Primum non nocere: COVID-19 vaccination is no exception!
Dear Editor
We extend our sympathies go to the patients (and their families) who sadly died after COVID-19 vaccination due to blood clots (now reported both for Astra Zeneca and J&J vaccines). We are glad to see the pauses in administration of these vaccines and support common sense recommendations to prevent further deaths. Those who died have been mostly young women, likely with no pre-existing medical conditions. What would have been their probability of dying of COVID-19? Close to zero.
Prof. Hunter argues in his opinion for a “full speed ahead” approach to vaccination. He states, “For comparison, in women taking hormonal contraceptives the risk of thrombosis is about 60/100,000 person years and risk of fatal pulmonary embolism is about 1/100,000.” This is true but differs from our current dilemma. Those women are making individual choices based upon informed consent. Sadly, the vaccination programs do not to date involve similar transparency and informed consent. The goal of any intervention – including vaccination – is Primum non nocere "first, do no harm."
The discovery of vaccination-related clotting, though very rare, has to become an important part of the conversation. There are reasons for young persons to continue to use these vaccines – a young adult with COVID-19 is extremely unlikely to die of her disease but can transmit disease to a more vulnerable person whose risk of death is far higher. How do we balance the death of one young person against the potential saving of other lives?
Vaccination must continue aggressively for those whose risk of dying from COVID-19 are high, arguably with any of the available vaccines; with those vaccinated fully informed of every known risk.
Rapid Response:
Primum non nocere: COVID-19 vaccination is no exception!
Dear Editor
We extend our sympathies go to the patients (and their families) who sadly died after COVID-19 vaccination due to blood clots (now reported both for Astra Zeneca and J&J vaccines). We are glad to see the pauses in administration of these vaccines and support common sense recommendations to prevent further deaths. Those who died have been mostly young women, likely with no pre-existing medical conditions. What would have been their probability of dying of COVID-19? Close to zero.
Prof. Hunter argues in his opinion for a “full speed ahead” approach to vaccination. He states, “For comparison, in women taking hormonal contraceptives the risk of thrombosis is about 60/100,000 person years and risk of fatal pulmonary embolism is about 1/100,000.” This is true but differs from our current dilemma. Those women are making individual choices based upon informed consent. Sadly, the vaccination programs do not to date involve similar transparency and informed consent. The goal of any intervention – including vaccination – is Primum non nocere "first, do no harm."
The discovery of vaccination-related clotting, though very rare, has to become an important part of the conversation. There are reasons for young persons to continue to use these vaccines – a young adult with COVID-19 is extremely unlikely to die of her disease but can transmit disease to a more vulnerable person whose risk of death is far higher. How do we balance the death of one young person against the potential saving of other lives?
Vaccination must continue aggressively for those whose risk of dying from COVID-19 are high, arguably with any of the available vaccines; with those vaccinated fully informed of every known risk.
Competing interests: No competing interests