Blood clotting is actually very common in people suffering from coronavirus, so the seemingly alarming figures could be picking up people who caught the virus around the time of AstraZeneca vaccination
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The Oxford/AstraZeneca vaccine has not had an easy few months. First, trial results suggested it was not as effective as other jabs, then several European countries ruled it was unsuitable for the over-65s.
Now, in the latest twist, Ireland, the Netherlands, Germany, Denmark, Iceland, Bulgaria, France, Italy and Norway have all halted their AstraZeneca rollouts over fears the jab is causing blood clots.
So should people be worried if they have been immunised with the British jab? The numbers suggest not.
According to the charity Thrombosis UK, up to 1 in 1,000 people each year will experience a dangerous blood clot in a vein, known as a venous thrombosis.
That means about 66,000 people in Britain might be expected to suffer a blood clot annually, or 1,222 a week.
According to AstraZeneca, so far across the EU and UK, there have been 15 events of deep vein thrombosis (DVT) and 22 events of pulmonary embolism (PE) reported among those given the vaccine, based cases up to Mar 8.
Oxford-AstraZeneca vaccine supply in EU
The company estimates there have been 17 million AstraZeneca vaccines delivered in that time. That means that the risk of suffering from DVT or a PE after vaccination is 37 in 17 million, or roughly one in 460,000.
At the current prevalence rate, in a population of 17 million we might expect 314 cases to naturally show up in the week following a vaccine, so 37 starts to look very low.
And even if all 37 cases were linked to the vaccine (which is highly unlikely) the risk is still far lower than the risk of dying from coronavirus, which has an infection fatality rate of between 0.5 and one per cent, or between 1 in 200 and 1 in 100.
Dr Peter English, immediate past chair of the BMA Public Health Medicine Committee, said: “When a vaccine is administered to millions of people, it is inevitable that some adverse events – that would have happened anyway – will happen shortly after vaccination.
“It is most regrettable that countries have stopped vaccination on such ‘precautionary’ grounds: it risks doing real harm to the goal of vaccinating enough people to slow the spread of the virus, and to end the pandemic.”
Effectiveness at preventing Covid-19
Another factor which must be taken into account is the characteristics of the vaccinated population.
Both DVT and PE are most common in people aged 50 and over, as well as those with underlying health conditions, and those who are overweight or obese. In other words they are most common in the very population which is being prioritised for the jabs.
Jo Jerrome, CEO of Thrombosis UK said: “We need to remember the risk of DVT/PE increases with age and that we are currently vaccinating the very oldest in our population.
“If the figure is 37 per 17 million, who will be mainly over 60s, we think this is very low and less than the background risk associated in the general population, so would agree with current statements from the Medical and Healthcare Products Regulatory Agency (MHRA) and the WHO that there appears to be no association.”
In Britain at least, the numbers of incidents of DVT and PE do not differ between the vaccines.
Michael Makris, professor of Haemostasis and Thrombosis at The University of Sheffield, pointed to reports showing there have been 13 cases of pulmonary embolism in 10 million doses of the AstraZeneca jab, and 15 cases of the Pfizer/BioNTech vaccination.
And there is one more possibility. Blood clotting is very common in people suffering from coronavirus, itself, so the figures could be picking up people who caught the virus around the time of vaccination.
Stephen Evans, professor of Pharmacoepidemiology, from the London School of Hygiene & Tropical Medicine, said: “Coagulation disorders are very common in patients with Covid-19. Early reports from China noted over 30 per cent of patients reaching hospital had thrombocytopenia.
“Unless we are sure that those who suffered these unfortunate events very definitely did not have Covid-19 then it would seem to be premature to suggest it was the vaccine that caused these events.”
Ronan Glynn, Ireland’s deputy chief medical officer, said it was important to halt the vaccinations as a precaution, but admitted the country may be overreacting.
“It may be nothing,” he said on Sunday. “I sincerely hope that in a week’s time we are accused of being overcautious.”
But a week is a long time in a national vaccination programme and such a pause may come with consequences. Let us hope lives are not lost because of this overreaction.
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