Norwegian experts say blood clots were caused by the AstraZeneca Covid vaccine | Hacker News Reader

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

sciencenorway.no

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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.

If only the same standard were applied to all statements about Covid.

Or, really, everything in the news.

But... then... there would be less news.

Wouldn’t it be nice

nobody wants to read the "Journal of Unsurprising Results Consistent With Evidence"

I do.

Is the quality degradation in news some variant of tragedy of the commons?

Just thinking the same thing

This is the source article, with likely a lot more information: https://www.vg.no/nyheter/innenriks/i/QmwR1V/professor-om-mi...

per google translate, it may have more information but not more data, nor independent confirmation of the experts' opinions.

Actually this is independent testing for the AZ vaccine. As in, the only testing not done by AZ themselves.

It all depends on how you look at it...

Pretty sure all countries that distribute it have their own independent data sets, or are you suggesting AZ runs the health care systems across Europe?

I'm pretty sure it was approved only based on testing done by AZ themselves. So there were no "independent" tests when it was approved.

As I said before, that's normal procedure for any medication, so we're arguing about the definition of "independent".

Btw the case in Italy was autopsied and found to not have any blood clots.

Edit: found a link in english for Italy

https://www.ansa.it/english/news/general_news/2021/03/16/ast...

I'm from Italy, and we had similar cases too: https://mantovauno.it/cronaca/non-ce-lha-fatta-il-carabinier...

Do remember that this expert is the person the premier Norwegian hospital picked as their spokesman for their press conference on this. So in essence what he says is the opinion of the Norwegian health care system, not just his own, about these cases. This isn't some random expert, giving an of the cuff opinion.

But that's what I come to HN for.

hes a clotting expert, not a COVID expert. So of course he sees clots everywhere. Are you sure he's the spokesman, or just making this claim as an independent researcher. There is nothing in the two articles I read saying this is an official position of the hospital.

Yes I'm definitely sure he is speaking for the hospital, and that he was speaking at the hospitals press conference. This has been all over the news here in Norway, every news outlet treat this as legit, and from the hospital / government.

acknowledged. I did some more searching and found several articles where the hospital seemed directly involved.

>hes a clotting expert, not a COVID expert. So of course he sees clots everywhere

and while I'm sure that a cancer expert has a tendency to see cancer more than your average guy, I'd still rely on a cancer expert for an opinion on cancer

this is a weird take. A clotting expert is supposed to comment on clotting issues, that this is a covid vaccine isn't even really relevant.

Why do you say that? Yes it is relevant. The vaccine has caused multiple cases of patients with blood clots. Some have been fatal.

Analysis of these patienta and their clots by a clotting experts is highly relevant.

Correct, it’s irrelevant what type of medicine it is. But of course there should be a huge warning in the PIL and the patients should be able to read it.

This is an issue under active discussion that is extremely relevant to basically everyone right now. That every information on this topic is preliminary should be obvious to every intelligent person.

I appreciate reporting on the scientific discussion in such a case.

Is there any independent support of data which contradicts the claim?

Governments have taken the decision to pause vaccinations with AZ, on the basis of this emerging information.

It's only right that we, the people, can see what our elected representatives are basing this decision (to pause) on. It makes sense to me.

I'd say the timing was just right!

A lot of media was already trying to frame all of this into a political problem, fueling conspiracy theories, and trying to destroy the credibility of European independent regulators.

It's disgusting what happened in the past few days, casting doubt over regulators, doctors and scientists that were dealing directly with these cases and had hands-on data, thankfully there's transparency in these countries, and regulators are doing what they're supposed to be doing.

"See, look, they knew it was dangerous but the MSM suppressed it."

If you don't publish you feed conspiracy theorists. Better to transparently publish the information that you have.

The phrase "experts say" is often used in headlines where it may technically be true ("one or more experts personally believe X") but to the reader's mind it translates as "a majority consensus of the field's experts have agreed on X given new, relevant evidence". I don't think this dichotomy is accidental.

Based on all the information available about this vaccine, this vaccine is premature to administer.

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?

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.

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-mi...

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.

This comment should not be downvoted as it is both topical and helpful.

Thank you. I wish downvoting had to be accompanied by a reason!

Downvotes have nothing to do with topicality and helpfulness. They are purely a mechanism for sharing and reinforcing social norms by promoting and protecting The Narrative.

it doesn't make sense to stop a vaccination campaign if a small number of people have side effects, assuming the vaccination utility is high.

Utility is compared against other choices of vaccine and how much more time it would take to distribute those instead, or compared against not giving it to certain groups that are susceptible to the reaction (and the time it takes to find those groups), not against doing nothing.

You and a criminal both breath, does this mean you should also be arrested?

Criminals aren't arrested for breathing. Next!

Boeing 737 max has a lower crash rate than cars, do you think the ban was warranted?

Cars should also be banned and replaced with alternatives (be it safe self driving tech, public transit or biking). Car crashes are one of the top killers of young people in terms of crashes, and we’re just starting to understand the effects of air pollution on young lungs.

Or maybe stop banning things and let people make their own decisions.

What about WMDs? Where do you suggest we draw the line?

If drivers were the only ones impacted, I’d agree. For example professional race car drivers have all consented to the risks, so what they do on the race track is up to them. But when cars are used for general transportation there are all kinds of negative externalities that people can’t opt out of.

Other people are always impacted by our decisions. That's just the world we live in. Damn near everything you do affects the people around you in some way.

Do the people around alcoholics consent to that?

At some point the risks/reward of various behaviors (let alone the substances that enable them, you don't see people scrambling to ban belts because people hit their kids with them) are such that legislating away things with varying degrees of state violence to back it up isn't worth the tradeoff.

In the UK 40 people standing on a sidewalk are killed by car drivers every year

In my local town a couple of months ago a car driver managed to embed their car in a house, fortunately the resident was upstairs at the time and not sitting in their living room, otherwise they would have been dead

Last week another driver hit a stone column, 3' from the road (with sidewalk between), damaging a 500 year old building and meaning the residents had to be evacuated. They're still in a hotel.

How do you propose those people make their own decisions?

Again, that's comparing apples and oranges. Not to mention, what's the cost-adjusted safety comparison look like, given that a 737 costs more than a thousand cars!

Your whataboutism needs some work.

That's exactly my point, it's an apple to orange comparison, I've intentionally left out other dimensions of comparison and cherry picked something that's similar, which is exactly what original post was doing between contraceptive and the vaccines

This makes no sense whatsoever. It just sounds smart, but it totally misses the point. Both are medications. Both are taken by healthy individuals. The comparison is sound and makes sense.

Are all medications vaccines? Are all medications used to prevent an highly transmissive disease? Are all medications designed to be administered within a short period of time? Come on it doesn't take a genius to see it's an apple to orange comparison

> Are all medications used to prevent an highly transmissive disease

We may argue this makes any rare side effect from the vaccine, which is meant to avoid a potentially serious illness, more acceptable than those from the pill.

Sure, if we have no alternatives, and the news of these side effects will not impact the rollout of other vaccines

I heard a doctor comment yesterday that seems to summarize what's happening: "It's perceived as worse to actively kill someone than to kill them through inaction; the scale doesn't matter."

So even if the vaccine is responsible for these deaths, the people making the administration decisions will choose having 10x or 100x the number of people die from not getting them vaccinated quickly. So much for "science-based decision-making"...

Trolley problem with a needle and some dice

Covid has a certain chance of killing any particular person (not the same chance for each person), the vaccine has a much lower chance than average COVID and prevents the COVID chance.

This vaccine has a much lower chance of killing you than COVID on average. From which you cannot draw the conclusion that vaccine has a much lower chance of killing any particular person - e.g. a healthy 20-something. That part is not at all clear.

I'm bothered by two things.

The first is multivariate studies are notorious for throwing false positives especially when positive cases are in the sigle digits.

Comparing data sets collected under different surveillance regimes is difficult.

The vaccination pause is not about the rate of general blood clots, but a specific kind of blood clot in the brain among a younger population that’s usually way more rare.

One is voluntary, one is not (not really). There's a huge difference in a vaccine for everyone causing deaths and medication you can live without that you chose to take. There's nothing comparable between the two.

The risk from pregnancy is way higher than the risk from covid. You'd accept a 5% risk to avoid a 10% risk, but you wouldn't accept a .5% risk to avoid a .001% risk. From the vaccine blood clot data it looks like ~.07 thousands of a percent die from blood clots, while for young people the risk of death from covid is around ~.7 thousands of a percent. Thus if a) the blood clots are caused by the AZ vaccine, and b) the risk of getting covid as an individual is <10%, taking the AZ vaccine carries a higher risk of death than not taking it does.

The clotting with AZ is very different and more serious than what the thrombosis associated with the pill - about half of those who get it die even with best medical care. It predominanctly affects folks who would have a miniscule risk of death by Covid19, so this absolutely needs to be investigated.

Yep, this^ is the point. It is amazing that this key point is missed in so many discussions.

Now.. maybe it is still worth the risk for a young 20 year old female, but I am not so sure - especially since we luckily have other vaccines that do not show this risk.

There are safer vaccines so there is little point in risking this one. That said, it depends on how many future infections people that age face.

If this vaccine is causing at most 4 deaths per million people* vs 648 recorded US covid deaths 15-24 out of a population of 43.5 million. 4 * 43.5 = ~174 < 648. So, it would have been noticeably safer for a random 20 year old American to have taken it Jan 2020 than risk covid. https://knoema.com/atlas/United-States-of-America/topics/Dem...

So if the total future infections are say 1/4 the total infections up to this point then their roughly equivalent risks. Tipping one way or the other based on actual number of infections.

* It’s rare enough that actual risks aren’t clear, but assuming the vaccine is the cause we can assume the risks are at or below that level.

Well it's certainly worth doing risk reward calculations but so far they seem pretty clearly in favour of taking the vaccine.

If you assume you are 100% getting the virus maybe. But if you take a lot of precautions, work from home, don't get out unless necessary, wear a mask... it's not clear at all.

I guess if you are very low risk. I figure as a guestimate - people killed by vaccines - prob less that 1 a day. People killed by covid - about 7000 a day. So covid looks worse. Not a sophisticated analysis although the regulators do do those.

So why not prescribe aspirin until say a month after the second dose.

Because aspirin has no meaningful impact on as severe an autoimmune platelet implosion as is described in these cases.

Ah so its not just thickening of the blood then fair enough.

If only medicine was logical like that. Not a cake recipe.

Are the clots any different than the ones caused by COVID-19 itself?

Do we know for sure it's just the AZ vaccine and not the body's reaction to the spike protein(that is, other vaccines should face the same issue).

I saw the description by the doctor who treated the person who died here in Norway. He called it a "catastrophe in the brain" [1] and the life just could not be saved.

It sounds really nasty. Blood clots + low blood plate count at the same time.

[1] https://www.nrk.no/norge/innlagt-helsearbeider-dode-_-unders...

A few weeks after my dad had a covid vaccine he had several seizures, which have continued to happen.

On top of that, nearly 3 weeks into hospital and he caught covid. At least the vaccine worked and that's mostly sorted.

MRI says he has suffered catastrophic brain damage and is about to be released for palative care for the last

Now importantly

- I don't know which vaccine he had (and I'm certainly not going to bother my mother over that at the moment)

- He's suffered from seizures for the last few years, although those normally follow infections and high temperatures

But it's disquieting

I'm sorry to hear about your father's suffering. However I feel it's important for you to sound an alarm to the relevant doctors and/or public health units if you feel there's a link between his seizures and the vaccine.

Whether or not it was the AZ vaccine or not..

They know he had the vaccine and they know his medical history far more than I do - I'm not a medical expert, they are.

But are they thinking about it right now? Maybe asking them about it would trigger a response.

That's awful. I'm sorry for you and your family.

"He's suffered from seizures for the last few years, although those normally follow infections and high temperatures"

A vaccine will certainly cause the body to fight the perceived infection, including with high temperatures for some people. It's possible given his history those vaccine side effects should have been considered?

Isn't the low blood platelet a direct result of the clots, isn't that expected?

Don't the clots need/use up thr platelets in the process of clotting?

I have no idea since I am no doctor but from what I read in the article it's not a common situation. The usual treatment for blood clots is blood thinners. Not exactly sure how they work but I've thought it thins it by lowering the number of plates.

But it seems that the spike protein on the virus/vaccine is quite similar to a protein on the blood plates so if the body has a runaway immune system response to the vaccine it could attack the blood plates too.

The implication here is that this could be true for all the vaccines, there are some similar reports in Israel which do not use the AZ vaccine.

These cases are extremely rare though which is probably the most important thing here. It should not disqualify the vaccines.

Thanks so much for the info.

I was just wondering about Israel -- they vaccinated sooo many people, if this was an issue with the body's reaction to the S protein, it should pop up in Israel too.

Probably just a different pathway that gets activated without involvement of much platelets, https://en.wikipedia.org/wiki/Coagulation

Just because apples and oranges can both rot doesn't mean they are both bad. There are different things at play here.

First, the vaccine: Allowing a vaccine that kills people can have very real consequences that go beyond Covid. Vaccines should be as safe as possible, and not doing so can push more folks into vaccine skepticism and anti-vaccine stances. The Covid vaccine making blood clots really can not only mean the pandemic lasts longer and folks stop taking MMR vaccines. That is enough of an issue as-is. The other thing with this particular issue is that it is just one of the vaccines that is doing it - there are other choices, and it just slows how quickly we can vaccinate folks.

As far as contraceptive pills: First, doctors do look at risk factors. Some years back, when I still smoked, my doctor wouldn't give me a pill with estrogen in it because of my age plus smoking meant I had a bigger risk of blood clots. It's OK, like the covid jab, I had other options. The other thing that is really important is that the birth control pill, even with the risk of blood clots, severely cuts the risk of death for some folks. Some women bleed so severely that it risks their health each month. And more to the point, it does a decent job of preventing pregnancy.

Being pregnant - and giving birth - is really, really dangerous, but we sometimes forget this because modern medicine has made death rates drop.

In addition to the severity of the clots, the difference is that the side-effect is not expected and not mentioned in the patient information.

Quote from the German PEI institute [1]:

> It is true that for birth control pills thromboses, even with fatal outcome, are known as a very rare side effect. They are listed in the Summary of Product Characteristics (SmPC). The birth control pill is available only on prescription. Every woman must be informed of this risk by the prescribing physician. For the COVID-19 Vaccine AstraZeneca, there is currently a suspected very rare side effect of sinus vein thrombosis with accompanying platelet deficiency, sometimes fatal. It is not listed in the SmPC.

The whole statement is quite informative: [1] https://www.pei.de/EN/service/faq/coronavirus/faq-coronaviru...

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: “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)

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?

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)_/¯

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.

Perhaps the few available platelets were all consumed in the act of forming the clot so they registered as low because they were gone?

That would cause systemic problems for the person and almost certain death.

Platelets are filtered out of the blood by the spleen and then stored or cleaned up there. The spleen likely just cleans them up as per instructions from the immune system. On the other side are production problems where your bone marrow stops producing platelets, but that is more commonly due to cancers or cancer treatments.

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

Sort of the theme with Covid ultimately. I’m curious who will have the guts to re-examine the global shutdown as an exaggerated reaction as we go forward.

40 cases of blood clots (and 0 confirmed deaths) in 17 million

538K confirmed deaths in 328 million (the US population)

They really aren't comparable.

EDIT: see replies below for details about deaths connected to the clots. I take that back. But my general point still stands, COVID is far, far more dangerous than the vaccine.

Did you read the article? The Norwegians claim that one of the health workers died.

I meant to write “confirmed deaths”, sorry. Updated my comment.

“confirmed” might seem like nitpicking but it’s widely speculated that the actual death count for COVID is much higher than the confirmed number too.

7 cases in Germany, with 3 deaths. Patients were aged 20 to 50 years.

https://www.pei.de/EN/newsroom/hp-news/2021/210315-pei-infor...

https://www.pei.de/EN/service/faq/coronavirus/faq-coronaviru...

Thanks, I’ve updated my comment. I still believe my original point stands.

so what's puzzling is that the fatality rate from this complication is so high in Germany (3 of 7) where it's so much lower in the US and UK. Pausing vaccination with the AZ vaccine in Germany doesn't seem like an overreaction. At the very least, reviewing & communicating best practices for detecting and treating this would be in order.

I think it's even more nuanced than that. The people suffering issues here are young people that would otherwise probably not die or have serious long term effects of Covid-19. People are going to think "Why should I risk death, even if it's just a relatively small risk?"

> But my general point still stands, COVID is far, far more dangerous than the vaccine.

It is worth breaking that down by age, sex, and other risk factors.

For an 80 year old male obese smoker, who lives in a country with high COVID-19 rates, I have no problem believing that COVID-19 is more dangerous than the AstraZeneca vaccine.

For a 25 year old female with no comorbidities, who lives in a country with low COVID-19 rates, this is much less clear and will now have to be determined statistically.

In Norway, five women below 50 years have died of COVID-19 (in total) and one from the vaccine

Source (in English): https://www.fhi.no/en/id/infectious-diseases/coronavirus/dai...

But did these women have any comorbidities?

The sample is so small that even if they did it wouldn't be possible to say anything definitive about any possible connection. The death rate here in Norway is minuscule compared to the UK, US, France, etc.

> 538K confirmed deaths in 328 million (the US population)

That is a hugely inflated numbers. For example, people who died in motorcycle accidents who tested positive for COVID at the time are counted in that total. It may be useful to the CDC to count that way but it is not an accurate number to show how dangerous COVID actually is.

Flu death statistics are way down this year. Did the flu magically disappear this year? I doubt it. Almost all respiratory infections were counted as COVID out of an abundance of caution.

Yes, COVID is dangerous. However, the count that is published is way over stated.

This is not necessarily the case, and based on excess mortality data if the number is off it is most likely under reported (look at the senior home reporting in NY state and the reluctance of certain states, like Flordia, to openly share this data).

In the case of the motorcycle accident: the man was in a crash and hospitalized for over a week where he died of COVID related respiratory failure. While he would not have been in the hospital had it not been for the accident, had it not been for COVID he very well may have survived his time there.

Regarding the Flu, it is way down this year precisely because of the measures that have been taken for COVID. It is less transmissible than COVID, so it stands to reason that it would die out during a time when most people are taking precautions to prevent the spread of a more transmissible virus.

This canard is still being trailed out?

Excess death counts are available, and they are even higher than the COVID death counts, suggesting that the official count may actually be an underestimate of total fatalities. However, the claim that that it is "way over stated" is not borne out by the actual statistics.

Your only response to the well known fact that the data has flaws [0,1] is more unspecified statistics. Why should I put any trust in those if I know the death count statistic has clear flaws?

I'd rather our society not be directed based on easily manipulated statistics. It cloaks hidden agendas behind the guise of science and math which is dishonest.

[0]: https://www.denverpost.com/2020/05/15/colorado-covid-coronav... [1]: https://www.fox35orlando.com/news/fox-35-investigates-questi...

The hospital near me has not found ANY positive flu cases in the last year. It seems like the Covid restrictions (masks, handwashing, and social distancing) were extremely effective at preventing the spread of the flu. It wasn’t magic. It was basic hygiene.

Sounds too good to be true so it probably is not. If that is the case why didn't this 'basic hygiene' eliminate or curb the coronavirus?

Because covid is considerably more contagious than most flu strains.

COVID is not the virus, it is the disease that results from the coronavirus. The virus is the contagious part.

Sure, but do you really believe everyone was so hygienic that the flu was entirely eliminated in some areas? Most of the trips I have taken out involve at least a couple encounters with people wearing their masks improperly, touching their face, sneezing, coughing, etc. We should see at least some small amount of flu. Zero is suspicious IMHO.

The actual data does not show zero cases, but it does show an incredible decline in flu infections this year.

There will always be a small number of people wearing masks incorrectly but that doesn’t invalidate everyone that does. And it’s not just masks etc, it’s also the lengthy lockdown, working from home instead of commuting on public transit, etc etc. It does seem strange that a hospital would report absolutely zero but we have no idea of the context. Maybe the OP lives in a sparsely populated area.

UNC is in the Research-Triangle, not a sparse area: https://chapelboro.com/news/health/unc-hospitals-report-zero...

What global shutdown though?

I'm fully for that. And when we find out that a hard lockdown would have saved hundreds of thousands of lives, I hope we'll also have the guts to lock up the people who advocated against it, simply to further political goals. And try them for murder.

Let’s do it. And, if you are wrong (just the people that really couldn’t paint Covid into it’s proper form and let it metastasize into a boogeyman disease), tax everyone to help pay for all the businesses that had to close or people that had to lose jobs.

How about trying for murder the people who advocated the global "soft" lockdown that plunged hundreds of millions of people in poor countries into poverty (https://www.worldbank.org/en/news/press-release/2020/10/07/c...) and killed hundreds of thousands of children (https://www.reuters.com/article/us-health-coronavirus-childr...), just to increase the life expectancy of their 80 year old grandparents by a year or two.

"But the children..."

It did not even, or only marginally, increase the live expectancy of the over 80 year old.

How about trying for murder the people who advocated that the economy is more important and killed thousands of people through negligence? We can never know due to the vast array of different variables involved, but to say what Brazil is going through, or what some US states went through, and the associated death toll is somehow better than a lockdown seems a very weird take.

When thousands are sick, and hospitals are full, medical personnel is stretched to their limits, nobody can get intensive care, regardless of age. Poverty is a serious issue that needs to be tackled, but ignoring direct and indirect deaths due to Covid is simply wrong.

The hospitals are full because massive amounts of exaggerated takes on Coronavirus were propped up by many vehicles (media, moral heroes, etc). We couldn’t identify the true at-risk demo and target them.

No, enough of the moral take. We didn’t approach this pragmatically, and we need to stand up against the grandstanding that fervently uses emotional hostage taking as a talking point.

FUD was at maximum from the start. Toilet paper shortages. What else can I say.

We're a year in. We can identify at risk cases, and, from the beginning, only heavy cases get to the hospital.

Huh? No. Give it a rest. The United States hospital system didn’t get inundated because the target demo visited it.

Hysteria got everyone going to the hospital. That’s it. You know how I’m sure? Because it’s the same phenomenon that got everyone to stock up on toilet paper.

It was the fucking FLU. What a shame.

Anyone that disagrees with this better fucking provide the Covid numbers in comparison to previous year flu numbers.

Who is talking about the US hospital system?

Today, hospitals in France at 83% capacity, in the region around Paris at 104%. During the first wave, the situation in Italy was so bad doctors had to choose who had a higher chance of survival and only admit them, and leave others to die on the streets.

I cannot believe there are still people in an alternative reality.

https://www.worldometers.info/coronavirus/?utm_campaign=home...?

Here are some numbers. Do check when was the last time a "flu" killed ( confirmed) 2.7m people. Not to mention it's still ongoing, mutating, and new variants are more easy to spread and heavier, especially among younger (<50 years) people. Please educate yourself and stop spewing nonsense that was debunked a month in the pandemic.

https://time.com/5929751/childhood-mortality-2020-covid-19/

That Reuters article is speculation from nearly a year ago.

> just to increase the life expectancy of their 80 year old grandparents by a year or two.

HN Quick Capsule Review:

* a user named "logicchains" begins a nationwide campaign to lock up the set of people who a) love their octogenarian grandparents and b) advocated for a lockdown.

HN Quick Capsule Review Future Edition:

* bored adtech recounts uncle's harrowing run in with a union job

Don't forget about wealthy countries hoarding vaccines and denying developing countries access too.

I think the it will be shown the countries who took it seriously are going to winners both in terms in deaths, long term care for long haulers and economy. Asians countries are booming since their economy wasn't affected because the stringent lock downs controlled the virus.

>Asians countries are booming since their economy wasn't affected because the stringent lock downs controlled the virus.

The biggest "Asian" countries excluding China, Japan and Korea, didn't have hard lockdowns like in New York or California (Japan's constitution didn't even allow it), just voluntary social distancing and early closure recommendations, and effective contact tracing. China had lockdowns but it's economic numbers are extremely unreliable.

Hard vs Soft lock down is maybe a difficult distinction. Excluding China, Korea and Japan is a lot but Vietnam, Malaysia, Indonesia, Australia, New Zealand, Taiwan and Singapore all had lockdowns that were stricter (more observed and more enforced) than anything in California. Of course a lockdown has less impact when it is not really enforced (California) and you could make the case that near universal mask wearing has been a bigger boost to most Asian countries’s efforts to stop Covid-19.

> Asians countries are booming since their economy wasn't affected because the stringent lock downs controlled the virus.

This is an exaggeration, at best. There may have been countries that grew in the latter part of 2020, but to characterize these as "booming" is misleading.

Japan had its first economic contraction since 2009 (down 4.8% over 2019). They've been flirting with deflation throughout 2020. And they're one of the countries with the lightest responses.

https://www.bbc.com/news/business-56066065#:~:text=Japan's%2....

Developing countries in Asia are no better off:

"ADB said GDP in developing Asia will contract 0.7% this year and three-fourths of the region’s economies are set to register negative growth for 2020. That includes countries like Singapore, Thailand, India and the Philippines. China, where the coronavirus outbreak was first reported in late-December, is the only country that is expected to register a positive growth, albeit far below normal levels of growth."

https://www.cnbc.com/2020/09/15/adb-2020-outlook-most-asian-...

Vietnam, China,Taiwan had positive GDP growth in 2020 and as far as i know the only countries with positive GDP. Your article is from September. Q4 data is now out so you can get the full 2020.

Countries that failed to contain the virus like Europe and the US had negative GDP growth and racked up large amounts of debt.

> Your article is from September. Q4 data is now out so you can get the full 2020.

You're certainly welcome to do the work to prove the (extraordinary) claim that you're making.

As I said, even if you can find a few examples of growth amidst the broader disaster, most are nowhere near what they would have been.

First article on Google News.

https://www.google.com/amp/s/www.cnbc.com/amp/2021/02/01/tai...

“ Taiwan's economy grew 2.98% in 2020 compared to a year ago, advance estimates by the island's statistics office showed on Friday — the growth outpaced China's 2.3% expansion”

The Chinese growth rate was in the CNBC article. So basically, you're saying that Taiwan grew.

I'll give you Taiwan. Now tell me about the rest of Asia.

This doesn’t make sense. Japan and South Korea didn’t even lock down or close schools, and compared to the USA they’re doing fantastic.

Have zero faith in the current generations that are adults. It will have to be future generations that can think clearly without judgement.

How are you going to get those future generations to think clearly without judgment? The same things that afflict the thinking of the current adults will afflict the next generations when they are adults.

Agreed, I have more faith in upcoming generations, albeit risk is still there.

I think the argument for suspending the vaccine was that the number was still significantly higher than the expected value, despite being very low.

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.

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.

> risk turns out to be 1 in 50.000

It's more like 1 in 500,000.

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.

That's an odd sample to use unless you have some sort of agenda. The 40 out of 17MM is much more statistically significant.

If you give a vaccine to 17 million people and 40 of those are children and all 40 children dies then should we just ignore that fact because the "40 out of 17MM is much more statistically significant"? Of course not.

That's the epitome of a gross exaggeration.

Everyone would seek treatment, the clotting has like a 40% fatality rate.

If you read more closely you'll notice they're talking about a particular kind of thrombosis[1] which is accompanied by low platelet counts. This particular symptom is usually sign of a particular autoimmune response and has an incidence of about 4-5 per million people per year.

[1]: <warning, contains images of heavy bruising> https://en.wikipedia.org/wiki/Thrombotic_thrombocytopenic_pu...

so basically, base rate fallacy strikes agan.

Time will tell, but I'd put my money on a lot of undiscovered cases in Europe and the UK. Vaccinations have mostly been in elderly people who are at high risk of health complications anyway, it's only recently that younger populations started receiving the vaccine. And Norway is among the most paranoid of these countries, with good health data and monitoring.

Norway has also had at least three serious cases with 130.000 people vaccinated, so the incidence is certainly higher than 1 per 2.3 million.

At this point, with a plausible mechanism of action being discovered, it's either that or a "bad batch". But this doesn't seem like the kind of problem that would likely be caused by contamination or bad ingredients, and there's been enough time by now that the batch numbers behind the cases will have been thoroughly checked.

This will be a very tricky ethical consideration, with not only weighing different risks between different age groups, but also the public's trust in vaccines and the advice provided by health authorities.

My money says that AZ will be pulled from countries with few Covid deaths and/or other vaccine options available in the near term. And some controversy in countries that do not meet these criteria.

> Norway has also had at least three serious cases with 130.000 people vaccinated, so the incidence is certainly higher than 1 per 2.3 million.

That's not how numbers work. You can't look at California, for example, and conclude that because 63% of voters chose Biden, his national vote share is certainly higher than 52%.

It's 1 in 43.000 (Norway) versus 1 in 2.3 million (AZ numbers). That's a two orders of magnitude difference. While I can amend my statement to agree it's not certain that local factors and randomness haven't affected the outcome that much, it's a very suspicious observation.

n=3 here. It's misplaced to be talking about orders of magnitude when a single case would drastically move the needle.

If there were only one case in Norway (i.e. 1 in 130,000) it would still be orders of magnitude difference. But that's not meaningful.

If the rate were 1 in 2.3 million, then with 130,000 people vaccinated:

p = 1/2,300,000

N = 130,000

Prob(0 cases) = (1 - p)*N = 0.9450...

Prob(1 case) ~= p * N * (1 - p)*N = 0.0534...

Prob(2 cases) ~= p*2 * (N*2 / 2) * (1 - p)*N = 0.0015...

Prob(3 cases or more) = 1 - P(0) - P(1) - P(2) ~= 2.886e-05

Which is small enough to refute you comment, yes?

No. The evidence against the rate being 1 in 2.3 million is that the total number of cases divided by the total number of people vaccinated is a higher rate.

You can't take a subset of the population, find that that subset is out of step with the rate in the total population, and then conclude that the rate in the total population is wrong. The number of cases isn't necessarily evenly distributed, and your model is one that applies to independent random events. But the fact that a case occurred in Norway rather than in another country doesn't dramatically change the overall rate.

This probably doesn't convince you, but as additional data, Norwegian authorities have now confirmed five hospitalizations due to this presumed side effect, two of which resulted in death.

https://www.vg.no/nyheter/innenriks/i/86OmPr/drama-i-kulisse...

Of course, Norwegian health authorities point out in the interview that the ethical consideration will be different between countries, depending on expected vaccine delivery and local incidence of covid.

More data is obviously convincing. Why would you off-handedly suggest that I'm fundamentally irrational?

I figured you put more weight on «Norway and Europe are different populations and have different probabilities for this reaction» rather than the specific numbers from Norway. I wasn’t implying that you are irrational or stupid.

I just realised that using * twice to represent a power shows up as just a single * - here is the correct version (the numbers are anyway correct):

Prob(0 cases) = (1 - p)^N = 0.9450...

Prob(1 case) ~= p * N * (1 - p)^N = 0.0534...

Prob(2 cases) ~= (p^2) * (N^2 / 2) * (1 - p)^N = 0.0015...

My apologies for that.

According to VG is the German number close to 1 blood clot in 61.400 vaccinated

Source: https://www.vg.no/nyheter/utenriks/i/x32Xyl/tyskland-31-tilf...

Keep in mind that Norway has only 1 to 2 COVID-19 deaths per day at the moment.

Indeed, and this far, "only" 8 women below 60 years have died from COVID-19 (in total)

Source: https://www.fhi.no/sv/smittsomme-sykdommer/corona/dags--og-u...

Uh, I did not think that far. So if the vaccination is responsible for the deaths, it almost killed half the number of women below 50 that COVID has since March 2020. Fucking hell, and people outside Norway complain that the governmend is taking action? (EDIT: only one death, not three)

It's one death, not three, but I share the conclusion with the data that's currently available.

Update: two new deaths following vaccination, with a similar clinical picture, were just reported, they are now investigating if the vaccine is the likely cause

Source (Norwegian): https://legemiddelverket.no/nyheter/legemiddelverket-har-mot...

But surely that's a result of at least some restrictions? Lockdown and limited travel can't really be a solution forever - whereas vaccines probably are.

That is a significant number for a medicament that is given to healthy people.

If you had children and one of them died as a result of a vaccine, you would not say is a small population affected.

There are other vaccines that can be used. I believe Oxford will license Sputnik and manufacture it.

Is it significant? The contraceptive pill has known risks of blood clotting that are significantly higher than that.

If we are full of concern about this, maybe we should be focusing more on a drug that is used by millions of women year over year to improve its safety.

https://www.webmd.com/sex/birth-control/birth-control-method...

No one is forced to or risk death by not taking contraceptives. Don't compare apples and lightbulbs just because they both might have the same shape. It's nonsense.

No one anywhere to my knowledge is being forced to take any COVID vaccine.

Vaccines have been prioritised for the old and vulnerable so that 17 million number will likely have been given to a large number of unhealthy people.

>> If you had children and one of them died as a result of a vaccine, you would not say is a small population affected.

This is just a smart way of saying "Won't someone think of the children?" It's not genuine for you to speak of general-population statistical percentages in one sentence then evoke the emotional response from someone's specific loved-one in the next.

>> There are other vaccines that can be used

We need to get needles in arms NOW to save the most lives; any delay or alternative approach is actively killing people.

Did you mean to say AstraZeneca will produce it? As I understand Oxford is the developer and AZ is the producer.

It's still too early for the general public to draw conclusions from the data provided. Derek Lowe had some early observations on these numbers and their significance in regards to the critical missing data needed to make decisions:

https://blogs.sciencemag.org/pipeline/archives/2021/03/16/wh...

> "...they say that is indeed “much lower than would be expected to occur naturally in a general population of this size“. It also appears to be similar to what’s been seen with the other coronavirus vaccines..."

Until we know the methods and expectations behind numbers provided, naively taking them at face value suggests that this vaccine reduces the risk of these blood clots in the general pre-covid population. In the absence of statistically robust information about these alerts, we're stuck assuming that the experts know what they're doing until the detailed work is available and recognizing that (as Derek pointed out months ago) public attention is going to find focus on the inevitable mortality and illness rates without accomodating that people also die and have health issues for other reasons. Watch a random selection of 17 million people for a month, a five digit number of them will die. More if they're predominantly on the elder end of the scale...

Derek did a good job on this issue, both warning it would happen before and re-emphasizing that it's most likely statistical anomaly. Even if the blood clots were a result of the AZ vaccine, it would still make more sense for most people to take the vaccine (I would), so a ban is entirely unjustified.

Governments banning their citizens from taking Astrazeneca should use accurate language "it's banned" instead of the language "pause rollout".

Taking a COVID vaccine is a choice individuals make and governments have denied them during a pandemic.

> Governments banning their citizens from taking Astrazeneca should use accurate language "it's banned" instead of the language "pause rollout".

Pausing is exactly what is happening here in Norway. And the government is not involved, all these decisions her in Norway have been made by the relevant medical institutions.

I guess I'll take my 2.35e-6 chance (40 in 17M) to get blood clots over a 1.6e-3 chance to contact covid (4‰ infection rate) and die from it (4% mortality rate).

At least the german Paul-Ehrlich-Institut (which is responsible for the decision here in Germany) states [1]:

> "The number of these cases after vaccination with COVID-19 AstraZeneca is statistically significantly higher than the number of cerebral venous thromboses that normally occur in the unvaccinated population. For this purpose, an observed-versus-expected analysis was performed, comparing the number of cases expected without vaccination in a 14-day time window with the number of cases reported after approximately 1.6 million AstraZeneca vaccinations in Germany. About one case would have been expected, and seven cases had been reported.

1 expected vs 7 observed seems significant. Of course, with tiny rates like that it's challenging to draw a clear conclusion.

Their whole FAQ is very concise and informative: [1] https://www.pei.de/EN/service/faq/coronavirus/faq-coronaviru...

Also, even if we know for sure it's because of the vaccine and of those additional 6 cases, 3 died, we have to keep in mind how many more people would die from covid in 1.6M unvaccinated individuals.

most news reporting about adverse health events makes the problems sound far more severe and significant than they really are.

And most brands with a product to sell make the problems seem far less severe and significant than they really are, which is why we need to question both.

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-infor...

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-pi...

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.”

Thank you, this article has actual real information.

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.

"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".

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.

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.

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.

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.

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).

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.

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.

> 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.

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.

> 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.

The US will have >600 million doses from Moderna and Pfizer delivered by July, and currently even has 30 (soon 60) million AZ doses in storage that won't get approval before these 600 million other doses are delivered.

There's certainly countries where this will be a difficult ethical consideration, but it's far from clear-cut everywhere with the data and timelines that are currently available.

I'm sorry, but anti-vaxxer nutjobs do that hype all on their own. And people are already sensibly worried about rushed testing, and approval processes.

(It is sensible to be worried, and to keep a sharp eye.)

Now there appears to be a complication with one vaccine. No hype is required, for people to become enraged if there is no investigation. Most jurisdictions have said 'pause for a few days, until we look into this'.

This is very, very sensible. Logical. Calm and cool, as a reaction.

Let me put this another way.

By your response, you're suggestion that we should not have even bothered with clinical trials? Just inject anything we thought might work, right away, just in case?

Because, if you're advocating against pausing, for something that would get a second look in a clinical trial... ?

> By your response, you're suggestion that we should not have even bothered with clinical trials? Just inject anything we thought might work, right away, just in case?

That's very clearly not my suggestion. You're being absurd. You're talking as if the AZ vaccine had no clinical trial. It did. It's been proven safe for the vast, vast majority of the population.

At no point did I say that this shouldn't be investigated. It should be. But there is no need to pause the rollout of the vaccine while that happens. A reminder: 40 cases in 17 million. Very few of those 40 cases have been fatal. "Pause for a few days" is very generous. How many days? We all know investigations like this can go on for weeks. Months, even. All the while the much more dangerous thread, COVID, is allowed to spread further.

The mouse brain derived Japanese Encephalitis caused death, often 2 years after vaccination. It too went through clinical trials, and seemed perfectly safe at first. It was pulled as a result.

Yet, those clinical trials were not rushed, nor the government approvals, nor did it have the sort of pressure you are applying right now.

Further, you have no idea how wide spread, or severe this may be. You cite numbers from the media, yet reject pausing, without even knowing the precise number of people unable to get vaccinated as a result, or if more cases of clotting may appear as time passes.

You have no real data.

Let's get some.

FYI, we are not far apart ideologically here. I get what you are saying, but imagine this..

2 weeks pass, and it is shown that the problem is quite severe. The vaccine is tossed.

Next the anti-vaxxers, the media, start spewing words of distrust. Helpfully, the media shows a grandmother crying, for days, over and over, about her dead son.

How many may refuse vaccination, and die then?

I believe it makes more sense to demonstrate caution, due to the sad politics of humanity.

AstraZeneca isn't even approved in the US yet so the delay will most likely have no effect there.

>> there are other options

> Not with sufficient supply there isn’t.

Depends. If AZ is not removed entirely from use but instead only from the most affected group (women under 50), then this can be achieved by shuffling around which group gets which vaccine. So the same number of people will be vaccinated, and vaccination deaths are avoided.

> Only if people (and the media especially) hype up a very small danger to be more than it is.

At least here in Germany, it was mainly the healthcare workers who specifically rejected AZ. Police, fire brigade, kindergarten teachers, etc. were eager to get any vaccine. So simply blaming it on the media is maybe short-sighted, there are other dynamics at play here.

Who is to say that other vaccines don't have the same side-effect? That could especially be assumed of the other viral vector vaccines, so Johnson & Johnson, Sputnik and CanSino, none of which have received much scrutiny so far.

Even if the mRNA vaccines are safe, we depend on J&J and AZ doses for our reopening plans in Europe. We can expect economic damage from any wait for alternative vaccine doses.

J&J uses a different adenovirus than AZ (and human rather than chimpanzee). Of course, this is now demonstrated as a potential side effect to be on the lookout for.

Several European countries are already finding that millions of people are refusing the AZ vaccine due to unfounded and disproven aspersions made against it by political leaders in Europe. So either way vaccine deployment gets hurt. If you suspend usage vaccinations get delayed and people wonder if there are real problems, otherwise why is it's use being suspended? If you push ahead people complain concerns aren't being taken seriously. It's lose/lose all round.

Meanwhile Britain has got on with the job and vaccinated 25 million people (including me on Monday, with AZ), and avoided the fresh waves of infections crippling Europe and flooding their hospitals at the moment.

> there are close to 200 vaccines.

That number is at best vaccine candidates, and I suspect even that is a very charitable term.

The actual number of vaccines approved by any health agency is 12, most of which are not approved by any EU health agency. Including the number of vaccines in Phase III trials that might be approved in the next several months would get you maybe another dozen at most.

> 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.

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.

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.

> 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...

I specifically talked about the risks of delayed vaccination and did not frame the choice in the extreme terms you described.

Looks like it was a pretty short delay:

https://www.dw.com/en/astrazeneca-german-team-discovers-thro...

> railcar switch dilemma

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

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.

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

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-po...

Meanwhile Finland is not discontinuing the use of the AstraZeneca vaccine because there have been less blood clots than initially anticipated.

¯\_(ツ)_/¯

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.

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.

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.

Same with Ivermectin ( 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.

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

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-sho...

The car ride to get the vaccine is the bigger risk in their day.

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.

not realising.

Things like this happen with experimental untested vaccines.

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.

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.

There seems to be some working medication that helps people who have gotten covid: https://vdmeta.com/ and https://ivmmeta.com/

(I'm not working in the fields of medicine, statistics or virology.)

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

EMA concluded that these incidents were not caused by the vaccine so it kinda disproves your statement here.

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.

I think we agree that it wasn't caused by the vaccine so I have no idea what you are getting at

I guess you can't understand context. I'm saying they snubbed the vaccine to cover their asses for messing up the orders.

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

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.

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.

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.

Norway's number is only from healthy health workers. The UK number is not.

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.

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.

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...

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.

Maybe it would have been better after all if not just AstraZeneca were able to manufacture the vaccine, as was originally planned.

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.

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.

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.

>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?

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.

> Compared to the risk of going unvaccinated, it's an obvious choice.

I think the insidious and repugnant effect of this line of thinking is that it subverts the body autonomy and free will that every human being should enjoy.

The issue isn’t only risk, rather it’s individuals deciding based on their own judgement, which may involve their own evaluation (informed or not) of risk.

The public health establishment is set on presenting the illusion that people have absolutely no choice but to take a vaccine that was rapidly developed using novel technology.

In my opinion, this is unethical. No human being should be coerced or propagandized into taking drugs or medicine of any type.

The only responsibility of government should be presenting boring information about the vaccine to be used by people to decide what they’d like to do. But it’s very clear that society at large is set on propaganda and conformity in the pursuit of technocratic policy goals.

It’s precisely this well-intentioned pursuit of end goals augmented by the certainty of science that allowed the eugenics of the 1920s. And it seems like a century later we think we’re immune to that pernicious illusion afforded by science.

Did you respond to right comment? You seem to be arguing against something that I'm not arguing for.

I think if we're talking purely from the perspective of self-interest, many healthy individuals have no reason to get vaccinated. Getting vaccinated takes time and effort, and they can freeload off the large fraction of the population who is clearly going to get vaccinated.

I suspect this freeloading incentive is a big reason govt's haven't used the risk-reward framing as the major selling point for vaccines. That, and the fact that for healthy individuals, there are much larger risks you ought to spend your time worrying about (if you're only looking out for your own best interests).

> “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?

They do not. Rewritten for concision:

> “We have the reason: only the vaccine could have caused this immune response”

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

> 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.

> 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?

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).

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.

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.

It‘s not local, there have been similar cases in Germany and Italy, with confirmed deaths.

The committee "concluded that the vaccine is not associated with an increase in the overall risk of thromboembolic events, or blood clots," Cooke said.

the article doesn't say the "experts in the field" agree with the doctor, just that they collaborated, on a technical part of the experiment.

Again, this is such a small sample and out-there group that it's not representative and there are many explanations that are more likely than "the vaccine causes blood clots".

Here's a better article, https://www.nytimes.com/2021/03/15/health/astra-zeneca-vacci...?

"""Calculating further, he said, roughly 1 percent of the 1,000 to 2,000 daily blood clots — 10 to 20 a day — would occur in the vaccinated patients just as part of the normal background rates, not related to the vaccine.

“Only if epidemiological data show that that rate is higher, would one start to wonder about a causative relationship,” Dr. Moll said.

"""

AKA, base rate fallacy strikes again.

Exactly, for all we know the clotting rate could be lower within the vaccinated group.

If anyone has data to support either conclusion vs the base incidence rate, I'd love to see it rather than being downvoted.

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