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Clots

The home for all non-political Coronavirus (Covid-19) discussions on The Lemon Fool
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This is the home for all non-political Coronavirus (Covid-19) discussions on The Lemon Fool
XFool
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Re: Clots

#402386

Postby XFool » April 7th, 2021, 5:57 pm

zico wrote:
XFool wrote:Two questions I wanted to know the answers to, but not asked by the journalists, were:

1. Given the different risk tables for differing infection rates, does that imply there could be a further "course correction", even back to the status quo ante, if a further COVID wave arrives?

2. Do the scientists looking at this have accurate figures for the sex of people vaccinated?

For question 1, the answer is a resounding "Yes!". The chart below is based on infections at the peak of the second save (presumably Jan2021) - the chances of vaccine harm is unchanged, but the chances of being in ICU from Covid are much higher. Hopefully, we'll never get a peak like this again, so it probably isn't relevant (even though it was given as an example by Van Tam).

It sounded like the scientists have figures for the sex of people being vaccinated, but splitting down by sex wasn't helpful, because type of occupation may also play a role (e.g. more working-age women than men in health/care roles so more women jabbed, but also female job roles (e.g. carer) may expose them to more Covid risk than men.

Yes, that sounds like important information, but unlikely to be available for the vaccinated population - unless statistically - and only directly available for those who have suffered from the clot problem. Maybe that is enough detail?

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Re: Clots

#402388

Postby 9873210 » April 7th, 2021, 6:13 pm

zico wrote:For question 1, the answer is a resounding "Yes!". The chart below is based on infections at the peak of the second save (presumably Jan2021) - the chances of vaccine harm is unchanged, but the chances of being in ICU from Covid are much higher. Hopefully, we'll never get a peak like this again, so it probably isn't relevant (even though it was given as an example by Van Tam).

That's not much of a hope. COVID is infectious enough that without interventions most people will get it. Even with fairly rigorous lockdowns most people will get it eventually*. You need to look at the lifetime risk of getting COVID v. the lifetime risk of the vaccine (possibly a one time risk but we can't know that after less than a year). The 16 weeks or the height of the peak are arbitrary and should not inform policy unless something is likely to change after the 16 weeks.

Now if we had some evidence that one of the vaccines was safer and we just have to wait for production then locking down for a while to wait for the safer vaccine might make sense. But we have no such evidence.

*Unless we lock down hard enough to drive the virus to extinction, which is not going to happen.

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Re: Clots

#402455

Postby stewamax » April 7th, 2021, 10:42 pm

To M Macron and his EU apologists, 'incredibly rare' is presumably (..... garcon garcon, cette table, ici ....) saignant.
They despised our cooking and now berate our vaccine testing, all to deflect criticism of Sanofi (who will be a year late with their home-grown version) and Pasteur Institute (who threw in the towel).

I am due for my second Pfizer jab next week.
If it were A-Z, I would still take the risk. Who knows what hazards are lurking in Pfizer (or Moderna ...) that haven't yet surfaced.

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Re: Clots

#402474

Postby servodude » April 8th, 2021, 12:06 am

Julian wrote:
zico wrote:...
UK safety folks (MHRA) think there's a reasonable possibility that some deaths are being caused by the vaccine, with the likely mechanism being that the immune system gets overstimulated and hence causes blood clotting, leading in some cases to fatal events. Not a definite causal link, but a reasonable hypothesis it seems.
...

Thanks zico, a really useful summary. As with so much of this stuff though it raises a few additional questions for me, particularly wrt the early theories about a possible mechanism of action re the rare blood clots. In particular...

If it is the immune system getting over-stimulated then why is that not happening with other vaccines (let's just say Pfizer for now)? Are the AZ and Pfizer vaccines somehow stimulating the immune system in a subtly different way, perhaps because the Pfizer vaccine is only stimulating it once (with its SARS-CoV-2 spike impersonations) whereas the AZ vaccine is stimulating the immune system both with its version of the spike and also with its viral vector? (Actually that's not a particularly subtle difference.) Did the experts say anything about it maybe being related specifically to the adenovirus delivery vector's stimulation of the immune system?

Again, if its because of the immune system getting over-stimulated I would be really interested to know if there was anything interesting in the data regarding any correlation between whether the people with these rare clots had previously had a natural SARS-CoV-2 infection. At least for the mRNA vaccines the level of antibody response after just the first dose is apparently about 50 times higher in people who had previously been infected vs those who hadn't. If it was anything like the same level of increased antibody levels for the AZ vaccine I wonder whether that would put people previously affected at increased risk. Clearly that wouldn't be a sufficient condition otherwise these rare clots would have a massive incidence but I wonder whether it might be a necessary condition.

I do hope that they get to the bottom of this. Clearly the detailed investigations are still a work in progress and I'm sure lots of extra data are being collected and analysed. It's very disappointing this has arisen at all, it would be so much simpler if these rare clots giving rise to these concerns simply hadn't occurred and everyone was still full-steam-ahead with the AZ vaccine along with Pfizer, Moderna etc, but maybe one silver lining will be some additional scientific understanding that comes out of the investigations.

- Julian


This article for a couple of weeks back summarises this paper (that we've seen before) and tries to cover the mechanism for the Vaccine Induced Prothrombotic Immune Thrombocytopenia (VIPIT) which appears to be the term given to the specific disorder induced, in a way that even I can cope with

There have been reports of similar cases from the US (so with different vaccine) but these appear rarer

I expect a clearer picture will appear in time - I hope before too much damage is done
- sd

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Re: Clots

#402490

Postby Arborbridge » April 8th, 2021, 8:30 am

stewamax wrote:To M Macron and his EU apologists, 'incredibly rare' is presumably (..... garcon garcon, cette table, ici ....) saignant.
They despised our cooking and now berate our vaccine testing, all to deflect criticism of Sanofi (who will be a year late with their home-grown version) and Pasteur Institute (who threw in the towel).

I am due for my second Pfizer jab next week.
If it were A-Z, I would still take the risk. Who knows what hazards are lurking in Pfizer (or Moderna ...) that haven't yet surfaced.


It's interesting, though, that we are now having to admit that the EU had a point worth discussing, whereas we were rather in denial for a week or two. I've listened to UK gears crashing into reverse for a few days now.

I dare say, if we had had the much higher rate of clotting that the Germans had, we may not have been so gung-ho originally. But as I've written before, the Europeans have always inclined to the precautionary principle whereas in the UK we tend to bash on until irrefutable data comes up saying we shouldn't. Which can lead to all the bees dying or a silent spring before there's enough data to overwhelm the corporate lobbyists.

Arb.

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Re: Clots

#402491

Postby XFool » April 8th, 2021, 8:38 am

Arborbridge wrote:
stewamax wrote:To M Macron and his EU apologists, 'incredibly rare' is presumably (..... garcon garcon, cette table, ici ....) saignant.
They despised our cooking and now berate our vaccine testing, all to deflect criticism of Sanofi (who will be a year late with their home-grown version) and Pasteur Institute (who threw in the towel).

It's interesting, though, that we are now having to admit that the EU had a point worth discussing, whereas we were rather in denial for a week or two. I've listened to UK gears crashing into reverse for a few days now.

Actually, no. "the EU", in the form of the EMA, is essentially still saying: "Keep on taking the tablets" - albeit with a notification of possible side effects on the information leaflet. It is certain European countries that have taken a stricter line.

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Re: Clots

#402499

Postby Arborbridge » April 8th, 2021, 8:58 am

XFool wrote:
Arborbridge wrote:
stewamax wrote:To M Macron and his EU apologists, 'incredibly rare' is presumably (..... garcon garcon, cette table, ici ....) saignant.
They despised our cooking and now berate our vaccine testing, all to deflect criticism of Sanofi (who will be a year late with their home-grown version) and Pasteur Institute (who threw in the towel).

It's interesting, though, that we are now having to admit that the EU had a point worth discussing, whereas we were rather in denial for a week or two. I've listened to UK gears crashing into reverse for a few days now.

Actually, no. "the EU", in the form of the EMA, is essentially still saying: "Keep on taking the tablets" - albeit with a notification of possible side effects on the information leaflet. It is certain European countries that have taken a stricter line.


Yes, I'm guilty of using the convenient shorthand of EU when they are all sovereign countries making their own decisions. Something I've accused Brexiters of before now!
However, the point remains that those countries who said we should be more cautious, spotted an issue worth discussing, and the UK has now followed their lead. And there is really some justification for this risk being catalogues in the instructions sheets just like any other risk. However slight is does seem that it is real.

Interesting to hear David Spiegelhalter on Today this morning. He always good for ordinary mortals to listen to in order to put risk in perspective.

Arb.

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Re: Clots

#402504

Postby redsturgeon » April 8th, 2021, 9:17 am

In the UK we took the risk of rushing things through, there was always a danger to that decision and the clotting issue is one that has surfaced. Given the information at the time it was probably the right decision but it's still too early to judge.

Fortunately younger people will have a choice of alternative vaccines when their turn comes so little harm done...unless you are the family or friends of one of the unfortunate clotting victims. I wonder if the lawyers will be on to this for compensation? Luckily for AZ the UK government indemnified them.

John

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Re: Clots

#402510

Postby Mike4 » April 8th, 2021, 9:25 am

XFool wrote:
Arborbridge wrote:
stewamax wrote:To M Macron and his EU apologists, 'incredibly rare' is presumably (..... garcon garcon, cette table, ici ....) saignant.
They despised our cooking and now berate our vaccine testing, all to deflect criticism of Sanofi (who will be a year late with their home-grown version) and Pasteur Institute (who threw in the towel).

It's interesting, though, that we are now having to admit that the EU had a point worth discussing, whereas we were rather in denial for a week or two. I've listened to UK gears crashing into reverse for a few days now.

Actually, no. "the EU", in the form of the EMA, is essentially still saying: "Keep on taking the tablets" - albeit with a notification of possible side effects on the information leaflet. It is certain European countries that have taken a stricter line.



This proposed solution grates a little though, surely?

Side effects list for AstraZenica vaccine:
Nausia (most drugs have this)
Headache
Occasionally, death

I'd definitely think twice about taking a drug with this on the side effects list. Not many drugs include death on the list, do they?

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Re: Clots

#402511

Postby Wuffle » April 8th, 2021, 9:25 am

I would say the fortune still favours the older.
Young people don't really need vaccinating from anything. Otherwise shonky excepted.
Hence the fact that the risks are in about the same place.

W.

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Re: Clots

#402514

Postby Arborbridge » April 8th, 2021, 9:31 am

redsturgeon wrote:In the UK we took the risk of rushing things through, there was always a danger to that decision and the clotting issue is one that has surfaced. Given the information at the time it was probably the right decision but it's still too early to judge.

Fortunately younger people will have a choice of alternative vaccines when their turn comes so little harm done...unless you are the family or friends of one of the unfortunate clotting victims. I wonder if the lawyers will be on to this for compensation? Luckily for AZ the UK government indemnified them.

John


I just hope if this escalates history does not get re-written. People might remember the problems which occurred rather than the huge benefits.

Arb.

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Re: Clots

#402516

Postby Arborbridge » April 8th, 2021, 9:34 am

Wuffle wrote:I would say the fortune still favours the older.
Young people don't really need vaccinating from anything. Otherwise shonky excepted.
Hence the fact that the risks are in about the same place.

W.


There's a cross-over point at various ages for the risks.

As for the young - I have a 13 year old grandaughter whose life would surely be in danger with covid as she suffers really badly with asthma. She's been hospitalised with it several times, yet they will not put her on an accelerated path to a Covid vaccine.

Arb.

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Re: Clots

#402518

Postby XFool » April 8th, 2021, 9:37 am

redsturgeon wrote:In the UK we took the risk of rushing things through, there was always a danger to that decision and the clotting issue is one that has surfaced. Given the information at the time it was probably the right decision but it's still too early to judge.

However, how could such a seemingly rare and unusual event be picked up by not "rushing things through"? It's rarity means it would likely only be picked up after a trial involving millions of people. Which surely would not be a trial, rather a mass vaccination campaign.

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Re: Clots

#402525

Postby XFool » April 8th, 2021, 9:45 am

Mike4 wrote:This proposed solution grates a little though, surely?

Side effects list for AstraZenica vaccine:
Nausia (most drugs have this)
Headache
Occasionally, death

I'd definitely think twice about taking a drug with this on the side effects list. Not many drugs include death on the list, do they?

Reminds me how I was once on a trial for a drug and, much later on, after the trial had stopped, I learned that one of the side effects they had found in the trial was "death". :)

However, during the double blind, double dummy trial I had already managed to work out(!) at the time that I was on the 'placebo'. Or at least I was on the baseline, standard comparison drug.

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Re: Clots

#402528

Postby DrFfybes » April 8th, 2021, 9:55 am

Mike4 wrote:This proposed solution grates a little though, surely?

Side effects list for AstraZenica vaccine:
Nausia (most drugs have this)
Headache
Occasionally, death

I'd definitely think twice about taking a drug with this on the side effects list. Not many drugs include death on the list, do they?


Aspirin. Paracetamol, Ibuprofen, pretty much anything. All drugs are poisons, just depends on the dose and frequency.

Imagine you are stood at the side of a road wearing a blindfold, someone is shooting at you. Chances are they won't hit you, and if they do it won't be serious, but it could be fatal. It takes 6 seconds to run across the road but once a week a car drives past at 25mph

Do you cross the road to safety?

604,000 seconds in a week, 6 seconds to cross the road, 1 in 100,000 chance of being hit, 30% chance of the impact being fatal.

Paul

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Re: Clots

#402530

Postby dealtn » April 8th, 2021, 10:00 am

Mike4 wrote:
Side effects list for AstraZenica vaccine:
Nausia (most drugs have this)
Headache
Occasionally, death

I'd definitely think twice about taking a drug with this on the side effects list. Not many drugs include death on the list, do they?


Interesting how assumptions are different.

I would assume that most medicines would have "death" as a possible side-effect, albeit extremely unlikely.

Luckily I don't have any medicines in the house to check what is said on the accompanying literature.

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Re: Clots

#402532

Postby zico » April 8th, 2021, 10:08 am

Arborbridge wrote:
I dare say, if we had had the much higher rate of clotting that the Germans had, we may not have been so gung-ho originally. But as I've written before, the Europeans have always inclined to the precautionary principle whereas in the UK we tend to bash on until irrefutable data comes up saying we shouldn't. Which can lead to all the bees dying or a silent spring before there's enough data to overwhelm the corporate lobbyists.
Arb.


I would certainly hope the UK medical experts were also looking at the Germany data (and vice versa), because British and German people aren't a separate species. Germany initially banned use of AZ for over-65s so they will have been giving AZ to a lower age profile than people in England, which should explain the higher prevalence of clotting problems in other countries.

Another thought about those useful "risk/benefit" charts, and how people under 30 should use them. A person's individual risk exposure is much more important than the national average of cases.
To take 2 extremes to show the point.
Example A - A 29-year old working from home in a prosperous Cornwall town is very very low risk, and so their risk of harm from the vaccine is much greater than the potential harm for catching the vaccine.
Example B - A 29-year nurse, living in a crowded multi-generational dwelling in Tower Hamlets is pretty high risk, so risk of Covid is much greater than harm from vaccine.

More generally, the keener someone is to engage asap in "risky" activities (which I'd class as indoor pubs, nightclubs, parties), the more important it is that they get the vaccine. Matt Hancock also made the point in interviews this morning that being vaccinated also gives more protection to your contacts, friends, family, work colleagues, so the decision could (should?) depend on what importance a person places on protecting other people.

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Re: Clots

#402548

Postby dealtn » April 8th, 2021, 10:54 am

zico wrote:
More generally, the keener someone is to engage asap in "risky" activities (which I'd class as indoor pubs, nightclubs, parties), the more important it is that they get the vaccine. Matt Hancock also made the point in interviews this morning that being vaccinated also gives more protection to your contacts, friends, family, work colleagues, so the decision could (should?) depend on what importance a person places on protecting other people.


I would also suggest "they" should compare with other "risks" such as getting clots from taking contraceptive pills, or taking long haul air travel, they perhaps accept without further thought.

People are generally very bad at assessing risk, and especially so low probability events and "tail risk".

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Re: Clots

#402552

Postby Mike4 » April 8th, 2021, 11:06 am

dealtn wrote:
zico wrote:
More generally, the keener someone is to engage asap in "risky" activities (which I'd class as indoor pubs, nightclubs, parties), the more important it is that they get the vaccine. Matt Hancock also made the point in interviews this morning that being vaccinated also gives more protection to your contacts, friends, family, work colleagues, so the decision could (should?) depend on what importance a person places on protecting other people.


I would also suggest "they" should compare with other "risks" such as getting clots from taking contraceptive pills, or taking long haul air travel, they perhaps accept without further thought.

People are generally very bad at assessing risk, and especially so low probability events and "tail risk".



Oddly, your advice here is not much help.

Telling people they should do as you say rarely results in them accepting your advice and reassessing with a clear mind. It normally results in them digging even deeper into their retrenched position.

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Re: Clots

#402554

Postby zico » April 8th, 2021, 11:10 am

dealtn wrote:
I would also suggest "they" should compare with other "risks" such as getting clots from taking contraceptive pills, or taking long haul air travel, they perhaps accept without further thought.

People are generally very bad at assessing risk, and especially so low probability events and "tail risk".


Agree that people are very bad at assessing risk. In this particular case, we're asking people to choose between 2 very low risk events.
There has been relentless publicity that Covid is just an older persons' disease, and not something for any healthy young person to be worried about.
We're now being told there's an extremely low risk that the jab itself will kill you - probably around 1 in a million.

So if you're a healthy young (or youngish) person who hasn't yet been called for vaccination, what do you do when you get the call?
A) Decide to get the jab, accept the 1 in a million risk of dying from the jab.
B) Decide to avoid the jab, and accept the very low risk of dying from Covid.
C) Ask for a different jab (but that might also have a 1 in a million risk, who knows?)
D) Decide "I'm not going to bother to take the time to go for an appointment, because both risks are so low, so I'll just get on with my life".

My concern is that a lot of people will go for option D, which will be bad news for Covid suppression.


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