Fears about blood clotting occurring after the Oxford‑AstraZeneca vaccination has led countries such as Germany and Canada to restrict this vaccine’s use.
The NHS is correct to continue using it. But the fact that expensive alternatives are having to be bought from pharmaceutical companies does highlight how commercial interests could stand in the way of making sure everyone has access to safe medicine.
The problem is a rare blood clot affecting the brain called Cerebral Venous Sinus Thrombosis. The blood clotting is unusual, seemingly caused by low numbers of platelets in the blood, which are part of the body’s blood clotting control mechanisms.
This raises the question of what the balance of risk and benefit of the vaccine is.
Clear and transparent advice has now been issued by the European Medicines Agency (EMA) that the vaccine is safe and should continue to be used.
There have been 169 cases across Europe out of 34 million doses given, and in Britain, there have been 79 cases and 19 deaths after 20 million doses given.
All ages and sexes have been affected with three deaths under age 30. This gives a risk of about four in one million developing a blood clot and one in a million dying.
It’s not been possible for scientists to tell if any age group or sex is more affected as the numbers are so low.
The balance of risk and benefit does vary according to your age. For people in their 60s, the risk of serious harm from the vaccine is vanishingly low at 0.2 cases per 100,000 people vaccinated.
The benefit for over 60s is 410 intensive care admissions avoided.
But for younger age groups the risk to benefit ratio is different. There’s still a very low risk at one case per 100,000 people vaccinated.
Because younger people are less likely to be seriously ill with Covid-19, the benefits are much lower.
Therefore, the NHS is proposing to give the Pfizer or Moderna vaccine and not the AstraZeneca vaccine to those under 30.
It’s important to stress that these risks are very low. A young person’s chance of dying in a road accident is one in 100,000 over 16 weeks, very similar to the risk from the vaccine.
What this has highlighted is that the NHS has a good drug surveillance system. It was developed after the thalidomide disaster. Pregnant people were prescribed this drug as an anti‑sickness medication but it caused birth deformities that went unnoticed for a long time.
The system put in place afterwards is what spotted the serious possible side effects of the AstraZeneca vaccine that were too rare to be discovered in the early trials. There has since been transparency in reporting these side effects to the public.
This contrasts starkly with the lack of transparency of the commercial contracts in all other aspects of the government’s handling of the Covid-19 crisis.
Test and trace and protective PPE equipment procurement saw cronyism and putting profits before safety. They’ve contributed to Britain having one of the highest Covid-19 death rates in the world.
The AstraZeneca vaccine is one of the few low-cost vaccines available in the world, costing £2.19 a dose.
There are powerful commercial interests who would want to maintain the super profits made by Pfizer, Moderna, and others, which cost up to ten times as much. Those medical companies have much to gain from a loss of confidence in AstraZeneca.
Most countries in the world do not have the cold chains of super-deep freezers that are required for messenger RNA vaccines.
But this episode also demonstrates how commercial interests stand in the way of dealing with worldwide vaccine shortages.
All countries need to be free to produce a variety of vaccines at low cost in quantity without facing legal actions for breaching patent laws.