add to this the public's willingness to vaccinate in the face of these numbers, both now and in the future. It's a shifting of risk from high-risk groups to low-risk groups.
      - BrianOnHN 6y ago
        > risk turns out to be 1 in 50.000 It's more like 1 in 500,000.
        lyschoening 6y ago
        The numbers are three healthcare workers out of 120,000 vaccinated in Norway, with one death, so the risk is 1 in 40,000 from what we know. On top of that we can speculate that healthcare workers are more likely to seek treatment than the average vaccine recipient and they are healthy adults of average age.
acallaghan 6y ago
The rate of blood clots as a side effect for the AZ covid jab is less than that of the combined contraceptive pill - does that mean that both need to be discontinued?
- bennofs 6y ago
  Maybe I've missed it, but I didn't find anything in the article about whether the vaccine does need to be discontinued or not. In any case, being clear about what side effects are possible and researching them to get a better understanding is a requirement in my opinion.
  - kwhitefoot 6y ago
    You need to read the VG articles, they are much more thorough than the one linked on HN but they are in Norwegian. Google Translate does a fair job. https://www.vg.no/nyheter/innenriks/i/QmwR1V/professor-om-mistenkte-vaksinebivirkninger-aarsaken-er-funnet https://www.vg.no/nyheter/innenriks/i/QmwR1V/professor-om-mi... https://www.vg.no/nyheter/innenriks/i/KyWoy6/jakter-astrazeneca-svar-her-er-hypotesen-de-jobber-etter https://www.vg.no/nyheter/innenriks/i/KyWoy6/jakter-astrazen... A key quote from the second of those is this: Madsen har tidligere forklart at det er to nivåer å undersøke bivirkninger på: Gruppebasert, og individbasert. Ifølge Madsen det ikke er noe som tyder på at AstraZeneca-vaksinen er forbundet med en større risiko for blodpropp i statistikken – men det de undersøker, er om det kan finnes bivirkninger som er spesielle og rammer få personer. My translation: Madsen has earlier explained that there are two levels of investigation regarding side effects: group based and individual. Accoeding to Madsen there is nothing to indicate that the AstraZeneca vaccine is associated with a greater risk of blood clots in the statistics - but what they are investigating is whether there are side effects that are special and affect few people.
    - AnthonBerg 6y ago
      This comment should not be downvoted as it is both topical and helpful.
Hamuko 6y ago
Meanwhile Finland is not discontinuing the use of the AstraZeneca vaccine because there have been less blood clots than initially anticipated. ¯\_(ツ)_/¯
kkoncevicius 6y ago
With all these vaccines and companies competing with one another I often wonder what is real, what is unstated, and what is a PR stunt against the competition.
- ed25519FUUU 6y ago
  Reminds me a little of the Media blitz against hydroxychloroquine early in the outbreak. I knew an out of patent treatment wasn’t going to do it when there’s so much money to be made.
  - xtracto 6y ago
    Same with Ivermectin ( https://youtu.be/w3u39moxStQ?t=1570 https://youtu.be/w3u39moxStQ?t=1570 ). There has been a lot of evidence that at least it helps in something against COVID19. But the fact that there's no money to be made form that prevented laboratories from doing real research, leaving us only with anecdotal evidence from several places that have been using it.
piokoch 6y ago
Is there some massive action against AZ vaccine. Looking on any provided data it seems that those blood clots cases are below population averages, but everyday I read about someone killed by AZ vaccine. I feel lost, frankly speaking. AZ vaccine is way cheaper than Pfizer or Moderna vaccine, could it be some PR action from those producers whose business is hurt by AZ. I don't want to sound as some proponent of conspiracy theories, but is there any reliable source that confirms that there is something wrong with the AZ vaccine. For now it looks like some governments got scared by people panicking on Twitter and started panicking too...
- SiempreViernes 6y ago
  This is the first big vaccine from AZ, so part of it is that they are just bad at the various practical bits of the process compared to the more experienced multinationals. So for example, problems with quality control made for a unnecessarily challenging analysis of trial data. Slowness in reporting details when possible complications showed up in during the trials made the US authorities really pissy and they've still not granted it permission for emergency use. And then there is their awful communications around the production issues where they spent like a month giving progressively worse and worse news to their customers about how much vaccine would actually show up. All those very real problems make for good padding to any article about any new issue about the AZ vaccine. So because it is simply easy news to write it will get written, and this helps explain why there are so many.
  - sudosysgen 6y ago
    Maybe it would have been better after all if not just AstraZeneca were able to manufacture the vaccine, as was originally planned.
smcg 6y ago
Europe really messed up their vaccine orders and they are looking for excuses to cover it up.
- kyriakos 6y ago
  EMA concluded that these incidents were not caused by the vaccine so it kinda disproves your statement here.
  - chithanh 6y ago
    This is not how I read the EMA statement. They don't see any evidence but they didn't exclude the possibility either. Which is why they want the observations documented in the package insert.
  - smcg 6y ago
    I think we agree that it wasn't caused by the vaccine so I have no idea what you are getting at
  - smcg 6y ago
    I guess you can't understand context. I'm saying they snubbed the vaccine to cover their asses for messing up the orders.
rumblestrut 6y ago
I have a family member who read a similar story, and because he has blood clotting issues, it's giving him pause to taking any vaccine. Nevermind that the AZ vaccine isn't even available where he lives (U.S.) yet. But couple a fear-mongering headline with an aging population, and this is what you get. Thanks, media. Bang up job you did there.
lars 6y ago
I'm happy this research has been done so quickly, but am somewhat annoyed that the public conversation is so focused on whether or not the vaccine can possibly cause any problems, and not at all focused on the risk management question of what the optimal choice here is. The chance of getting a blood clot seems so low that it may for all I know be equivalent to the risk of dying in the streets while jaywalking to get to the vaccination center. Compared to the risk of going unvaccinated, it's an obvious choice. That's not the choice we have though. The correct comparison seems to be the expected risk of taking the vaccine vs expected risk of waiting for a dose of another vaccine. Calculating this on an individual level should be straight forward given the risk of contracting COVID in a given area. Ideally the calculation would also take into account the effect that vaccination has on the virus reproduction number. That's harder to model, but approximate models like this exist. If you actually put numbers to it and do this computation, you'll get an answer, or at least a distribution of outcomes, where it's straight forward to see what choice is optimal. Then public discussion can be around what the parameters of this model should be, and we'll stand a chance of making the right choice. This is a potentially very consequential optimization problem, and the public discussion about it is as if no one understands that that is what it is.
- jansan 6y ago
  >The chance of getting a blood clot seems so low that it may for all I know be equivalent to the risk of dying in the streets while jaywalking to get to the vaccination center. Compared to the risk of going unvaccinated, it's an obvious choice. Are you sure this holds true for a 25 year old healthy person?
  - lars 6y ago
    Well, this is the discussion I'd like to see. You have people born in the 90s hospitalized in Norway now. Many experience long term physical and cognitive effects. And as long as we're assuming everyone goes unvaccinated, the chance of contracting COVID goes towards 1 over time, while the R-number explodes as we open up society to avoid economic ruin. Not a good scenario IMO. As I said, the relevant comparison in the real world is versus waiting for another vaccine, where it the choice is much less obvious, and dependent on the disease level in the population.
donohoe 6y ago
I am flagging this and so should you. The "experts say" part lacks independent support. There is more news expected from EU on this today. Headline like this cause more damage and spread distrust of vaccines.
- Dma54rhs 6y ago
  I rather learn the truth than hide it because some people don't like it. Tomorrow I will get my first AZ jab myself btw.
raphlinus 6y ago
Not specifically in relation to this latest Norwegian claim, but an excellent backgrounder on the blood clot problem: https://www.sciencemag.org/news/2021/03/it-s-very-special-picture-why-vaccine-safety-experts-put-brakes-astrazeneca-s-covid-19 https://www.sciencemag.org/news/2021/03/it-s-very-special-pi...
- dhimes 6y ago
  Excellent find- thank you. “It’s a very special picture” of symptoms, says Steinar Madsen, medical director of the Norwegian Medicines Agency. “Our leading hematologist said he had never seen anything quite like it.”
- xtracto 6y ago
  Thank you, this article has actual real information.
  - twirlock 6y ago
    >this article doesn't challenge my worldview, so suddenly facts exist again
mrabcx 6y ago
One important aspect: The AZ vaccine was in Norway (and many EU countries) initially only approved for those under 65. The AZ vaccine in Norway has therefore solely been given out to health workers. On the other hand, in the UK the vaccine has been given out to both elderly and to health workers. It is quite possible that the immune response from AZ is not quite the same across age groups and may at times be more severe for a younger population.
SonicTheSith 6y ago
Most people here got the math wrong... it is not x of 17mil. but X number of cases for women vaccinated with AZ in the age group 20-50. This kind of thromboses seem to happen mostly to women. While there is no correlation yet found, such kind of thrombosis are until now mostly caused by hormones from for example anti baby bills or other situations where the hormonal balance is not normal. Most that were vaccinated in the uk with AZ are old people. The cases only happened in countries were AZ was used to vaccinate younger people such as health care workers. While pfizer and moderna were used only for old people. Plans were made to soon start wide spread vaccination using AZ on those below 50. If the hypothesis holds that women below age 50 have a risk larger than dying from covid to get the brain thrombosis. We might need to give AZ only to men + women older than or younger than N years.
- jakeva 6y ago
  "anti baby pills" is an interesting term, here in the U.S. we normally call it "contraceptives". I'm assuming you're in Europe, I know in German it would be "Antibabypillen".
- carlmr 6y ago
  Is there any data on whether the people that had the thrombosis on AZ were also on contraceptives? The high incidence group seems to be women under 50. The same group that is most likely group to take contraceptives. Maybe two things that cause bloodclots at the same time make it much worse.
lwjwrehljkewr 6y ago
Norwegian experts say FUCK LOCKDOWNS! FUCK MASKS! FUCK DEMOCRATS!
macinjosh 6y ago
I will take a vaccine once one gains FDA approval. Can't imagine why anyone is surprised a barely tested medication might have some negative side-effects.
milkrocks 6y ago
Things like this happen with experimental untested vaccines.
milkrocks 6y ago
Do you run beta software on production systems? You're answer is most likely no, so why would you put a beta vaccine in your body? Play stupid games win stupid prizes, no remorse for the 40 guinea pigs who died.
Someone 6y ago
It’s said in many texts about this (possible) problem, but I don’t understand how serious blood clots and low levels of blood platelets can go together. https://en.wikipedia.org/wiki/Platelet https://en.wikipedia.org/wiki/Platelet: “Platelets […] are a component of blood whose function […] is to react to bleeding from blood vessel injury by clumping, thereby initiating a blood clot.” So, I would expect low platelet counts to be associated with excessive bleeding, not excessive clotting (and indeed it is. See https://en.wikipedia.org/wiki/Thrombocytopenia https://en.wikipedia.org/wiki/Thrombocytopenia) Do most platelets for these patients end up in clots, and is production stopped? Are there other cell types or mechanisms that can cause clotting? Can anybody enlighten me?
- AnthonBerg 6y ago
  This effect is indeed strange, and rare, and underlines the severity of the mechanism and the result. It is mentioned and described somewhat in the Norwegian articles that are linked to. As I understood the Norwegian text, there is severe clotting in unusual places like the brain and stomach, and the blood is effectively left void of platelets. As I understand - as a layman - is that an autoimmune-related reaction causes what I would consider to be an implosion of the platelets. This is still rare, but it will of course be investigated and we will of course figure out why this happens, and then it probably doesn’t have to happen to anyone! Maybe there’s a genetic component ¯\_(ツ)_/¯
- deleted 6y ago
  [deleted]
- burpee 6y ago
  I've had the exact some happen (It's rare, but here I am), including a transient ischemic stroke while having virtually no platelets. There is no real understanding for the cause of immune thrombocytopenia in the first place, but the combination of low platelets and clotting happens in quite a few cases. Platelets take on a lot of roles beyond clotting (for example they transport serotonin, which itself has been linked to clotting) and clotting itself is about more than just platelet counts (which would need a few pages to even start to explain). Once the immune system targets platelets though, unexpected things tend to happen beyond just uncontrolled bleeding, none of which are particularly well understood due to the low number of cases. The cause of idiopathic thrombocytopenia is most commonly attributed to an immune response, although it can have several other causes. What I can say is that thrombocytopenia following a viral infection is more common than it appears to be following this vaccine. I believe this would be a more fair comparison than to compare it against the general population. The percentage of people who would have this same stroke when having COVID-19 would in all probability be much much higher.
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khosro 6y ago
Clots form and dissolve in small quantities in the body all the time. Occasionally the amount is large and leads to pulmonary embolism and death, without a vaccine being given. Inflammatory chemokines can slightly shift this balance. Immunization leads to an inflammatory response, and any inflammation shifts the clotting balance. This is an expected side effect. The degree of this inflammation varies in different people and varies with the severity of the inflammation. Most importantly, the benefit of protection against COVID OUTWEIGHS the small increase in clotting risk.
baxtr 6y ago
Meanwhile EMA (European Medicines Agency) just decided that it is safe to use the vaccine. How are these two headlines compatible with each other?
Pyramus 6y ago
The German institute for vaccines (Paul-Ehrlich-Institute), responsible for the German temporary suspension, has an excellent FAQ on the topic (also posted by user Dragonfly) [1]: * Germany has seen 7 events (3 deaths) per 1.6M doses, age 20-50, 6 female * Caused by severe cerebral venous thrombosis with platelet deficiency * Analysis showed heightened levels relative to background * Much more severe than side effect of contraceptive pills, and yet unknown In terms of frequency of events Germany seems to be in between UK/US and Norway. [1] https://www.pei.de/EN/newsroom/hp-news/2021/210315-pei-informs-temporary-suspension-vaccination-astra-zeneca.html https://www.pei.de/EN/newsroom/hp-news/2021/210315-pei-infor...
libertine 6y ago
Hopefully Alexander Ginzburg is right: “Perhaps in this case an incomplete degree of purification was used and some products that could remain in the final product could contribute to platelet aggregation in some of the patients who received the preparation,” Ginzburg was quoted as saying. [1] It would mean it was a production problem, not an adverse reaction to a vaccine well manufactured. AZ has been under pressure to deliver, but if this is the case would mean an extremely bad QA process, which for vaccines is probably highly unlikely. [1]https://www.world-today-news.com/the-creator-of-sputnik-v-pointed-out-why-blood-clots-form-in-the-astrazeneca-vaccine/ https://www.world-today-news.com/the-creator-of-sputnik-v-po...

239 points by yread 6y ago

Is it really so crazy to think that these vaccines which were (necessarily) rushed to production might have problems? The solution is not to just shut our eyes and say “well COVID is worse”. We have to understand the risks to administer the right vaccine to people with risk factors, and so we know how to treat the conditions that result.

afavour 6y ago
I don't think anyone is shutting their eyes to the risk. COVID is worse and a lot more people out there have risk factors associated with COVID than have risk factors associated with the AZ vaccine. We can do both here: investigate these reports while continuing to fight back COVID.
- lwjwrehljkewr 6y ago
  I bless you my son into the church of the Branch Covidian.
- draw_down 6y ago
  I don’t agree, I see a ton of discourse of the variety “if you eat hotdogs don’t worry what’s in the vaccine”, the point being it’s foolish to worry about the vaccine risks. Besides that this particular clotting issue has been repeatedly denied, which is why the researchers here are saying emphatically that the vaccine is the cause. Some country, I think Germany, slowed deployment of this vaccine for this reason and got a lot of heat because again, there can’t be anything wrong with the vaccines. COVID will kill you, vaccines will save you, and if you think different you get to sit in the corner.
vintagemodel 6y ago
There seems to be some working medication that helps people who have gotten covid: https://vdmeta.com/ https://vdmeta.com/ and https://ivmmeta.com/ https://ivmmeta.com/ (I'm not working in the fields of medicine, statistics or virology.)

imdsm 6y ago

I think a lot of folks are making the mistake of realising that inaction is action. To not vaccinate is an action, and one that carries its own risks.

simonh 6y ago
not realising.

vibrio 6y ago

Based on all the information provided in this article, this article is premature to publish. The headline is accurate, as 'experts say', but lack of any independent support of data supporting the claim, makes this dubious (at best) to publish at this point.

ppf 6y ago
If only the same standard were applied to all statements about Covid.
- CWuestefeld 6y ago
  Or, really, everything in the news.
  - germinalphrase 6y ago
    But... then... there would be less news.
    - thitcanh 6y ago
      Wouldn’t it be nice
    - dekhn 6y ago
      nobody wants to read the "Journal of Unsurprising Results Consistent With Evidence"
      - staticautomatic 6y ago
        I do.
    - acje 6y ago
      Is the quality degradation in news some variant of tragedy of the commons?
- ohhhhhh 6y ago

simonh 6y ago

Interesting, and very concerning if it's true. I was given my first shot of the AZ vaccine on Monday afternoon, so I was aware of the reports of blood clots at the time although only in outline. I just don't understand how come the same reaction hasn't been seen in the millions of people vaccinated with AZ outside Norway (edit - it has been, thanks for the info, none of the articles I've come across properly explained this). Regardless I don't regret going ahead and getting the jab even for a second. Even if this turns out to be perfectly accurate, it seems to me the risk from the virus is dramatically greater. In fact while I don't want to trivialise what happened to these people, it's awful, I think the biggest concern for me is the millions of people who are not getting vaccinated or have delayed vaccinations due to these concerns, the thousands of them that will end up contracting Covid-19, and the hundreds of them that will end up dead. This is a real-life example of the runaway railcar switch dilemma. The train car is heading towards a crowd of millions of people and will plough through the middle of them killing many hundreds, or you can throw the switch and divert the railcar so it hits a handful of people prone to the blood clot reaction. A horrible situation to be in. Oh well, I made the choice for myself which group I want to join*. * Yes, a terrible analogy, but it's the best I could come up with during my lunch break.

jansan 6y ago
> I just don't understand how come the same reaction hasn't been seen in the millions of people vaccinated with AZ outside Norway. Dude, it has been seen outside Norway, and the observations are exactly the same, at least here in Germany. A certain group of people, maybe in combination with a certain type of drug they are taking, seem to be at risk for a very specific thrombosis in combination with a very low blood platelet count. There is some detective work necessary now to identify this group, so they can be excluded from AZ vaccinations, and then go on with the vaccination. That's what needs to be done now, and as fast as possible.
- simonh 6y ago
  Thanks you, that's very helpful. None of the articles I've come across on this have explained the context outside Norway, including the one linked in this thread.

boomskats 6y ago

> “We have the reason. Nothing but the vaccine can explain why these individuals had this immune response”, he states. Do these two sentences not _directly_ contradict each other?

deleted 6y ago
[deleted]
clankyclanker 6y ago
They do not. Rewritten for concision: > “We have the reason: only the vaccine could have caused this immune response”

raverbashing 6y ago

Sensationalist and misleading title Yes, it's the vaccine "that caused it". In a 1 in a million case. In the same way you can die eating a donut and choking on it. The real news is that it might have involved a platelet targeting immune reaction. Guess what else causes clotting problems (in much higher frequency)? Covid

hvidgaard 6y ago
3 have had the immune response in about 120.000 vaccinated with AstraZeneca. That's too small a sample to really conclude anything, but as far as Norway is concerned it might be a 1:40000 risk.
- chii 6y ago
  but norway has to consider whether they just got _really_ unlucky, and saw these numbers, when some countries like the UK hasn't. Or the UK has, but they are either unreported, or the different demographic group is not showing up with the same numbers so uncomparable. It's a hard thing to tease out.
  - hvidgaard 6y ago
    I agree, as I said it's too small a sample to really say anything. If we include the numbers from Denmark it's 4 in 250.000. Still not good if we need to use it on a large scale, and certainly not if we need to use it again and again.
  - Daho0n 6y ago
    Norway's number is only from healthy health workers. The UK number is not.

mynegation 6y ago

Is there any history of such reactions to vaccines in the past?

kkoncevicius 6y ago
Most well known is probably narcolepsy induced by Pandermix flu vaccine. [1] But in my understanding any vaccine can have side effects. When my kids get vaccinated I always have to sign a paper stating that I understand the risks of possible seizures, blood cloths, sudden death, etc. Even thou I understand that risks are very small it's always hard to read and sign something like that. [1]: https://www.sciencemag.org/news/2015/07/why-pandemic-flu-shot-caused-narcolepsy https://www.sciencemag.org/news/2015/07/why-pandemic-flu-sho...
- swader999 6y ago
  The car ride to get the vaccine is the bigger risk in their day.

dekhn 6y ago

There is absolutely not enough evidence from this particular doctor to justify the claim. It's irresponsible to publish this.

dsnr 6y ago
> In collaboration with experts in the field from the University Hospital of North Norway HF, we have found specific antibodies against blood platelets that can cause these reactions[...] So the evidence is definitely not from only „this particular doctor“, but from a group of experts on the matter.
- DoingIsLearning 6y ago
  > we found specific antibodies against blood platelets So are they claiming that this is actually due to the vaccine formulation itself, i.e. does this finding exclude the initial hypothesis of a Quality issue or a specific 'bad batch' of the vaccine?
  - dekhn 6y ago
    the news article doesn't say; it attributes a quote to the doctor saying "it's the vaccine" but it's unclear whether that means "bad batch". Personally, if 3 health workers all go to the same hospital in a remote region complaining of clots, it's more likely that something local happened (as you say, QA, or any number of other sources).
    - kwhitefoot 6y ago
      The article is a very poor quality summary. The articles in VG are much better. I put a quote from one and a translation elsewhere on this HN page.
      - dekhn 6y ago
        I've read all of them so far and I still think the professor was being irresponsible in his wording and the press is being dumb for amplifying it.

auiya 6y ago

Astra Zeneca says it's less than 40 cases in 17 million. Are those numbers accurate? That seems like quite a small population affected.

rambojazz 6y ago
I think the argument for suspending the vaccine was that the number was still significantly higher than the expected value, despite being very low.
- cranekam 6y ago
  40 out of 17 million is 0.0002%. Surely 0.0002% of any cohort go on to develop blood clots? I'd certainly pick those odds over being unvaccinated.
  - marvin 6y ago
    If the risk turns out to be 1 in 50.000, which would be on the conservative side if the observations from Norway are correct, it's not a clear-cut question in a country with low incidence of Covid. Especially if other vaccines are available with a small delay. The British tool for calculating covid risk puts risk of death as 1 in 500.000 for a healthy 25-year old, and risk of hospital admission as 1 in 13.000. Must also add to this the public's willingness to vaccinate in the face of these numbers, both now and in the future. It's a shifting of risk from high-risk groups to low-risk groups.
    - BrianOnHN 6y ago
      > risk turns out to be 1 in 50.000 It's more like 1 in 500,000.
      - lyschoening 6y ago
        The numbers are three healthcare workers out of 120,000 vaccinated in Norway, with one death, so the risk is 1 in 40,000 from what we know. On top of that we can speculate that healthcare workers are more likely to seek treatment than the average vaccine recipient and they are healthy adults of average age.

acallaghan 6y ago

The rate of blood clots as a side effect for the AZ covid jab is less than that of the combined contraceptive pill - does that mean that both need to be discontinued?

bennofs 6y ago
Maybe I've missed it, but I didn't find anything in the article about whether the vaccine does need to be discontinued or not. In any case, being clear about what side effects are possible and researching them to get a better understanding is a requirement in my opinion.
- kwhitefoot 6y ago
  You need to read the VG articles, they are much more thorough than the one linked on HN but they are in Norwegian. Google Translate does a fair job. https://www.vg.no/nyheter/innenriks/i/QmwR1V/professor-om-mistenkte-vaksinebivirkninger-aarsaken-er-funnet https://www.vg.no/nyheter/innenriks/i/QmwR1V/professor-om-mi... https://www.vg.no/nyheter/innenriks/i/KyWoy6/jakter-astrazeneca-svar-her-er-hypotesen-de-jobber-etter https://www.vg.no/nyheter/innenriks/i/KyWoy6/jakter-astrazen... A key quote from the second of those is this: Madsen har tidligere forklart at det er to nivåer å undersøke bivirkninger på: Gruppebasert, og individbasert. Ifølge Madsen det ikke er noe som tyder på at AstraZeneca-vaksinen er forbundet med en større risiko for blodpropp i statistikken – men det de undersøker, er om det kan finnes bivirkninger som er spesielle og rammer få personer. My translation: Madsen has earlier explained that there are two levels of investigation regarding side effects: group based and individual. Accoeding to Madsen there is nothing to indicate that the AstraZeneca vaccine is associated with a greater risk of blood clots in the statistics - but what they are investigating is whether there are side effects that are special and affect few people.
  - AnthonBerg 6y ago
    This comment should not be downvoted as it is both topical and helpful.

Hamuko 6y ago

Meanwhile Finland is not discontinuing the use of the AstraZeneca vaccine because there have been less blood clots than initially anticipated. ¯\_(ツ)_/¯

kkoncevicius 6y ago

With all these vaccines and companies competing with one another I often wonder what is real, what is unstated, and what is a PR stunt against the competition.

ed25519FUUU 6y ago
Reminds me a little of the Media blitz against hydroxychloroquine early in the outbreak. I knew an out of patent treatment wasn’t going to do it when there’s so much money to be made.
- xtracto 6y ago
  Same with Ivermectin ( https://youtu.be/w3u39moxStQ?t=1570 https://youtu.be/w3u39moxStQ?t=1570 ). There has been a lot of evidence that at least it helps in something against COVID19. But the fact that there's no money to be made form that prevented laboratories from doing real research, leaving us only with anecdotal evidence from several places that have been using it.

piokoch 6y ago

Is there some massive action against AZ vaccine. Looking on any provided data it seems that those blood clots cases are below population averages, but everyday I read about someone killed by AZ vaccine. I feel lost, frankly speaking. AZ vaccine is way cheaper than Pfizer or Moderna vaccine, could it be some PR action from those producers whose business is hurt by AZ. I don't want to sound as some proponent of conspiracy theories, but is there any reliable source that confirms that there is something wrong with the AZ vaccine. For now it looks like some governments got scared by people panicking on Twitter and started panicking too...

SiempreViernes 6y ago
This is the first big vaccine from AZ, so part of it is that they are just bad at the various practical bits of the process compared to the more experienced multinationals. So for example, problems with quality control made for a unnecessarily challenging analysis of trial data. Slowness in reporting details when possible complications showed up in during the trials made the US authorities really pissy and they've still not granted it permission for emergency use. And then there is their awful communications around the production issues where they spent like a month giving progressively worse and worse news to their customers about how much vaccine would actually show up. All those very real problems make for good padding to any article about any new issue about the AZ vaccine. So because it is simply easy news to write it will get written, and this helps explain why there are so many.
- sudosysgen 6y ago
  Maybe it would have been better after all if not just AstraZeneca were able to manufacture the vaccine, as was originally planned.

smcg 6y ago

Europe really messed up their vaccine orders and they are looking for excuses to cover it up.

kyriakos 6y ago
EMA concluded that these incidents were not caused by the vaccine so it kinda disproves your statement here.
- chithanh 6y ago
  This is not how I read the EMA statement. They don't see any evidence but they didn't exclude the possibility either. Which is why they want the observations documented in the package insert.
- smcg 6y ago
  I think we agree that it wasn't caused by the vaccine so I have no idea what you are getting at
- smcg 6y ago
  I guess you can't understand context. I'm saying they snubbed the vaccine to cover their asses for messing up the orders.

rumblestrut 6y ago

I have a family member who read a similar story, and because he has blood clotting issues, it's giving him pause to taking any vaccine. Nevermind that the AZ vaccine isn't even available where he lives (U.S.) yet. But couple a fear-mongering headline with an aging population, and this is what you get. Thanks, media. Bang up job you did there.

lars 6y ago

I'm happy this research has been done so quickly, but am somewhat annoyed that the public conversation is so focused on whether or not the vaccine can possibly cause any problems, and not at all focused on the risk management question of what the optimal choice here is. The chance of getting a blood clot seems so low that it may for all I know be equivalent to the risk of dying in the streets while jaywalking to get to the vaccination center. Compared to the risk of going unvaccinated, it's an obvious choice. That's not the choice we have though. The correct comparison seems to be the expected risk of taking the vaccine vs expected risk of waiting for a dose of another vaccine. Calculating this on an individual level should be straight forward given the risk of contracting COVID in a given area. Ideally the calculation would also take into account the effect that vaccination has on the virus reproduction number. That's harder to model, but approximate models like this exist. If you actually put numbers to it and do this computation, you'll get an answer, or at least a distribution of outcomes, where it's straight forward to see what choice is optimal. Then public discussion can be around what the parameters of this model should be, and we'll stand a chance of making the right choice. This is a potentially very consequential optimization problem, and the public discussion about it is as if no one understands that that is what it is.

jansan 6y ago
>The chance of getting a blood clot seems so low that it may for all I know be equivalent to the risk of dying in the streets while jaywalking to get to the vaccination center. Compared to the risk of going unvaccinated, it's an obvious choice. Are you sure this holds true for a 25 year old healthy person?
- lars 6y ago
  Well, this is the discussion I'd like to see. You have people born in the 90s hospitalized in Norway now. Many experience long term physical and cognitive effects. And as long as we're assuming everyone goes unvaccinated, the chance of contracting COVID goes towards 1 over time, while the R-number explodes as we open up society to avoid economic ruin. Not a good scenario IMO. As I said, the relevant comparison in the real world is versus waiting for another vaccine, where it the choice is much less obvious, and dependent on the disease level in the population.

donohoe 6y ago

I am flagging this and so should you. The "experts say" part lacks independent support. There is more news expected from EU on this today. Headline like this cause more damage and spread distrust of vaccines.

Dma54rhs 6y ago
I rather learn the truth than hide it because some people don't like it. Tomorrow I will get my first AZ jab myself btw.

raphlinus 6y ago

Not specifically in relation to this latest Norwegian claim, but an excellent backgrounder on the blood clot problem: https://www.sciencemag.org/news/2021/03/it-s-very-special-picture-why-vaccine-safety-experts-put-brakes-astrazeneca-s-covid-19 https://www.sciencemag.org/news/2021/03/it-s-very-special-pi...

dhimes 6y ago
Excellent find- thank you. “It’s a very special picture” of symptoms, says Steinar Madsen, medical director of the Norwegian Medicines Agency. “Our leading hematologist said he had never seen anything quite like it.”
xtracto 6y ago
Thank you, this article has actual real information.
- twirlock 6y ago
  >this article doesn't challenge my worldview, so suddenly facts exist again

mrabcx 6y ago

One important aspect: The AZ vaccine was in Norway (and many EU countries) initially only approved for those under 65. The AZ vaccine in Norway has therefore solely been given out to health workers. On the other hand, in the UK the vaccine has been given out to both elderly and to health workers. It is quite possible that the immune response from AZ is not quite the same across age groups and may at times be more severe for a younger population.

SonicTheSith 6y ago

Most people here got the math wrong... it is not x of 17mil. but X number of cases for women vaccinated with AZ in the age group 20-50. This kind of thromboses seem to happen mostly to women. While there is no correlation yet found, such kind of thrombosis are until now mostly caused by hormones from for example anti baby bills or other situations where the hormonal balance is not normal. Most that were vaccinated in the uk with AZ are old people. The cases only happened in countries were AZ was used to vaccinate younger people such as health care workers. While pfizer and moderna were used only for old people. Plans were made to soon start wide spread vaccination using AZ on those below 50. If the hypothesis holds that women below age 50 have a risk larger than dying from covid to get the brain thrombosis. We might need to give AZ only to men + women older than or younger than N years.

jakeva 6y ago
"anti baby pills" is an interesting term, here in the U.S. we normally call it "contraceptives". I'm assuming you're in Europe, I know in German it would be "Antibabypillen".
carlmr 6y ago
Is there any data on whether the people that had the thrombosis on AZ were also on contraceptives? The high incidence group seems to be women under 50. The same group that is most likely group to take contraceptives. Maybe two things that cause bloodclots at the same time make it much worse.

lwjwrehljkewr 6y ago

Norwegian experts say FUCK LOCKDOWNS! FUCK MASKS! FUCK DEMOCRATS!

macinjosh 6y ago

I will take a vaccine once one gains FDA approval. Can't imagine why anyone is surprised a barely tested medication might have some negative side-effects.

milkrocks 6y ago

Things like this happen with experimental untested vaccines.

milkrocks 6y ago

Do you run beta software on production systems? You're answer is most likely no, so why would you put a beta vaccine in your body? Play stupid games win stupid prizes, no remorse for the 40 guinea pigs who died.

Someone 6y ago

It’s said in many texts about this (possible) problem, but I don’t understand how serious blood clots and low levels of blood platelets can go together. https://en.wikipedia.org/wiki/Platelet https://en.wikipedia.org/wiki/Platelet: “Platelets […] are a component of blood whose function […] is to react to bleeding from blood vessel injury by clumping, thereby initiating a blood clot.” So, I would expect low platelet counts to be associated with excessive bleeding, not excessive clotting (and indeed it is. See https://en.wikipedia.org/wiki/Thrombocytopenia https://en.wikipedia.org/wiki/Thrombocytopenia) Do most platelets for these patients end up in clots, and is production stopped? Are there other cell types or mechanisms that can cause clotting? Can anybody enlighten me?

AnthonBerg 6y ago
This effect is indeed strange, and rare, and underlines the severity of the mechanism and the result. It is mentioned and described somewhat in the Norwegian articles that are linked to. As I understood the Norwegian text, there is severe clotting in unusual places like the brain and stomach, and the blood is effectively left void of platelets. As I understand - as a layman - is that an autoimmune-related reaction causes what I would consider to be an implosion of the platelets. This is still rare, but it will of course be investigated and we will of course figure out why this happens, and then it probably doesn’t have to happen to anyone! Maybe there’s a genetic component ¯\_(ツ)_/¯
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burpee 6y ago
I've had the exact some happen (It's rare, but here I am), including a transient ischemic stroke while having virtually no platelets. There is no real understanding for the cause of immune thrombocytopenia in the first place, but the combination of low platelets and clotting happens in quite a few cases. Platelets take on a lot of roles beyond clotting (for example they transport serotonin, which itself has been linked to clotting) and clotting itself is about more than just platelet counts (which would need a few pages to even start to explain). Once the immune system targets platelets though, unexpected things tend to happen beyond just uncontrolled bleeding, none of which are particularly well understood due to the low number of cases. The cause of idiopathic thrombocytopenia is most commonly attributed to an immune response, although it can have several other causes. What I can say is that thrombocytopenia following a viral infection is more common than it appears to be following this vaccine. I believe this would be a more fair comparison than to compare it against the general population. The percentage of people who would have this same stroke when having COVID-19 would in all probability be much much higher.

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khosro 6y ago

Clots form and dissolve in small quantities in the body all the time. Occasionally the amount is large and leads to pulmonary embolism and death, without a vaccine being given. Inflammatory chemokines can slightly shift this balance. Immunization leads to an inflammatory response, and any inflammation shifts the clotting balance. This is an expected side effect. The degree of this inflammation varies in different people and varies with the severity of the inflammation. Most importantly, the benefit of protection against COVID OUTWEIGHS the small increase in clotting risk.

baxtr 6y ago

Meanwhile EMA (European Medicines Agency) just decided that it is safe to use the vaccine. How are these two headlines compatible with each other?

Pyramus 6y ago

The German institute for vaccines (Paul-Ehrlich-Institute), responsible for the German temporary suspension, has an excellent FAQ on the topic (also posted by user Dragonfly) [1]: * Germany has seen 7 events (3 deaths) per 1.6M doses, age 20-50, 6 female * Caused by severe cerebral venous thrombosis with platelet deficiency * Analysis showed heightened levels relative to background * Much more severe than side effect of contraceptive pills, and yet unknown In terms of frequency of events Germany seems to be in between UK/US and Norway. [1] https://www.pei.de/EN/newsroom/hp-news/2021/210315-pei-informs-temporary-suspension-vaccination-astra-zeneca.html https://www.pei.de/EN/newsroom/hp-news/2021/210315-pei-infor...

libertine 6y ago

Hopefully Alexander Ginzburg is right: “Perhaps in this case an incomplete degree of purification was used and some products that could remain in the final product could contribute to platelet aggregation in some of the patients who received the preparation,” Ginzburg was quoted as saying. [1] It would mean it was a production problem, not an adverse reaction to a vaccine well manufactured. AZ has been under pressure to deliver, but if this is the case would mean an extremely bad QA process, which for vaccines is probably highly unlikely. [1]https://www.world-today-news.com/the-creator-of-sputnik-v-pointed-out-why-blood-clots-form-in-the-astrazeneca-vaccine/ https://www.world-today-news.com/the-creator-of-sputnik-v-po...