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Not giving it to 65+ people seems overly cautious. There are zero cases in that group and even just a small delay will mean many dead. This is trading a potenti
by alkonaut 6y ago
Not giving it to 65+ people seems overly cautious. There are zero cases in that group and even just a small delay will mean many dead. This is trading a potential unlikely side effect for a large number of severe Covid cases in high risk groups.
Edit: yes I'm aware they have only a dozen or so dead per week but that also translates to hundreds of severe cases, missed elective surgeries, etc. For what would most likely result in zero side effects in the elderly group.
- silon42 6y agoFor now, I agree, probably best to keep using it. But if turns out there is need to re-vaccinate yearly (2x again), the decision is not as obvious.
- gms7777 6y agoIt's a real world example of a trolley problem. They're choosing to let a large group risk severe disease or death through inaction, rather than pulling the lever and have a small group be at risk due to their actions.
- monster_group 6y agoCorrect. But to me it seems that pulling the lever to kill a few would be considered more culpable from legal perspective rather than not doing so (and let more people die). IANAL - I am curious to know how law perceives it.
- busymom0 6y agoDon't the COVID vaccine companies enjoy blanket immunity? https://www.reuters.com/article/us-astrazeneca-results-vaccine-liability-idUSKCN24V2EN https://www.reuters.com/article/us-astrazeneca-results-vacci...
- hef19898 6y agoSlowely I'm getting the impression that a lot of decisions around AZ are politically driven. In Germany, the new recommendation is now to use Biontech for the second shot after AZ. In that recommendation, it is also stated that there are no studies nor data supporting that. Quite funny, because there is, to my understanding, a study taking place in the Uk for that. It is expected to be done by end of April. Someone has to explain to me why that recommendation couldn't wait until there is data.
- gmueckl 6y agoI guess that a decision needed to be made in a timely manner to provide guidelines for those who get their second dose before end of April?
- hef19898 6y agoWhich would mean mixing vaccines without any trials done on the effects of this. As compared to using a second AZ shot, which has been analyzed and approved. Seems risky to my untrained eye. And it wouldn't be hte first AZ related recommendation that changes every other week. We had so far: - not for people over 65 because of underrepresentation in the trials - not for people under 60 because of blood clots before any studies were finished - Nobody wants AZ, so we will give it to everyone who is willing to take it I don't see a strigent strategy here.
- gmueckl 6y agoCan't argue with that. Everything about the AZ vaccine in politics and the media has been a shitshow so far. AZ themselves probably were caught off guard by the initial bad reporting and the wave of negative public reactions. They don't normally have to play the mass media game in their business.
- bluGill 6y agoIt means getting a shot of AZ and two of Pfizer/biontech then. Seems reasonable, and this type of mixing is done all the time.
- mustafa_pasi 6y agoComplete nonsense. Do you honestly think the Danish medical authority gives a shit about the squabbling between the UK and Germany over AZ? To the point where they would even condemn people to death and put their careers at risk? I do not find that plausible at all. What I found plausible is that you are too gullible and do not realize that your "impression" was fed to you by the media, who definitely have a political agenda, one way or the other.
- eloff 6y agoI think that's exactly it. There is a tradeoff to be made here with likely deaths on both sides, and the government is choosing much higher numbers of deaths because it looks better for them politically. That's immoral and cowardly. I don't see any way to justify the decision they've made logically.
- zpeti 6y agoThis pandemic is basically this entire story. COVID deaths are much more visible than the missed cancers, the depression and drug abuse caused by lockdowns, so basically it’s an easy choice for governments, lockdowns are better politically.
- RobertoG 6y agoThat argument doesn't make a lot of sense to me. It assumes that the numbers caused by the lock-downs are bigger than the numbers caused by Covid. It assumes that there is not positives to the lock-downs (maybe some people is less depressed at home than at their work, not deaths by flu, etc..) and, most important, it assumes that not lock-downs would not increase deaths by other causes (intensive care overworked).
- kspacewalk2 6y agoThe number of deaths due to missed TB vaccinations alone will be a very substantial percentage of number of COVID deaths.
- ceejayoz 6y agoMaybe, maybe not. TB should be readily stopped by masking and distancing measures; we might get something of a respite from it. I'm not aware of any numbers in either direction yet.
- ceejayoz 6y agoConfidently stated, but the impact of lockdowns is likely more complex in reality. It may require years of research to tease out all the components; lockdown vs general pandemic stress, differences in implementation, etc. For example: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00091-2/fulltext https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0... > Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas.
- marvin 6y agoThis would be correct if Covid was very widespread in Denmark, most of the at-risk >65 population wasn't vaccinated already and there weren't alternatives available very shortly. But none of these are true, so the overall ethical decision becomes more complicated than that. It's fallacious to describe this as an instance of the trolley problem, as there's also the public's trust in vaccines to consider. You'll see that the rest of Europe have arrived at a different conclusion, largely due to the fact that Covid is much more widespread there.
- hef19898 6y agoDecsions like that undermine trust. Now scepical people can point at Denmark and say: "See, it is dangerous, I don't take it" Because nobody will take time to understand how and why Denmark came to that conclusion. Not in a time where people are happy only reading half of a headline.
- dragonsngoblins 6y agoYou mean people outside of Denmark. Inside of Denmark people will look at the next vaccine the government decides to go with and feel more willing to trust it precisely because their government withdrew support of the one causing clots
- dragonwriter 6y ago> They're choosing to let a large group risk severe disease or death through inaction, rather than pulling the lever and have a small group be at risk due to their actions. I think your interpretation of the relative risks is wrong, but I’m open to seeing the calculations by which you come to this conclusion.
- nasmorn 6y agoI mean the 65+ group is also most at risk of dying of Covid. I don’t see the moral hazard here. I understand that you can argue against vaccinations of younger people whose Covid risk might be eclipsed by the thrombosis risk. But for old people it seems simply stupid.
- rsynnott 6y ago_Are_ there unvaccinated over-65s in Denmark? AIUI it's generally a bit ahead of the EU curve, and over-70s are generally done in most European countries.
- dandellion 6y agoI had to look up "AIUI" because I didn't understand your comment, it turns out it's a capitalization for "as I understand it", so you basically made your comment less readable to avoid typing 15 characters, which at a modest typing speed will take about 3 seconds to type. So if you've read this far it means it's already been a negative return to type the shortcut.
- alkonaut 6y agoAs far as I know most EU countries are on a similar trajectory and only differ by a few percent (I.e. they use all the vaccines they get and most have only the common procurement). What can differ is which groups are vaccinated, e.g. Sweden has 19% vaccinated with at least 1 dose but the coverage by age group is e.g 85% in 80-89 and just 35% in 70-79 and 60-69 is only 10%.
- fooofw 6y agoYes. Elsewhere in the thread, I linked the official Danish vaccine calendar [1] (from today, April 14) which estimates that 65 years and above will complete vaccination end of May, though this is subject to change based on actual deliveries. The vaccines in the plan do not include AstraZeneca though they do include Johnson & Johnson as can be seen from the more detailed plan [2]. Neither plan is available in English unfortunately. [1] https://www.sst.dk/-/media/Udgivelser/2021/Corona/Vaccination/Kalender/Vaccinationskalender-14042021.ashx https://www.sst.dk/-/media/Udgivelser/2021/Corona/Vaccinatio... (in Danish) [2] https://www.sst.dk/-/media/Udgivelser/2021/Corona/Vaccination/Kalender/Specificeret-vaccinationskalender-14042021.ashx https://www.sst.dk/-/media/Udgivelser/2021/Corona/Vaccinatio... (in Danish)
- joakleaf 6y agoThe 65+ group are to a large extend already vaccinated or have begun vaccinations with other vaccines in Denmark. The expected overall delay from not using AstraZeneca until all adults have been vaccinated is 3-4 weeks. Current death rate in Denmark is 2/day. Population 5.8 Million.
- kspacewalk2 6y agoSounds like a while lot more deaths than potential clot cases (not to mention clot deaths, which might be zero in a population that small).
- marvin 6y agoNorway has ~10 deaths from Covid in the <60 age range throughout the entire pandemic, and 3 deaths from AstraZeneca-related side effects in the same age group. But only a small minority of the <60 population has been vaccinated; almost exclusively healthcare workers. You would expect the deaths from side effects to eclipse the number of covid deaths if vaccination continued. So it's a pretty safe assumption at this point that AZ is a bad option for younger age groups in countries with similar numbers, assuming that other vaccines will soon be available (they will)
- SiempreViernes 6y agoSure, but at the same time 3 is too small a number to have any confidence in that expectation. Looking at the rates from other countries where AZ has been deployed more heavily, it seems like Norway mostly had bad luck, and the rate is fairly small. Though as you say for the younger population the risks with covid are also small and the choice ultimately depends on the infection rate in the country. An interesting question is if there actually is any public health argument in favour of vaccinating the inhabitants in the countries that have managed to keep it out completely? There the choice is between taking on the risks of the vaccine versus just not allowing travel, and the public health impact of the latter isn't very clear.
- 6y ago
- vinni2 6y agoDenmark as low number of cases and down to 7 day average of 2 deaths. Assuming they have lockdown measures in place they aren’t risking much from dropping AstraZeneca.
- Tenoke 6y agoExrended lock down measures aren't without costs either.
- joakleaf 6y agoDenmark has been slowly opening up the last month (schools/daycares/offices) and will continue to open shopping centers and restaurants the coming months. A <72-hour negative tests is required for e.g. hairdressers and restaurants. Plans for opening up travel to other countries and returning without quarantines during the coming months are in place. We do very rigorous testing, and the number of cases/deaths has not risen over the last month despite opening up parts of society, so the assumption is that we can open up more (carefully). Denmark is number two worldwide with respect to tests per inhabitant with 5.1 million tests for each 1 million inhabitants (i.e. 5.1 tests per inhabitant). Generally less than 0.5% of the tests are positive
- marvin 6y agoThe >65 population in Scandinavia is largely vaccinated already, and incidence of new cases is low. So it's a decision that might be questioned, but which would have small real-world consequences even if it turned out to be incorrect in isolation. That part of the decision might just be the combination of uncertainty combined with the public's skepticism towards this particular vaccine. Giving an impression of listening to the public might have been considered a better overall choice than making a big communication effort for little real-world benefit. Other vaccines will be available very shortly for the few >65 people not yet vaccinated.
- mxcrossb 6y agoSweden’s numbers are illustrative here, with COVID cases rising steadily since January, but deaths are going down.
- alkonaut 6y ago> The >65 population in Scandinavia is largely vaccinated already, and incidence of new cases is low. 80+ population is largely vaccinated. 70+ isn't, and 60+ is barely begun, at least in Sweden. But most deaths are in 80+, so current situation is that hospital admissions are trending up (because adults are largely unvaccinated), ICU is trending up (because 50+ are unvaccinated) but deaths are trending down (because 80+ are vaccinated).
- TheForumTroll 6y agoDenmark is done with 65+ vaccinations in two days.
- dusted 6y agoIt's kinda complicated, while I'm 100% on board with vaccinating, I do see the problem.. "You have some chance of getting Covid" then "If you get Covid you have some chances of getting seriously ill, permanent damage or die" vs "You have 100% chance of getting the vaccine" then "If you get the vaccine, you have come chance of dying" So it's not super simple to calculate the risk, especially not for me, so I shouldn't comment at all..
- alkonaut 6y agoThe thing is that in the 60+ group or 65+ group it's not that complicated: there have been zero concerns about the virus there, but the disease is very dangerous in that group. The difference in risk of dying from Covid vs dying from vaccination is large, even with Denmarks quite low spread. It's quite possible that people under 60, or perhaps only women under 60 should not take it. In that group, the numbers are at least starting to be possible to compare. Which is why many countries have stopped it in that group (despite the risk of covid death even in that group being higher!). So it's indeed not very simple, but you can always find a group where even conservatively counting the risk is enormous from the disease and tiny from the vaccine.
- TheForumTroll 6y agoYou are overlooking something pretty substantial. Denmark are almost done giving vaccinations to everyone older than 65 (2-3 days left). If they kept using AstraZeneca they basically only have people younger than 65 to give it to.
- tomjen3 6y agoNot really. We have already vacinated most of the high risk groups and our hospitals are not at risk of capacity. It just means that people like me who are at the end of the queue will lose six months more of our lives waiting for a vaccine (they have also paused J&J, I am assuming that one is gone too).
- alkonaut 6y agoI’m assuming it’s similar to Sweden in terms of vaccinated over 60 and fraction of vaccines that are AZ? Sweden has only around 10% given a first dose in the 60-69 group yet and a huge fraction of the doses given to that group are now AZ, so that mRNA vaccines can be given to other groups.
- notatoad 6y agoHere in Canada the AZ vaccine was never approved for use in people 65+, and it had nothing to do with the blood clotting issues. The blood clots only seem to affect under-50 people, but it seems like there might be other reasons to avoid giving it to the elderly
- alkonaut 6y agoThat was the case in many countries due to early signals of low efficacy in old people. Those concerns have since disappeared and these side effects have appeared. So in some countries the approval was entirely reversed from “only under 65” to “only over 65”.
- dv_dt 6y agoVaccine availability from other sources can also figure into it.
- dragonwriter 6y ago> There are zero cases in that group and even just a small delay will mean many dead. Not really. AZ is a small fraction of the total vaccines being deployed in Denmark. > For what would most likely result in zero side effects in the elderly group. The elderly group is almost fully vaccinated because they were prioritized; allowing AZ to go forward with that group would have no meaningful effect on the delay in overall vaccination completion, or its expected impacts. This is explicitly noted in the article as part of the reason Denmark.made the decision.