Risk of rare blood clotting higher for Covid-19 than for vaccines | Hacker News Reader

Risk of rare blood clotting higher for Covid-19 than for vaccines

ox.ac.uk

35 pointslsllc14 comments

I'm reluctant to accept the claim that the risk outweighs the benefits for young women. Denmark recorded two deaths after CVTs likely caused by the vaccine in 2021, but not a single death in the age group <50 from COVID, up until Dec 4th of 2020:

https://en.wikipedia.org/wiki/COVID-19_pandemic_in_Denmark

(If anybody has age-related data on a more complete timeframe, please provide)

The risk of getting infected with COVID is not 100% in the first place, and even then there's bound to be a huge number of cases that are never recorded, because they are mild or asymptomatic. This exaggerates the pathology and makes risk-reward estimation more difficult.

Specifically young women risk CVT from stuff like anticonception. Which is not considered dangerous. So like, sure there is some risk, but let not pretend this is about concern about health.

Young women derive a benefit from contraception. If the risk of CVT from a vaccination outweighs the risk of COVID infection for young women, then they do not derive a benefit. The data suggests that this may well be the case.

Denmark is a poor example since it is small, had too few cases and clearly is one of the farthest from herd immunity in Europe. Looking at the somewhere like the UK for what would happen, there were very measurable deaths in the <34 group that would occur if a country that did crisis management as (relatively) effectively Denmark opened without vaccination:

https://www.euromomo.eu/graphs-and-maps

So the 2 deaths would have to be averaged over additional years of lock down without an exit plan.

Sure, there is no reason not to prioritize mRNA for younger women if it is available, but these botched announcements will kill tens of thousands of young women world wide even if the production is never reduced and the delays in countries like South Africa are short lived.

I am deeply saddened by the behavior of the US and EU in this regard, it really amounts to a simultaneous false virtue signaling and through snubbing all but the best options, push other nations that don't have priority access to mRNA to now make deadly decisions for some kind of honor that doesn't even make sense.

> Looking at the somewhere like the UK for what would happen, there were very measurable deaths in the <34 group that would occur if a country that did crisis management as (relatively) effectively Denmark opened without vaccination

Your source doesn't show a <34 age group, nor does it differentiate sex. Women have a significantly lower risk than men.

I have looked at data from Germany, which shows 59 deaths of females under 40 since the start of the pandemic:

https://www.ined.fr/fichier/rte/166/Page%20Data/Germany/Germ...

This translates to a roughly one in 350,000 chance of death from COVID over more than a year, for females in that age group.

There have been nine deaths linked to the vaccination:

https://www.wsj.com/articles/astrazeneca-vaccine-faces-fresh...

I do not have data on the amount of AZ doses administered to that cohort, but according to this source the total amount is below 3 million:

https://apnews.com/article/germany-cities-suspend-astrazenec...

That translates into a roughly one in 330,000 chance of death from the vaccine, for ages 60 and under.

It is of course difficult to estimate the future risk of COVID infection, but it's not obvious that it outweighs the risk of the vaccine for that particular cohort.

> So the 2 deaths would have to be averaged over additional years of lock down without an exit plan.

This is a false dichotomy. Not everybody needs to be vaccinated to dramatically reduce the risk of COVID infection. In particular, it would be unethical to vaccinate those for which the individual risk of vaccination outweighs the risk of infection.

> Sure, there is no reason not to prioritize mRNA for younger women if it is available, but these botched announcements will kill tens of thousands of young women world wide even if the production is never reduced and the delays in countries like South Africa are short lived.

This is speculation that isn't supported by data.

> I am deeply saddened by the behavior of the US and EU in this regard, it really amounts to a simultaneous false virtue signaling and through snubbing all but the best options, push other nations that don't have priority access to mRNA to now make deadly decisions for some kind of honor that doesn't even make sense.

This sounds rather arrogant and short-sighted. It's likely that at the current rate, deaths among young women attributed to vaccinations would overtake deaths from the illness itself, which would completely destroy trust in the regulatory bodies, causing irreparable damage to all future vaccination campaigns.

Sorry, I meant 14-44 m+f, which had 4200 excess deaths in 2020 in the part of Europe sampled, you would need to add a portion of the 30k <64 for what the actual EU advice was (no women under 60) in a scenerio where you don't have an mRNA.

Women under 30 may have this slightly raised risk of death with the vaccine if you control the virus without vaccine which you can't actually do indefinitely. The relative mortality of Denmark being 4 times lower than the others shows that the 4.2k deaths, so that ~2k would repeat many times to get to herd immunity and in the meantime you would be willing 10 times that in the women under 64 with taking the first EU advice given too literally.

I don't agree with this idea that we have to find data to weigh ridiculously unlikely harms for the individual. That gets into freeloader math like not vaccinating your particular patient because the rest of their demographic is vaccinated enough.

Also when you add other outcomes for covid patients who go to hospital you will have much larger subsequent negative outcomes and some death rates from associated problems Like MRSA, error, c-dificile, subsequent antibiotics, etc..

> deaths among young women attributed to vaccinations would overtake deaths from the illness itself, which would completely destroy trust in ..

Clearly a magical vaccine that was available and injected immediately would have killed more people than the virus would have in that scenario, but patients who refuse the vaccine in that scenario don't get to live in that scenario because they create this scenario.

> Women under 30 may have this slightly raised risk of death with the vaccine if you control the virus without vaccine which you can't actually do indefinitely.

The data shows that through the entire pandemic up until this point, a woman under 40 in Germany would've been better off not taking the vaccine. The virus can not spread exponentially forever. Herd immunity would be reached with or without vaccine. The question then becomes, which parts of the population do you vaccinate and which parts do you risk infection with?

You are basically speculating that risking infection of women under 40 would be worse than vaccinating them, up until herd immunity is reached. Maybe that is true, but it's not obvious that it is true, and it may well not be true, judging by the numbers we have.

> I don't agree with this idea that we have to find data to weigh ridiculously unlikely harms for the individual.

If you consider a risk of death of 1 in 350,000 as "ridiculously unlikely", then you would have to accept that death from COVID is also "ridiculously unlikely" for that part of the population. It then is only logical that you would take the lesser of two "ridiculously low" risks, and that's exactly how it works in medicine.

> Clearly a magical vaccine that was available and injected immediately would have killed more people than the virus would have in that scenario, but patients who refuse the vaccine in that scenario don't get to live in that scenario because they create this scenario.

I don't understand your point. I'm not talking about what would've happened under "magical" circumstances, but what would most likely have actually happened, had the vaccinations continued.

To be clear, even if the risk of vaccinations was far lower than the infection, the psychological impact of such "bad numbers" would've still been damaging to the campaign, leading to fewer overall vaccinations into the indefinite future. Humans are predictably irrational, and this needs to be taken into account.

> If you consider a risk of death of 1 in 350,000 as "ridiculously unlikely", then you would have to accept that death from COVID is also "ridiculously unlikely" for that part of the population. It then is only logical that you would take the lesser of two "ridiculously low" risks, and that's exactly how it works in medicine.

Right, but wrong. You dismiss the low factor because it is outweighed by other factors. For example you give someone a medicine that may kill them in rare circumstances to return them to a physically active life Just as you tell people to ride bikes despite deaths and brain injuries.

This framing has to simply stop. In past decades it was not acceptable to mix up public health with this personalized health nonsense and it is most likely going to result in an ebola-like outbreak with a slightly dangerous vaccine getting out of hand while people fear monger on the internet over odds that we accept whenever we step on to a public street.

Relevant twitter thread by Kai Kupferschmidt, a science journalist, whose top-notch coverage of COVID-19 related topics, I have come to appreciate during this pandemic. Key points: - This paper tells little about the AstraZeneca vaccine, which seems to have a much higher risk of CVST than the mRNA vaccines. Actual quote from press conference: "I think our data say actually nothing about the AZ vaccine." - The number of CVSTs for mRNA vaccines are surprising and very different from the ones presented by ACIP yesterday.

https://twitter.com/kakape/status/1382655684496523264

Regarding AZ, the paper refers to EMA data from three weeks ago[1], which under normal circumstances would be very recent, but in this case I guess it's rather old.

I looked up official numbers[2] from Germany from yesterday: about 4 million AZ first dose vaccinations, 55 reported cases of CVST, 11 fatal (6 women, 5 men).

Since the CVST occur within a week or two after vaccination, you'd expect a few more cases causally related to the 4m vaccinations, so around 15 cases per million vaccinations and around 3 deaths. That's higher than the number they cite, but still much lower than the number they arrive at for Covid.

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

[2] https://www.pei.de/DE/service/presse/aktuelles/aktuelles-inh... PEI is the German EMA equivalent, basically

Key findings:

* In this study of over 500,000 COVID-19 patients, CVT occurred in 39 in a million patients.

* In over 480,000 people receiving a COVID-19 mRNA vaccine (Pfizer or Moderna), CVT occurred in 4 in a million.

* CVT has been reported to occur in about 5 in a million people after first dose of the AZ-Oxford COVID-19 vaccine.

* Compared to the mRNA vaccines, the risk of a CVT from COVID-19 is about 10 times greater.

* Compared to the AZ-Oxford vaccine, the risk of a CVT from COVID-19 is about 8 times greater.

> CVT has been reported to occur in about 5 in a million people after first dose of the AZ

As I understood Danish health authorities they assessed it to 1 in 40.000, which is a bit more.

Personal Experience. I clot very easy. (Aggressive Factor 5 Leiden) A few days without a blood thinner means a stoke or other issue. Visual issues always come first so I get warning before major symptoms start.

After having Covid I basically can only miss one pill. Anything more and things go bad quickly.

I hate the side effects, and they make working a challenge, so I had been trying to walk a line of just enough to not cause problems. I have no margin now.

As for vaccine. Well it terrifies me. I can’t up the blood thinners any higher, can’t handle any additional clotting. Of course a second round round of covid could be worse.

This was known for about half a year already. The risk with COVID-19 is about 40%, extreme. A high risk was also predicted for all vaccination types, not just the vector ones. But so far the mRNA ones evaded it.

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