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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

by 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.
Shorel 6y ago
I say both risks are totally related. Covid itself causes blood clots. The solution here has been to administer aspirin to Covid patients. So the solution for the AstraZeneca vaccine should be the same. Vaccinate people, give them some aspirin over two weeks, just in case.
- elliekelly 6y ago
  It reminds me of the blood clotting scare tactic sometimes used to discourage women from taking birth control. I remember raising it once with my OB/GYN who quickly told me that the risk of blood clots from the pill is very low for a non-smoker like me while the risk of getting blood clots if I became pregnant is much higher.
- magnusmundus 6y ago
  It really complicates the operations though, which is already proving to be difficult for many countries: You have to add aspirin distribution & storage to the vaccine, which might be an issue for costs if not for the logistics of it. More importantly, you have to manage whether the vaccinated people can take aspirin. You don't want this to be how you find out you have a different blood coagulation issue, or anything else that aspirin can affect adversely (I'm not a medical professional).
- TheOtherHobbes 6y ago
  There are two semi-independent clotting systems. Broadly, aspirin works on the one associated with heart attacks. Most strokes are caused by the other. So taking aspirin for strokes doesn't usually help. (Source: had a mild stroke, was told this by multiple neurologists.) Covid seems related to both. You need non-trivial blood thinners - Warfarin, rivaroxaban, apixaban - to affect DVT etc, and those are high-maintenance meds with side effects of their own. But there is some evidence that aspirin does help with Covid clotting, and low doses for short periods seem pretty safe. So the worst you'll do is improve your odds of avoiding problems from something that's already not much of an issue.
- marcosdumay 6y ago
  I wonder is the aspirin won't bring higher risk than the vaccine. The numbers people are passing around are way too low. Low enough that it's difficult to understand why somebody is taking any action at all instead of reading it as a minuscule statistical fluctuation.
afavour 6y ago
> 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. In this situation it's not that much of a dilemma, though. It's not as if those prone to blood clots are not at risk until they're given the vaccine, everyone is at risk from COVID and the blood clot prone maybe even more so. And the sheer number of people it will benefit means the choice is simple. > very concerning if it's true Little known fact: women's birth control pills also have a higher risk of blood clot. Always have. If that risk is considered to be acceptable then I don't see any reason why this isn't either.
- YinglingLight 6y ago
  >everyone is at risk from COVID Yet the majority of the population are not at risk for significant health complications from COVID. The question remains if the blood clot causing demographics overlap with those at risk for serious COVID cases.
- bbarnett 6y ago
  Yes, but, there are close to 200 vaccines. It isn't as if all vaccinations have stopped, there are other options, and panic and fear on the side of omg must vaccinate now, now,now!? Any hint, even the slightest, that complications may be ignored, could result in untold masses refusing vaccination out of fear. So let's pause one vaccine for a few days, and see if moving ahead, or more research is required.
  - afavour 6y ago
    > there are other options Not with sufficient supply there isn’t. That’s the issue almost every country is facing, and AZ production plants can’t just flip a switch and start making Moderna vaccines instead. No matter what if you stop using the AZ you’re going to have a sharp drop in the number of vaccinations you’re able to do. That would almost certainly result in more deaths than the side effect of the vaccine. > Any hint, even the slightest, that complications may be ignored, could result in untold masses refusing vaccination out of fear. Only if people (and the media especially) hype up a very small danger to be more than it is. The larger danger is and always was COVID itself, especially with the new strains spreading.
sobriquet9 6y ago
Your options are not just A) take the AZ vaccine right now, and B) never take any vaccine. You can also wait until more data becomes available, or until another vaccine becomes available. Doing so does carry some incremental risk, but this risk is smaller than the risk of not getting vaccinated ever.
- rob74 6y ago
  > until another vaccine becomes available Well yeah, other vaccines (Biontech/Pfizer and Moderna) with far fewer side effects and apparently higher effectivity are already available, and that's part of the problem. It's not that the potentially fatal blood clots are the only side effect of the AstraZeneca vaccine, people also pretty often get infection symptoms (fever etc.), which is of course not that bad, but still unpleasant. So you can't really blame people for wanting to get the better vaccine...
- simonh 6y ago
  I specifically talked about the risks of delayed vaccination and did not frame the choice in the extreme terms you described.
  - sobriquet9 6y ago
    Looks like it was a pretty short delay: https://www.dw.com/en/astrazeneca-german-team-discovers-thrombosis-trigger/a-56925550 https://www.dw.com/en/astrazeneca-german-team-discovers-thro...
dskloet 6y ago
> railcar switch dilemma In case you tried to remember, this is generally referred to as the trolley problem.

by simonh 6y ago

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.

Shorel 6y ago

I say both risks are totally related. Covid itself causes blood clots. The solution here has been to administer aspirin to Covid patients. So the solution for the AstraZeneca vaccine should be the same. Vaccinate people, give them some aspirin over two weeks, just in case.

elliekelly 6y ago
It reminds me of the blood clotting scare tactic sometimes used to discourage women from taking birth control. I remember raising it once with my OB/GYN who quickly told me that the risk of blood clots from the pill is very low for a non-smoker like me while the risk of getting blood clots if I became pregnant is much higher.
magnusmundus 6y ago
It really complicates the operations though, which is already proving to be difficult for many countries: You have to add aspirin distribution & storage to the vaccine, which might be an issue for costs if not for the logistics of it. More importantly, you have to manage whether the vaccinated people can take aspirin. You don't want this to be how you find out you have a different blood coagulation issue, or anything else that aspirin can affect adversely (I'm not a medical professional).
TheOtherHobbes 6y ago
There are two semi-independent clotting systems. Broadly, aspirin works on the one associated with heart attacks. Most strokes are caused by the other. So taking aspirin for strokes doesn't usually help. (Source: had a mild stroke, was told this by multiple neurologists.) Covid seems related to both. You need non-trivial blood thinners - Warfarin, rivaroxaban, apixaban - to affect DVT etc, and those are high-maintenance meds with side effects of their own. But there is some evidence that aspirin does help with Covid clotting, and low doses for short periods seem pretty safe. So the worst you'll do is improve your odds of avoiding problems from something that's already not much of an issue.
marcosdumay 6y ago
I wonder is the aspirin won't bring higher risk than the vaccine. The numbers people are passing around are way too low. Low enough that it's difficult to understand why somebody is taking any action at all instead of reading it as a minuscule statistical fluctuation.

afavour 6y ago

> 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. In this situation it's not that much of a dilemma, though. It's not as if those prone to blood clots are not at risk until they're given the vaccine, everyone is at risk from COVID and the blood clot prone maybe even more so. And the sheer number of people it will benefit means the choice is simple. > very concerning if it's true Little known fact: women's birth control pills also have a higher risk of blood clot. Always have. If that risk is considered to be acceptable then I don't see any reason why this isn't either.

YinglingLight 6y ago
>everyone is at risk from COVID Yet the majority of the population are not at risk for significant health complications from COVID. The question remains if the blood clot causing demographics overlap with those at risk for serious COVID cases.
bbarnett 6y ago
Yes, but, there are close to 200 vaccines. It isn't as if all vaccinations have stopped, there are other options, and panic and fear on the side of omg must vaccinate now, now,now!? Any hint, even the slightest, that complications may be ignored, could result in untold masses refusing vaccination out of fear. So let's pause one vaccine for a few days, and see if moving ahead, or more research is required.
- afavour 6y ago
  > there are other options Not with sufficient supply there isn’t. That’s the issue almost every country is facing, and AZ production plants can’t just flip a switch and start making Moderna vaccines instead. No matter what if you stop using the AZ you’re going to have a sharp drop in the number of vaccinations you’re able to do. That would almost certainly result in more deaths than the side effect of the vaccine. > Any hint, even the slightest, that complications may be ignored, could result in untold masses refusing vaccination out of fear. Only if people (and the media especially) hype up a very small danger to be more than it is. The larger danger is and always was COVID itself, especially with the new strains spreading.

sobriquet9 6y ago

Your options are not just A) take the AZ vaccine right now, and B) never take any vaccine. You can also wait until more data becomes available, or until another vaccine becomes available. Doing so does carry some incremental risk, but this risk is smaller than the risk of not getting vaccinated ever.

rob74 6y ago
> until another vaccine becomes available Well yeah, other vaccines (Biontech/Pfizer and Moderna) with far fewer side effects and apparently higher effectivity are already available, and that's part of the problem. It's not that the potentially fatal blood clots are the only side effect of the AstraZeneca vaccine, people also pretty often get infection symptoms (fever etc.), which is of course not that bad, but still unpleasant. So you can't really blame people for wanting to get the better vaccine...
simonh 6y ago
I specifically talked about the risks of delayed vaccination and did not frame the choice in the extreme terms you described.
- sobriquet9 6y ago
  Looks like it was a pretty short delay: https://www.dw.com/en/astrazeneca-german-team-discovers-thrombosis-trigger/a-56925550 https://www.dw.com/en/astrazeneca-german-team-discovers-thro...

dskloet 6y ago

> railcar switch dilemma In case you tried to remember, this is generally referred to as the trolley problem.