France reports three new cases of thrombosis, more deaths after AstraZeneca jabs | Hacker News Reader

France reports three new cases of thrombosis, more deaths after AstraZeneca jabs

rfi.fr

70 pointsreddotX106 comments

I personally think these "news reporting" style articles aren't all that helpful in understanding the issues. Context matters a lot. Here's an article I strongly recommend:

https://www.theatlantic.com/health/archive/2021/03/astrazene...

This is not a simple issue. The implications are serious in Europe in the short and medium term, as they're quite far behind in vaccinations compared to the US and UK. Then the implications for global health equity are even more worrisome.

I am dubious that these incidents are anything but statistical noise.

But.

This AstraZeneca trial has been a bit of a gong show.

https://www.reuters.com/article/us-health-coronavirus-vaccin...

“About 1,500 of the initial volunteers in a late-stage clinical trial of the Oxford/AstraZeneca COVID-19 vaccine were given the wrong dose, but weren’t informed that a mistake had been made after the blunder was discovered”

They’ve had a series of data issues, and they have not be super transparent about them. Is it safe? I think so, given the results from the deployment we’ve seen, but they didn’t inspire perfect confidence as they rolled this out.

"In total, 30 people out of 18 million vaccinated by 24 March had these clots. [in the UK]"

"There have been two cases of CVSTs after Pfizer in the UK, out of more than 10 million vaccinated, but these did not have the low platelet levels."[0]

So currently a one in half a million chance of being effected. For comparison 1 in 1000 women per year taking the contraceptive pill have a chance of a blood clot. Obviously this is a new drug and should be scrutinised, better understood, and if possible fixed - but at what point do we consider the daily articles scaremongering by people with an agenda?

[0] https://www.bbc.co.uk/news/health-56620646

Important to note that the blood clots from birth control are completely different than the ones from the vaccine, and are an order of magnitude or two less dangerous.

Which one is the more dangerous kind?

It doesn’t matter. People should know side effects if they can be deadly. Plenty if women don’t take the pill because of side effects and opt to use alternatives.

I think the age distribution is important. The claim is that AZ vaccine causes this rare blood clotting in people below 55 years old. Unfortunately I don't see information about this in the article.

The risk is quite low for the AZ vaccine (1 death per 2 million), but the 3 that have FDA emergency authorization are even safer (zero known side effect deaths). I wouldn’t take the AZ vaccine unless I was in a high-risk group. Use the AZ vaccine on older people and the others on younger people, the risk calculus changes as you get older.

> Use the AZ vaccine on older people and the others on younger people, the risk calculus changes as you get older.

I am not sure older people would be too fond of this risk calculus. What about using "the others" on older people, and producing more of "the others" to vaccinate younger people later on?

The risk for the general population of younger people is low, they are not too afraid about the virus, and a potentially large part of them have already gotten COVID and recovered just fine. So there is no hurry in general. From what I read, people who are at risk without being extremely ill in the first place are old people and over-weight people (regardless of age). cf. https://doi.org/10.1161/CIRCULATIONAHA.120.051936

Older people are both less at risk from this type of clot (at least based on current data), and much more likely to die from COVID. So the risk of them dying from COVID in the time they have to wait to get an alternative vaccine is almost certain higher than the risk of them dying from a clot from the AZ vaccine.

Over a certain age, the odds of dying are higher from COVID-19 than the AZ vaccine blood clots. Ideally nobody would need to take the vaccine that has a 1 in 2 million deadly side effect, but we’re supply constrained right now.

The numbers from UK diverge a lot of those from Germany. In Germany we had 2.4m first time doses of AZ administered and 9 dead (as of 29th of March), while the UK reported 8 dead from 15m doses (as you stated: 1 in 2m).

The difference is part of the concern in continental Europe.

> Mainland Europe, for example, has given the AstraZeneca vaccine to more people under the age of 60 than the UK, which vaccinated healthcare workers and older people first, using an even split of Pfizer and AstraZeneca shots

from https://www.ft.com/content/d5cd63c6-af01-4d29-a5e5-b69ade4f3...

I would assume as UK starts vaccinating younger people it's likely to show the same impact? (also is continental europe using more AZ vaccines than UK overall?)

Just to add to your point, how many of the 18mil (mostly old or ill) people vaccinated would have had blood clot issues in the next few months anyway?

CVSTs happen in women taking oral contraceptives at a rate of 1 in 1000 per year?

Not a doctor but that seems right to me.

Estrogen is a clotting factor and if you have elevated risk markers (like Factor V Leiden) that risk skyrockets when you add extra estrogen.

Many insurance companies get angry when you ask for blood tests to check before getting birth control (my wife was charged an extra 1k because she requested a blood screening after she learned she had a history with clotting).

I've had a cousin hospitalized for birth control related thrombosis, so again: my input could be biased here.

CVST is a rare form of stroke.

Does 1 in 1000 women taking oral contraceptives having rare strokes every year sound right to you?

No, but the original comment said 1 in 1000 have clots, not CVST.

> but at what point do we consider the daily scaremongering by people with an agenda?

Indeed, at what point do we consider that?

Is it after half the world has been indoctrinated into taking a several-month old experimental medicine for an illness that the overwhelming majority of people under the age of ordinary life-expectancy survive - or, more commonly - barely notice?

Or is it after we've spent so many trillions on that illness so as to be able to turn each and every one of the 9 million per year of us who simply do actually starve to death each and every year, into a millionaire?

Yes, do please tell us about daily scaremongering by people with an agenda and how bad it is for everyone, you just go right ahead and do that.

Your anti vax bullshit is wrong and misleading, on so many levels.

There's a significant difference between being reluctant to take a brand new, experimental medicine that exhibits high risk factors and low benefits, versus being opposed to vaccines per se.

Absolutely not opposed to the latter, vaccines are and have been of tremendously huge benefit to humanity.

The vaccines are new but they're not experimental. They have been through the standard trials and statistical analyses.

> The vaccines are new but they're not experimental. They have been through the standard trials and statistical analyses.

Not the full spectrum, the trials are still ongoing. That’s why they have, in the US (and the equivalent in many other jurisdictions) Emergency Use Authorizations, not regular approvals.

I'm objecting to the term "experimental".

Each of the Oxford-AstraZeneca, Pfizer-BioNTech, Moderna, and Johnson & Johnson vaccines all have Conditional Marketing Authorisation in the EU.

The EU contrasts this as being much more robust and stringent that a mere Emergency Use Authorisation.

See the section “What are the different data requirements between an Emergency Use Authorisation and a Conditional Marketing Authorisation, and what are the potential consequences of these?” https://ec.europa.eu/commission/presscorner/detail/en/qanda_...

Agree with you. And in many cases, the scaremongering is the agenda. It generates clicks. It sells ads. So the same media will try to scare you with that new virus that will kill everyone and you need to be terrified until the vaccine comes up, then tries to tell you the vaccine is terrible and dangerous. There isn't necessarily a logic behind this other than generating traffic.

I think the clots from contraceptive pills that you refer to are considerably less deadly than CVST. I don't know how the numbers stack up, I suppose indeed contraceptives are more dangerous than this vaccine anyway. But in any case, you're doing an apples-to-oranges comparison.

Contraceptive pills are taken by millions of women, of course, but there is a large proportion of women (possibly a majority) that do not want to take them. Alternatives like the condom, IUD, sterilization, etc. are widespread even if they are more uncomfortable, precisely due to the pill's side effects. And no one (or no one in their right mind, at least) questions a woman's decision to not take the pill.

Here we are talking about a vaccine that your health system actively calls you to take in the context of a campaign, no alternatives are given (in the words of a politician in my country, "vaccines are not yoghurts, you cannot pick your favorite flavor"), and while you are free to refuse it, you are then called an antivaxxer, and not given any guarantees about being able to take another in the future.

The standards really cannot be the same for something that you take at your own risk among tens of alternatives versus something that you are pressured to take without even a clear guarantee of alternatives. And you cannot use contraceptive pills as a metaphor for something that people just take willy-nilly without a second thought, because plenty of women definitely don't do that.

Corresponding ratio in Norway when they called a timeout on AZ was 4 fatal cases out of 125 000 vaccinated. Similar ratio has been seen in Denmark.

I have no idea if it is a bad batch or some unusual conditions in the Nordic countries (previous vaccines administered to this cohort?) -- but it does seem to be way beyond noise.

You don't have to trust (British) journalists to get the numbers. You can look it up in the Eudra Vigilance database yourself. Follow this (you might have to agree to some disclaimer at some point)

https://www.ema.europa.eu/en/human-regulatory/research-devel...

Find link with "European database for suspected adverse drug reaction reports.",

click Human,

click "en",

click "Search for report",

click "Suspected adverse drug reaction reports for Substances"

click "C"

search for "COVID-19 VACCINE ASTRAZENECA (CHADOX1 NCOV-19)"

click tab "Number of Individual Cases for a selected Reaction"

select "Nervous system disorders" from the dropdown

select "Cerebral venous sinus thrombosis" from the list

You get this: https://ibb.co/VDbYXpC

107 cases, 22 dead, 5 recovered (as of 3rd April). Note that UK doesn't put their numbers in this database so these adverse events are only out of the EU doses.

For extra fun look up Pfizer or other vaccines or other side effects like general brain hemorrhaging or strokes

What is so different with AstraZeneca? Should we expect similar side effects with other vaccines?

Different type of vaccine. No.

There aren't known blood clot side effects from Pfizer-BioNTech, Moderna and J&J. These vaccines are intended to have effects, since that's how your immune system is stimulated to produce a reaction, hence reactive vaccines, but there aren't blood clot stories hitting the headlines.

The blood clot stories hitting the headlines are doing a disservice. If one out of a million of something happens, the human cognitive bias will make it feel like it's likelier than it is.

.. or do Europeans prefer to be locked down for the rest of their lives?

People should ignore the news media and take the vaccine for God's sake, it hasn't killed 40% of the UK, has it ?

Downvote all you want, it does seem to me that people are simultaneously anti-vax and pro-lockdown. To wit, here is an article showing how rare the clots are:

"German regulators said they had received 31 reports of rare blood clots in the head in recipients of the AstraZeneca vaccine and nine deaths up to March 29, roughly doubling

Cooke said the EMA will include the Germany cases in its review "and they will form part of the ongoing evaluation that the committee is undertaking, as will any additional cases that are reported from other countries and regions.”

Based on the numbers reported to the agency so far, there have been 4.8 cases of the rare blood clots per million doses of the AstraZeneca vaccine administered, she said."

(https://www.france24.com/en/europe/20210331-eu-says-no-evide...)

"Based on the numbers reported to the agency so far"

The key word is "so far", the article explains that Germany saw the number double since the reporting.

https://www.ft.com/content/d5cd63c6-af01-4d29-a5e5-b69ade4f3...

Reports it as 10x the normal occurence of 3 per 100k. (and I assume that's before doing further slicing, probably slicing for younger women would show even more impact?).

I'm all for vaccine but it's a tight rope to have a successful rollout in EU: https://www.theatlantic.com/health/archive/2021/03/astrazene...

Maybe they could consider reserving the non-AZ doses to the most likely to be affected demographic.

(personally I'm lucky enough to be in a country that's not planning on using the AZ vaccine so there's no question, but rest of EU is different)

One of the suspicions is that AZ uses a non-stabilized form of the Spike protein, whereas Pfizer/Moderna change them a bit to make them stable.

Judging from UK data, it seems like the Pfizer vaccine does not have this particular side effect:

https://www.bbc.com/news/health-56616119

"The MHRA said it had received 22 reports of cerebral venous sinus thrombosis (CVST) - where a blood clot forms in the brain - and eight reports of "other thrombosis events with low platelets [the cells involved in clotting]" following use of the Oxford-AstraZeneca jab, out of a total of 18.1 million doses given up to and including 24 March

(...)

Meanwhile, the MHRA said there had been no reports of blood clots following use of the Pfizer-BioNTech vaccine.

As of 21 March, an estimated 10.8 million first doses of the Pfizer-BioNTech jab had been administered in the UK, the regulator said."

If this leads to the rich world refusing the AZ vaccine, and it all ends up being used in Brazil, that would actually be great!

If we simply extrapolate current trend, half of it will rot unused in US warehouse.

Maybe I'm mistaken, but I thought Johnson and Johnson was the one with the distribution issues?

The US has bought and taken delivery of AZ vaccine, but isn't permitting its use. so it's in storage (although they recently announced to give some of it to Canada, and I'd expect they'd give it all away before actually letting it expire, because why wouldn't you?)

Canada will only use AZ for people above 60, so hopefully Mexico takes that AZ

The USA is already “lending” to Canada and Mexico.

But somehow the rich world refused the Russian vaccine for months... what is this preference for US for-profit pharma companies even at the expense of their own population? The Russian vaccine is already shown to be more effective.

Honestly, political sanctions are one thing, but refusing help for political reasons?

https://amp.cnn.com/cnn/2021/04/03/europe/europe-russia-vacc...

Sputnik V has no approval, emergency or otherwise, in the EU or the US. They never submitted any trial data to get an EU approval.

Sure, and the Israeli vaccine has no approval, emergency or otherwise, in the Palestinian territories. They received only 10,000 doses so far, from Russian vaccine. Same story... enough people in the leadership will gum up the works for purely political reasons, cutting nose to spite face. It’s basically the opposite of “operation warp speed”:

https://www.bbc.com/news/55800921

Can you tell me the difference between these two situations? Leadership lets their own regular citizenry die for political reasons. USSR refused food aid from western Europe during Holodomor. Venezuela refused food aid recently also. You can describe it all as “has no approval”. WHY does it have no approval — that’s the question.

I'm perplexing to me, as well. Europeans didn't approve the vaccine but they also have strict lockdowns. Do politicians actively WANT lockdowns? Is that what people want? Aren't people desperate to be free again? They took forever to approve the U.S. vaccines, they also refused to negotiate beforehand, and were sticklers on cost. Now the U.S., Israel and the UK have run laps around the EU in preparedness.

When I was growing up we Europeans saw movies about the USSR, we heard news stories about Soviet citizens needing approvals to travel in their own countries, we saw checkpoints and checking of ID, and we patted ourselves on the back because we're Free. So - what happened?

It is because they did not submit approval request.

The EU is really bureaucratic, more than any governing body, it is a huge flaw, but in reality it make it easy to dismiss claim that a decision is political. If it not a decision made by the council, it is not political.

The biggest issue was that the EU exported about half of the vaccines manufactured in the EU. Had it done as the UK and the US and hoarded them for themselves, banning vaccine exports - the EU would’ve been way better off.

> Sure, and the Israeli vaccine has no approval

There is no Israeli vaccine. Israel mainly uses imported Pfizer vaccine.

Sputnik also has production issues, Russia has only 4M of fully vaccinated population as of today, how they can help other countries?

Many countries in the EU were under unwilling Russian dominion just a few decades ago. I don't think it's reasonable to blame them for mistrusting Moscow's motives. (And there's a lot of clear mischief that could happen; if the EU ends up in a situation where losing Sputnik V imports would set vaccinations back by months, and then Russia annexes Donbass, what are they going to do?)

The leaders mistrusting Russia’s motives has to be balanced against the death toll of their citizens.

Refusing emergency aid and help because of some postulated alleged unspecified “motives” and not even willing to debate with others what those motives could be — is highly irresponsible.

You have to put aside political chauvinism when it comes to aid. It’s like when Palestinians refuse Israeli vaccine or when USSR refused European food aid during Holodomor, or when Venezuela did similar recently.

What about all the regular people who need emergency aid now, why are some people in the “leadership” able to deny them even access to it, for political reasons — while their own families secretly get all the best resources first? They don’t worry for their own families, so the plebes can just wait while the situation is resolved eh...

There wasn't really an aid anyway. The sputnik vaccine doesn't have somehow more factories to produce it than others.

It's not like the choice was between vaccinating with X or waiting, availability is similar (or worse).

Are there many European citizens who want Russia's vaccine, though? I agree that it's bad if there are, but it's my impression that most people in most countries would rather wait.

Does the sputnik vaccine actually has a high production?

Trying to find number, but seems like so far there's been 30M doses produced. I think a few european countries are planning to manufacture it for Russia.

In any case doesn't really help, it's not like it's more easily available (and I guess costs are similar to AZ or J&J vaccines)

In small countries that have the pandemic under control like Norway there are worries that AZ could kill more people in the affected age ranges than the virus has done so far.

Are those worries supported by any data? As far as I can tell the rate of deaths after vaccinations is still incredibly low if you take into account how many people have been vaccinated. The fatality rate from Covid is much higher, even for young people. And that's not even taking into account the fact that a non-vaccinated person is also a potential carrier that can infect others.

> Are those worries supported by any data?

Yes. The incidence is as of a week or two ago significantly above what one would expect. Additionally this effect can be shown in all countries where AZ was given to people below the age of 55 and no such cases happened to people given other vaccines. You can quickly google for the numbers and days if you want.

I don't doubt that there have been cases of thrombosis, and that those may have been caused by the vaccine. But I haven't seen any proof that the rate of deaths caused by this is anywhere near as high as the IFR of covid. Even for young people. Do you have any data to support this? Just because people "are worried" doesn't mean they have any reason to be worried.

The IFR for young people from Covid is less than 0.03%. that is very, very low.

Depends on what you call "young" - have a look at figure 2 here: https://www.nature.com/articles/s41586-020-2918-0

For people 35-39 it appears to be 0.01%-0.1%.

> I haven't seen any proof that the rate of deaths caused by this is anywhere near as high as the IFR of covid.

This is a key flaw in your logic. The choices aren't just "get the AZ vaccine" or "100% chance of catching COVID", so you need to multiply the IFR of COVID by the chance you'll catch it to have a fair comparison.

I would argue that that chance approaches 100% until we reach herd immunity, which will still take quite a while in Europe. Especially if people keep refusing to take the AZ vaccine.

And even if the chance is only 1/4, I would estimate that the numbers would still be higher for covid than for AZ for people in their 30s and above.

> I would argue that that chance approaches 100% until we reach herd immunity

That seems unlikely. For one thing, after more than a year, there have been 130 million cases out of a population of 8 billion, which is less than 2%. Do you expect this to dramatically spike in only a few months at this point? Also, remember that there are other vaccines available, so it's not the case that AZ or catching COVID are the only two ways to herd immunity.

I assume that's the number of confirmed cases? Because we know that's a huge underestimate, even in countries with widespread testing. For example in the UK approximately 15% have had an infection already, and that's with lockdown measures etc: https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

I'm making the assumption that we want to reopen our economies again at some point, at which point the infection risk will obviously rise much higher than that (unless we have reached herd immunity). The only way to prevent that is to get people vaccinated. And right now for many countries in Europe AZ is the only vaccine available, since the supply of the mRNA vaccines is for too low.

I don't think your statement supports your conclusion.

There were more than 50 deaths by COVID-19 in Norway last month. How many people were vaccinated with AZ and didn't die? How many of them won't die in the coming months? Could they have gotten a different vaccine? What if there wasn't enough of those other vaccines?

In this statement: "AZ could kill more people in the affected age ranges than the virus has done so far"

What are "the affected age ranges"? Affected by what? COVID-19? AZ vaccinations? Thrombosis due to AZ?

13 people under 50 died in Norway from Covid. 3 in the same age range (I believe) died of CVST after AZ. Not sure after how many doses in the age range but likely below 120.000 given the relatively few shipped to Norway. After that the regulator suspended it.

It's still not proven that vaccinated people can't infect others: https://www.bbc.com/future/article/20210203-why-vaccinated-p...

Maybe, but it's very likely that the risk will be significantly lower than for unvaccinated people. And there was actually a CDC study a few days ago that confirmed that the vaccines prevent infection entirely, which would obviously stop transmission: https://www.bmj.com/content/373/bmj.n888

More so that wasn't the focus with the vaccines and it wasn't part of the testing.

Newer testing is showing a near complete stop of transmissions with vaccines. CDC is actively changing guidelines as these studies come out.

We also don't know how long the vaccine immunity lasts. I've been reluctant to get the vaccine because I've already had and recovered from COVID. Some people are telling me that immunity from having the virus may last only 90 days. If that's the case, why do we expect the vaccine immunity to last any longer?

There is evidence that the Pfizer vaccine is still effective at least 6 months later https://www.usatoday.com/story/news/health/2021/04/01/pfizer...

Thanks for that, the report appears to be very recent. However the story does note (at the end) that "how long they will remain effective" is still an outstanding question. And why would the vaccine immunity be longer lasting than the natural immunity from having contracted the virus?

The more time goes on, the more we'll know about these questions. Right now there is just no way to know what happens 1+ year after vaccination, since nobody has been vaccinated this long yet.

If I were you I would see the vaccine as a "booster shot" for whatever natural immunity you may still have, with the expectation that it will improve and prolong your immunity.

> The fatality rate from Covid is much higher, even for young people.

Are you taking into account that these blood clot deaths are happening disproportionately in younger people? Also, are you assuming that anyone who turns down the AstraZenaca vaccine is definitely going to get COVID?

Yes - IFR for people in their 30s is still between 0.01% and 0.1%, which is significantly higher than the rate of death with thrombosis after AZ.

OP is claiming that "AZ could kill more people in the affected age ranges than the virus has done so far." so that's what I'm questioning.

Their point is that AZ is less likely to kill you if you would get COVID without the vaccine. If you weren't going to get COVID either way, the vaccine exposes you to a very small risk that you wouldn't have been exposed to otherwise.

In regions where COVID is well-controlled, you might save lives by rejecting the AZ vaccine and maintaining the current lockdown/measures until non-AZ vaccines are available.

The risk of death from the AZ vaccine seems to be about 1 in 500k. If you're a country of 10 million people, you would expect roughly 20 deaths from the vaccine. If fewer than 20,000 people would get COVID, the vaccine would kill more people than COVID would. If more than 20,000 people would get COVID, the vaccine would save lives.

Basically the risk of dying from the vaccine applies to everyone, because we want everyone vaccinated. The risk of dying from COVID only applies to people who actually get COVID. You'd have to look at projections to see which is likely to be more risky, but you would have to have really good control of COVID for the vaccine to be riskier.

This is given they will remain sealed forever for the rest of the world.

No, just that they keep their numbers under control until younger people are able to get an alternative vaccine.

A handful of blood clots from millions of vaccinations ...

10's of thousands of deaths out of millions of covid infections.

forever lockdown.

The choices are grim but after a year of lockdown... I'm worried about what happens in the next elections.

I'm curious why are people down voting this?

Because it names and opposes the forever lockdown solution preferred by the HackerNews hivemind.

I don't know either, but there's a strong anti-vax vibe in this thread. For reasons that are somewhat unclear to me, France has one of the highest anti-vax sentiment rates in the developed world, so that can have something to do with it. https://www.connexionfrance.com/French-news/Covid-anti-vax-s...

My retort is, for those who don't like vaccines, if you don't want a vaccine what IS the solution to the problem of covid?

Being skeptical of one particular vaccine does not make someone an antivaxer.

But it's the most available one, since Pfizer's low on availability in the EU. Also, France, the country in the subject here, has a high vaccine skepticism rate (separate from Astra) ranging from 50-60 pct.. source being France24 report from December.

Smells like a false dichotomy. The fear is palatable.

Interestingly lockdowns, freedom passes, vaccine passports and masking are proposed as the new normal. Vaccination doesn't guarantee an end to lockdowns. Much like the post 9/11 anti-terrorism measures never ended. Fear is used to rationalize further encroachments on civil liberties.

Considering alternative vaccinations exist I’m not sure why this comment makes sense. One can imagine an end to the pandemic that does not involve vaccinating people under 55 with AZ.

That article is not very helpful is it. Explicitly, i believe knowingly, excludes information.

For example

> In a separate development, the UK medical regulator said on Saturday that out of 30 people who suffered blood clots after receiving the Oxford-AstraZeneca vaccine, seven have died.

Excluding that that population sample is in the region of 19 million people who have received at least one dose of ChAdOx in the UK and the incidence of the clot is likely lower than the incidence rate in the population in general, as I understand it.

Oh, so now it's ok to use this type of argument?

>the incidence of the clot is likely lower than the incidence rate in the population in general

It's lower than the incidence rate of general blood clots, not than that specific type of blood clots. One of Norway's chief physicians (not just some quack) concluded that the clots are indeed due to the AstraZeneca vaccine: https://sciencenorway.no/covid19/norwegian-experts-say-deadl... . At the time that occured, only 130,000 people had been vaccinated in Norway, and so the four deaths of people under age 50 resulting from the clots actually suggested the AstraZeneca might be more dangerous to young people than Covid (which has a less than 4/130,000 fatality rate for the young).

I don't see how you can "conclude" that with N=30, though. If these numbers were the basis for a study about some unimportant thing submitted to a peer reviewed journal it would be thoroughly laughed at and rejected.

AZ is safe. Get your shots, people.

> AZ is safe. Get your shots, people.

This attitude is what is causing people to distrust authorities.

Rather, treating understanding of numbers and statistics as an "attitude" seems to be more of a problem to my eyes. AZ is safe. That's not a statement of opinion. Get. Your. Shot.

It's ONE in 600,000. Very safe. I got my AZ shot two weeks ago.

It's really not helpful to say "Get. Your. Shot." in a threatening way to someone who's on the fence about getting vaccinated. It's a lot better to try to understand them and walk through their decision, and (gently!) question whether why they've taken the advice of a Facebook post over that of their doctor, or how they're comparing the (huge) risks of COVID infection against the (tiny yet highly publicised) risks of getting vaccinated.

The upthread poster wasn't "on the fence". I read that comment as vaccine denialism, not indecision. And misinformation needs to be called out as such, not coddled.

"Denialism" runs the gamut from your undecided aunt who read a Facebook post and can be talked around in five minutes, through to actual strong opposition to vaccines based on years of conspiracy theories, and absolutely none of the people on that gamut respond well to unsourced claims that a vaccine is safe.

If you want to feel smug and superior, make dogmatic statements. If you want to change opinions, then you have to treat denialists with respect for their humanity, and separate the person from the opinion.

OK, let's do some numbers and statistics then.

Norway has 3.414.711 people under 50, of which 13 have died from COVID since the start of the pandemic. Approximately one per month. Source: https://dc-covid.site.ined.fr/en/data/norway/

Thus, if you're under 50 in Norway, your risk of dying from COVID in the next 3 months is approximately 1 in 1 million. This is even lower for younger age groups (e.g. the population under 40 is 2.691.048 and only 3 have died in the whole pandemic).

The estimates on the risk of death from these clots range from 1 in 100.000 to 1 in 1 million.

So tell me again, how is it that obvious from the numbers that, say, a Norwegian 25-year-old woman should get her AZ shot instead of waiting for Pfizer/Moderna/J&J to be plentiful in 3 months?

Note that I'll probably get AZ myself if offered (for several reasons, notably including that COVID also comes with other risks apart from death, and also I'm from a country with more incidence than Norway). But no, it's not an obvious choice. And indeed, that kind of arrogant attitude does cause distrust.

By the way, I would take a 1:10 that you're American because 99% of the arrogant posts lecturing Europeans to take our AZ shots come from there. Of course, it's easy to speak so categorically from a country where you don't even need to make the decision of taking AZ or waiting for a better vaccine. The FDA shields you from that inconvenience by not even bothering to approve it, and your doses will end up being sent to Canada and Mexico. So basically, you don't have to decide to accept or refuse AZ because your institutions have already decided to refuse it (and rightly so, any country would do it if they were swimming in other vaccines... but then let's not pretend that they are all the same).

> The estimates on the risk of death from these clots range from 1 in 100.000 to 1 in 1 million.

Cite? That's absolutely not consistent with the 7-fatality (yes, seven) value listed above.

The 7 fatalities come from the UK, where the numbers are considerably better than in some other countries. In Norway there have been four deaths of over 50s with less than 200K vaccinations, which is especially bad, in Germany it's somewhere in between.

The 1 in 100K estimate comes from the EMA. Here they report it:

https://www.bbc.com/news/health-56616119

"The EMA, which has assessed data from around the world, estimates there is around a one in 100,000 risk of a CVST in people under the age of 60 who have been given the Oxford-AstraZeneca vaccine"

(not the primary source, but it's quite clear that the British national media station would not have a bias against the British vaccine...)

Well, I don't think it is impossible: for example if N is usually 10+-2 cases each year, then N=30 is very unlikely to be just a statistical artifact.

Usually N denotes the sample size, but in this case the sample size is <the number of people under 55 vaccinated with AZ>.

Edit: clarification

I don't know how you can "deliver" such snark; if you gave 100 people shots and 30 developed clots, by your erroneous reasoning, N = 30.

What matters is the number of clots relative to the normal (incidence) rate, and the odds that you'd find 30 clots when sampling a randomized size-matched subset of the total population.

Please don't try to talk with authority on a topic when you're undereducated, aside from coming across as an ass, your brazen confidence and lack of knowledge just gives room to counter-argue that would instead harm your supported causes.

Is it a lot less?

China and Spain both reported 0.2% death rate in the 20-29 range. 4/130,000 is 0.03%

The worst case scenario for vaccine side effect seems to be almost 7 times better than the disease.

https://ourworldindata.org/mortality-risk-covid

Careful with this comparison: you want to vaccinate 100% of the population but get as few as possible to contract coronavirus. This means that you cannot compare fatality rate of the infected vs fatality rate of the vaccinated and extrapolate to the entire population. In Norway if the trend of AZ fatalities were to continue they would quickly have more deaths of AZ below 55 than the virus claimed.

Edit: ah, you're saying if we vaccinate 100% that's but only 50% were ever going to get covid then we need to allow for twice the vaccine side effects compared to covid issues?

Original comment:

I'm not sure I follow your logic? Haven't we already allowed for that by comparing via percentages?

Unless we expect younger people to have a higher rate of side effects?

Sorry if I'm being dull...

Where are you getting those numbers from?

Based on Figure 2 of this paper the IFR for people 35-39 is between 0.01 and 0.1%. So in 130,000 infected people you would still expect between 13 and 130 to die from covid. And that's ignoring all sorts of other issues, like the amount of people that will need to be hospitalised, long covid, etc.

https://www.nature.com/articles/s41586-020-2918-0

https://www.theatlantic.com/health/archive/2021/03/astrazene...

Was a pretty good overview of the issues

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