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March 17, 2021 01:00 pm

What Is Going On With the AstraZeneca/Oxford Vaccine?

A whole list of countries -- including Germany, France, Italy, Spain, Sweden and Latvia -- have suspended dosing of the AstraZeneca/Oxford vaccine over reports of dangerous blood clots in some recipients. The company and international regulators say there is no evidence the shot is to blame, but that isn't stopping countries from taking action out of an abundance of caution. Derek Lowe, a medical chemist working in the pharmaceutical industry, explains what's going on with this vaccine: I think that there are several distinct levels to this problem. The first, obviously, is medical. The big question is, are the reports of vascular problems greater than one would expect in the vaccinated population as a whole? It's not clear to me what the answer is, and it may very well be "No, they aren't." That CNBC link above quotes Michael Head at Southampton as saying that the data so far look like the problems show up at at least the same levels, and may even be lower in the vaccinated group. AstraZeneca has said that they're aware of 15 events of deep vein thrombosis and 22 events pulmonary embolisms, but that's in 17 million people who have had at least one shot -- and they say that is indeed "much lower than would be expected to occur naturally in a general population of this size." It also appears to be similar to what's been seen with the other coronavirus vaccines, which rather than meaning "they're all bad" looks like they're all showing the same baseline signal of such events across a broad population, without adding to it. In that case, this could be an example of what I warned about back in December (and many others have warned about as well), the post hoc ergo propter hoc "false side effects" problem. I've been looking this morning, and so far have not found anyone clearly stating that the problems seen are running higher in the vaccinated patients [...]. I realize that there's a possibility (not a likely one, though) that some particular batch of vaccine is more problematic, but I haven't seen any solid evidence of that, either. The second half of the medical problem is naturally what happens when you suspend dosing of what is, in many cases in the EU, the only vaccine available. We've been seeing cases falling here in the US ever since a peak on the first week of January -- many of us were worried about what might have been a rise in February but which now just seems to have been a plateau, with cases continuing to drop since then. But many European countries are definitely seeing another wave of infections, and the EU case numbers as a whole are going in the opposite direction to the US ones. There are surely a lot of reasons for this, with new viral variants being one, slow vaccine rollouts being another, and now complete vaccination halts set to add even more. Put as bluntly as possible, even if the AZ/Oxford vaccine has these side effects (which again, I don't see any evidence for yet), you are still very likely to kill more people by not giving it. Lowe goes on to question what good the EMA and World Health Organization's recommendations and regulatory approvals are when one European country after another shuts down its use. He also brings up the third problem, which is public confidence. "The AZ/Oxford vaccine has been in trouble there since the day the first data came out," writes Lowe. "The efficacy numbers looked lower than the other vaccines that had reported by then, and as mentioned, the presentation of the data was really poorly handled and continued to be so for weeks. Now with these dosing suspensions, I have to wonder if this vaccine is ever going to lose the dark cloud it's currently sitting under..."

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