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Comment by tacitusarc | Hacker News Reader

6 obvious deaths that we're aware of. The risk of the vaccines is in their novelty and morbidity. An abundance of caution is required in this instance. It would be very bad to discover that there's a vanishingly small chance of blood clots within the first 3 months but a significant chance when paired with other events over the following decade.

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So I created a new account for this to avoid linking personal information...

I had blood clots in my lungs last week a few days after getting the J&J vaccine. I'm an otherwise totally healthy man in my 30s, no preconditions. The hospital reported it to the vaccine reporting agency, which I assume is reviewing all this information.

I'm not sure if they considered my case when making this decision. My clots were different type than what these women experienced (pulmonary, not cerebral).

Of course vaccinating the public is extremely important right now. If the risks of clotting really are 1 in a million, it makes sense to re-instate it. I also think that's an obvious conclusion and the people working on this are well aware of the public health trade-off.

I suspect they are working with more information than what's in the press release, and its prudent to give them some time to work through it.

I am so sorry. As somebody who has experienced pulmonary embolism, this is so scary.

Make sure to never forget to take your blood thinning medicine. You absolutely must get the blood clots completely dissolved, and the blood thinner medicine is highly effective at getting rid of it, if you take it.

I agree for the US to pause the rollout is likely based on more data than 6 known cases of clotting. Not trying to be conspiratorial but my two cents is the authorities have more data then what is publicly being shared.

Or they are aware that data reporting is spotty - many deaths could have happened and been attributed to other causes. How many heart attacks or strokes happened in those 6 million people? How many of those might have involved undetected clots?

If we assume that only 5% of cases are being detected and reported correctly, then the numbers look quite different.

Clotting happens much more frequently with or without vaccination. The reported cases are a kind of very rare type of clotting. It's easier to spot something unusual going on when mutiple rare events are observed.

In comparison there have been over 2000 deaths reported (US, all vaccines). But death is not unusual and unless one can find a specific link to vaccination that number alone is not alarming. Sometimes we live with known risk, anaphylactic shocks e.g., because they are unavoidable and benefits outweigh risk. But we do what we can to mitigate such risk.

In summary the current pause is triggered by the particular type of clotting, not just any clotting. But your case should contribute to the overall evaluation of the likely cause and risk.

The PR release tells people to watch for pain in their legs. So I think it’s possible and likely that clots are not only cerebral but arterial and venous.

But, IDK and I’m super skeptical they’re willing to halt vaccine and take this hit for 6 known cases. My guess is 6 deaths they’re willing to acknowledge and a few more cases that will come out.

But again, I know nothing and I would’ve expected their stock price to take a hit today.

Hope you get better soon.

Thanks. As I've now learned, almost all of these clots originate in the legs and pelvis and then travel to other parts of the body (lungs, brain).

So I think that's why they're telling people to watch for leg pain. I didn't have any issues with my legs, but it's apparently a common symptom to have pain and swelling there.

what were your symptoms that led you to go to the hospital to get checked for clots?

What is someone getting a vaccine as such is supposed to look for?

I got a little out of breath doing simple tasks like walking briskly or picking up my kids, and I had a pain in my back (actually lung) that gradually got worse over a few days.

Eventually the pain was severe enough that I went to the ER.

Looking back, the shortness of breath was a key indicator. It wasn't that I was struggling to breathe or anything, but I felt like I couldn't take a big deep breath easily and that's not normal.

The pain would also get worse at night when I tried to lie down to go to sleep. I thought I had pulled a muscle in my back at first, but it was quite painful.

ok now I'm worried. I got the JJ vaccine 4 weeks ago. Suffered semi bad flu for few hours that night then after felt great. Now some who now me may consider me a hypochondriac but I've felt a tad "off" since the vaccine but kept it to myself. Maybe only 2-3 tiny lightheadedness episodes while walking the dog (nothing major just more of "what was that"), or some very minor chest tightness and stomach bloating feel.

But last week (would have been 3 weeks after shot) I awoke in the middle of the night with pretty a bad chest pain like you describe. Felt like it was in middle of my chest and was quite painful. I had to physically sit up in my bed for about 5 minutes hoping it would subside. I got up and got some water and hoped it didn't get worse as I started contemplating what I should do if it does.

I was so tired though I just propped myself up with pillows and slept sitting up against the headboard because laying down seemed to make it come back worse. I eventually fell asleep and when I woke for the day I still felt a small amount of pain still. Went about my day normally and it seemed to go away later in the day.

I would think I am out of the window by now after 4 weeks to which I am in any danger from what I'm reading on news sites? I've been the gym since that episode and have done cardio fine. My wife suggests I take some low-dose aspirin for next few days.

If you’re having chest pain that’s severe enough to wake you up at night, I would talk to a doctor. It doesn’t have to have anything to do with the vaccine.

I would also not dismiss the nagging feeling in the back of your head that something doesn’t feel right. You know your body more than anyone.

Not to scare you, but I advise following up with a doctor as soon as possible. My 21 year old brother who was otherwise completely healthy suffered a similar short pattern of pain due to blood clots (not related to vaccine) but with severe neck pain for a short time one night.

It went away after that night, he was fine for 3 weeks with no pain or issues, was working out fine, etc. and thought nothing of it.

Suddenly one night went from perfectly fine sleeping to suffering a major stroke due to a blood clot in his brain within a 10 minute period, unable to do anything himself to get help as he lost all motor skills.

He said in retrospect he wishes he had followed up with a doctor on the thing he thought was no longer an issue 3 weeks before.

There are genetic tests they can run, as well, such as to see if you might have factor V Leiden.

Thanks. I’m hoping you’re well now and the clot was treated.

How were you treated for this, and how has recovery been?

They put me on blood thinners right away to prevent future clots and prevent the clots from getting bigger. I’ll be on them for at least a few months.

They then put me on pain meds and supplemental oxygen for a few days and watched me. The pain went away after a few days (I assume when the inflammation went down).

They didn’t actually treat the clots themselves. The body apparently does that itself over the course of a few weeks and months. There are invasive surgical ways to try to break them up but they felt I wasn’t bad enough to risk it since I could sit up and breathe on my own.

They checked my heart for tissue damage and thankfully didn’t find any. So now they’re doing a slew of tests to find the cause (genetics? Cancer? So far tests show cancer is unlikely).

Recovery has been good to be honest. I’m not really in pain. I do get out of breathe very easily but they say that’s normal and should go away in a few weeks as the clots dissipate. The lung damage should heal, I think.

The real danger from more clots to the brain or damaging the heart are prevented by the blood thinners, which are apparently highly effective. So I think I got lucky and I’m glad I went to the ER when I did.

Thanks for sharing and for keeping such a clear mind. My best to you.

> 6 obvious deaths that we're aware of.

1 death. The other cases are severe blood clotting but still alive by my understanding.

That's literally one-in-6-million chance of death with regards to this blood-clotting issue. A vanishingly smaller chance than the 1-in-40,000 (or 150-in-6-million) a healthy young person has of dying of COVID19.

So 1 death, 5 severe reactions related to blood clotting. Definitely a cause of concern, but lets not overplay the stats here.

This just another "Trolley problem": 150-people (even youngsters) would die from COVID19 vs the 1-person who died from the J&J vaccine.

If we include the general population (instead of focusing on the youngest and healthiest of us): COVID19 mortality rate is 1%ish, or 60,000-people-per-6-million.

Three quick points:

You have to multiply the IFR by the odds that the person gets COVID to begin with. In countries where there's no community transmission (Australia) or in countries where it's possible to kill the virus just by vaccinating the at-risk population combined with shut-downs, the multiplier should be pretty small. Even in countries that have handled it badly, it still might be only a 1/3 or 1/2 chance of catching it. So as a young healthy person my chances of dying from COVID are probably less than 1/100000.

I bring this up because I think it misses the actual point. Even if the vaccine had a 1/100000 chance of death or major complications, I would still take it. Because my life is not the only one that matters. Killing the virus is likely (in this country) to require most people who are physically capable (including the young) of taking the vaccine. My taking on a 1/100k risk with the vaccine vs a 1/100k risk without the vaccine is worth it, because for most other adults, the risk is much greater than 1/100k if the population doesn't get vaccinated.

Fortunately, I don't think pausing J&J is necessarily the wrong decision, even given the argument I just made. AFAIK it's the least common of the three vaccines, and so there should not be many "missing" vaccinations that result from the pause. The fact that taking a risk is justified does not mean that pointless risk is justified.

It's not clear to me that the J&J vaccine's supply is large or critical enough that it's going to make that much of a difference (yet). If the supplies of the Moderna and Pfizer vaccines are such that most people with J&J appointments can just get one of the others instead, that's really not that big a deal.

Walk-ins might be affected, though, but I'm not sure what percentage of the total daily vaccinations are walk-ins vs. appointments.

And as a sibling mentions, the general risk of dying from COVID-19 is not 150 in 6M, because the probability of getting (symptomatic) COVID-19 needs to be factored into that figure. I would not be surprised that if that probability drops to under 1 in 6M after accounting for that, though of course the symptomatic infection risk differs based on demographics.

One thing that I am worried about, though, is that this might make people trust all the vaccines less in general. My girlfriend and I had J&J appointments for this Friday; fortunately we were able to get a walk-in Moderna shot today, but the issues with the J&J vaccine did give her a little anxiety even about the Moderna vaccine. I think that (and worse) might be pretty common, and isn't unreasonable.

It’s actually one obvious death we’re aware of—the other five are still alive. Though that doesn’t change the calculus much.

yeah, and how many got "non-severe" clots? Obviously, it isn't a binary situation like: you are 100% OK vs you are dead from clot.

I wish people applied this much caution to the virus. Who knows what cancers it causes 10 years down the road.

Do any corona-family viruses cause cancers that we know of?

I don't know. But HPV and Herpes definitely can. Here's some more:

https://www.cancer.org/cancer/cancer-causes/infectious-agent...

It takes quite a long time to prove the link between a viral infection and a cancer that develops decades later, so it'll be a while before we know for sure.

I think that given the fact that we've been getting sick from corona-family viruses for years with no suspected link to cancers, this should be of relatively low concern, barring any specific information.

There are other potential longer term side effects that at least seem to have some emerging data to back them up, which seem more concerning to me.

How would we even know? In order to tell if coronaviruses caused cancer, we'd need to be keeping track of which people had ever been infected with one of them and how many of them ended up with cancer, and we're not. It'd just fall into the background level of cancer incidence otherwise. Hell, we haven't even figured out if they're the main cause of Kawasaki disease yet, and that's a fairly spectacular and dangerous condition affecting children. There's some evidence that some common viruses in the family might be really deadly to elderly people, but that doesn't seem to have been researched much either. There's a lot we just don't know.

This isn't actionable information, though. There are no good ways to mitigate all unknown potential risks, because the mitigations have risks themselves.

You mean proteins if you're talking modern/pfizer. It's literally triggered by one protein that matches a protein on the covid membrane. Everything in life is a chance, just stepping out and getting some sun puts you at risk for skin cancer yet still people have been doing it for a couple million years.

Well, consider that a lot of people who aren't applying as much caution to the virus itself just don't think it's that big a deal. Either they think their infection risk is low, or they expect they'll be asymptomatic, or think that even symptomatic infections aren't that bad. Through that lens, it makes sense to be wary of taking a vaccine with possibly-dangerous side effects when they don't believe the virus it protects against is all that bad.

I don't agree with the premise behind this reasoning, but I can see how it'd come about.

We have 17 years of SARS-CoV-1 patient data. We're even using their antibodies to treat COVID-19.

8000 infections of SARS worldwide. It took how many hundreds of millions of HPV infections and cancers to detect the link?

There is already plenty of evidence some people who survive the virus end up with lasting lung damage.

While this is not cancer, for those poor souls, a lifetime spent struggling to breathe is not much better.

I agree but only because about 5% of the vaccines currently distributed are J&J in the USA. The others will more than make up for it I'm sure. I think when we hit the wall and the supply outstrips the demand in the next few weeks as we approach 60-65% vaccinated and qanon and hippy antivaxxers are unwilling, I bet in month there will be so many open spots that they'll start cutting back manufacturing unless Biden convinces Moderna and Pfizer to keep going full speed ahead and we say distribute to Mexico/Central America/South American countries (like we ought to do).

Some experts have said that it's probably an immune reaction to the adenovirus which is used as the delivery mechanism in the vaccine. Wouldn't the side effects therefore be limited to the first weeks after the injection only?

You'd have to compare that to the chances of the long term effects of COVID causing issues down the line, which I'm willing to heavily bet is much more likely given what we've seen so far.

There's already been large scale phase 3 trials, and we've deal with vaccines for decades, they're not entirely novel and unknown each time.

The phase 3 trial for JnJ/Janseen had only ~44k participants whereas here we are talking on the order of ~1 per million (that are reported as of today)

> we've deal with vaccines for decades

I don’t think that’s accurate in this case. The type of vaccine that J&J released had up until months ago only ever been deployed in animals.

IIRC pigs had a problem with corona viruses that we solved”

The J&J is not a heap of dead virus like the common ones we have had forever. But a live harmless (we think) virus dolled up to look like Rona Corona.

Live harmless vaccines aren't anything new. Some of the TB vaccines from the 60s are of that variety. Live virus vaccines have safely been used for at least the past 5 decades. Stop spreading bullshit.

Ok. Well, perhaps you aren’t actually aware of what the J&J is. I enjoyed the part about spreading bullshit though, good one.

No, there have been no previous live viruses that have been genetically modified to look like other viruses (embedding Covid spike proteins) injected in humans before three months ago in any scale.

We have treated animals with exactly this however, including pigs against piggy rona.

I recommend reading the whole post next time, not just stopping at “live virus”.

This is what worries me. I have had the AZ vaccine. Will I be at risk of this syndrome every time I am exposed to coronavirus? In other words, is the risk cumulative?

6 deaths? I thought it was 1 death and 5 serious injuries?

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