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Comment by Freak_NL | Hacker News Reader

Yesterday scientists reported that they may have found the underlying cause for these few thrombosis cases:

https://www.npr.org/sections/coronavirus-live-updates/2021/0...

So the AstraZeneca vaccine does seem to trigger thrombosis in very rare cases, caused by a strong immune response. But luckily:

> The German researchers say the good news is that if their theory is correct, this rare adverse reaction to the jab can be identified and treated.

> They say recipients should be on the lookout for unusual bruising, swelling or headaches that start four or more days after getting the vaccination. If identified quickly, they say, the clotting problem can be managed relatively easily by health professionals.

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Indeed, the age group for cerebral venous sinus thrombosis (CVST) is very specific [1], mostly women < 55 (menopause?):

> The Committee’s experts looked in extreme detail at records of DIC and CVST reported from Member States, 9 of which resulted in death. Most of these occurred in people under 55 and the majority were women. Because these events are rare, and COVID-19 itself often causes blood clotting disorders in patients, it is difficult to estimate a background rate for these events in people who have not had the vaccine. However, based on pre-COVID figures it was calculated that less than 1 reported case of DIC might have been expected by 16 March among people under 50 within 14 days of receiving the vaccine, whereas 5 cases had been reported. Similarly, on average 1.35 cases of CVST might have been expected among this age group whereas by the same cut-off date there had been 12. A similar imbalance was not visible in the older population given the vaccine.

This seems to be yet another case where the news is incapable of keeping up with timely technical information. No mistakes were made, the pause could have gone either way and we should generally be more understanding of difficult but timely decisions made in the face of uncertainty.

[1] https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazene...

5 cases in UK all among men aged between 19 and 59 https://www.reuters.com/article/idUSKBN2BA1UM

IMHO the suspension was very sensible as well as the identification of a mitigation protocol. This is how medicine is supposed to work: no emotions or politicking about second-order effects on public perception and so on. Just the facts, analysis and conclusions.

Indeed, as with everything around this pandemic has been, the turnaround time has been breathtakingly fast. I'm curious what infrastructure or methodology is supporting such a radical pace?!

My understanding was that the rate was still lower than it is in the unvaccinated population; and while they conclude "only the vaccine could explain these cases", I wonder how many cases in the unvaccinated population are investigated this thoroughly.

That depends on the country. Norway had four cases of fatal blood clothing in young people which is significant considering only 9 people below 50 died of covid there.

No the point is that there should be on average ~4 people dying of these sorts of fatal blood clotting anyway.

Not in that age range and in that sample size. Don’t forget that those are not random blood clotting cases but very rare ones.

Any cause of death is very rare if you get hyper-specific about the details.

Which is the issue here. An event that should be rare is not rare among AZ vaccinated.

I can't find anything about Norway having 4 fatalities associated with blood clotting.

https://www.wsj.com/articles/scientists-say-they-found-cause...

>Norway registered three cases of CVST, one of them fatal. The country vaccinated around 120,000 people with the shot.

https://sciencenorway.no/covid19/norwegian-experts-say-deadl...

>Holme led the work to find out why three health workers under the age of 50 were hospitalized with serious blood clots and low levels of blood platelets after having taken the AstraZeneca Covid vaccine. One of the health workers died on Monday.

Five admitted younger than 50, three dead. In total has 130 000 Norwegians been vaccinated with Astra Zeneca.

Use your favorite service to translate from Norwegian: https://www.vg.no/nyheter/innenriks/i/gW4wbL/legemiddelverke...

Like me, GP might be confused, as two deaths from blood clots among five hospitalized for it were reported last week. Then yesterday, as mentioned in sibling's link, two more deaths were reported (as having happened on March 21). This is where the 4 figure is deduced from.

I don't know the source of this confusion; it might have disappeared in an editorial decision. But as reported in said link, it is certain that three are now dead and five have been hospitalized.

It would be interesting to know why Norway has had such a high incidence of this (presumed) deadly side effect, and why it hasn't been discovered in others.

For countries that have a low incidence of covid, a fatality rate like this among younger people makes it a tricky ethical decision, especially if other vaccines will soon be available. My money is on it either being explicitly pulled or sometimes becoming very unpopular in these countries.

It's crazy to say that it is a safe vaccine with those statistics.

> My understanding was that the rate was still lower than it is in the unvaccinated population

That was when it was thought to be a normal thrombosis. The one they identified then, was actually an extremely rare one "Cerebral venous sinus thrombosis":

> an estimated 3-4 cases per million annual incidence in adults

-- https://en.wikipedia.org/wiki/Cerebral_venous_sinus_thrombos...

I love following quickly-developing stories like this, where the best knowledge available develops day by day.

You can be dead certain that a lot of the people who read the news at an early point in time, will go to their deaths believing that the initial quote was correct. It pays off to have a shifting degree of certainty about things like this.

Same for all those "the same thing is 1000 times as common with the pill" posts

Just spitballing here, but it might be possible that these individuals have an immune system that is pre-disposed to an auto-immune attack on their platelets. If so it might have happened eventually anyway (hence no deviation from normal stats), but the vaccine happens to trigger it pretty consistently. If so, and if the thrombosis turns out to be treatable like the German researchers think, then getting the AZ vaccine might turn out to be a relatively safe, controlled way for people with the condition to find out that they have it (compared to something else triggering it at some random time where they are not on the lookout for symptoms, and thus more likely to die from the blood clots). All theoretical at this point, but it would be a pretty good outcome if this side effect of the vaccine in reality turns out to become a screening method for a previously unknown condition.

It really depends what rate you're looking at. It can be lower than normal when looking at the whole population that is vaccinated but high on a specific group of this population.

In this case, the fact that there might be complications specific to an specific age group and potential specific to women might be a hint that there's indeed a problem that was not seen. It does not mean that the vaccine is not safe, but it might be not safe in specific circumstances, like a lot of medications already are.

Is low-dose aspirin contraindicated with any of these vaccines?

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