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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
Bubblesofearth
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Re: Clots

#402240

Postby Bubblesofearth » April 7th, 2021, 11:07 am

Wuffle wrote:I also want my life back.
I don't even care if I have a Covid vaccination so long as I get the paperwork.
I literally don't care about a slight chance of blood clots.
Something, likely unsavoury, will get me in the end and I can't be bothered to agonise over what in the meantime.

W.


IMO resistance to having the vaccine vs catching Covid is a bit like fear of flying vs driving. It's about control. Plenty of people are scared of flying but happy to take to the roads despite the fact that the chance of dying in a plane crash is far less than when driving. The difference is we believe we are more in control on the roads than in the air.

Likewise I'm sure there are many people who believe they can duck catching covid but worry about the vaccine because they have no control over side effects.

BoE

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Re: Clots

#402244

Postby Julian » April 7th, 2021, 11:15 am

Arborbridge wrote:I am a little mystified by why there is no discussion in the media about the possibility of blood clots using Pfz as opposed to AZN.
At the very least there should be some mention or discussion of the comparatives, otherwise it raises the suspicion that we have an example of Pfizer being able to project a better image, or control their PR, better than AZN - to the disadvantage of the population. We are supposed to follow the science, not the marketiung ability.


Arb.

I was totally perplexed by that when all this news first broke, especially when the initial defence of the AZ vaccine was that the incidence of clots was no higher than would be expected in the general population (hence, in my mind, why weren't we seeing a general "background level" of blood clots in the Pfizer group). As things have progressed however it now seems, as I understand it, that they are particularly concerned about blood clots coincident with low platelet counts which apparently is a much rarer type of clotting condition and there only last night I saw it asserted more than once by different experts on various news programs that I watched that not a single instance of those particularly rare clots has been reported as a side effect of the Pfizer vaccine. That fact I believe is reinforcing the suspicion that there might well be a causal link between the AZ vaccine and this particularly rare category of clots. Assuming the side effect monitoring for the Pfizer vaccine hasn't missed some of these rare clots in the Pfizer vaccinated group I can see why suspicion of a causal link to the AZ vaccine is now growing.

I think what would really help confirm this suspicion, hence what many scientists are actively trying to research at the moment, is some verifiable theory as to how the AZ vaccine is triggering this condition. If a pharmacological explanation for the mechanism involved in the vaccine giving rise to this condition could be found (if indeed there is a causal link to the AZ vaccine and hence such a vaccine-triggered mechanism of action exists) that would pretty much confirm a causal connection and might well also be useful in assessing level of risk amongst different groups and hence be more accurate and confident in any contraindications that might be added to the documentation if it was deemed appropriate to continue using the vaccine for specified groups (which I suspect would be the case).

Even assuming the risks continue to be considered low enough, at least in certain populations, to justify continued use of the vaccine I still think this has the potential to be massively detrimental to the AZ vaccine. Firstly, many people aren't that good at objectively assessing low risks and secondly even if the risk is understood by an individual to be very low there is still the danger of a sufficiently large number of people taking the attitude of "I understand that the chance of me getting a very rare type of blood clot is vanishingly small with the AZ vaccine but there is still some risk whereas with the Pfizer (for instance) vaccine there seems to be zero risk so just to be safe I'm going to insist on getting a zero-risk vaccine".

From what I've read so far and from what I've been able to understand from the science I really do think that at least for these types of viruses the mRNA vaccines are the future unless some significant currently undiscovered issues emerge with the lipid nanoparticles. Assuming there is nothing troublesome found wrt the lipid nanoparticles then why would you want to use a virus vs a more metabolically inert nanoparticle to deliver the coding sequence into the cell (and for that matter why wouldn't you want to deliver it in a single step as RNA vs needing to transcribe it from DNA first)? More troublesome transport and storage procedures might be one retort but there is already a lot of work going on to get more stable mRNA vaccines that can use regular refrigeration. Also, Pfizer recently announced that in the second half of this year it will change the manufacturing such that its vaccine will leave the factory pre-diluted which will already be a big help in administering it.

- Julian

P.S. I had to google "TPTB" too!

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Re: Clots

#402247

Postby XFool » April 7th, 2021, 11:19 am

Arborbridge wrote:
Mike4 wrote:A brief goggle however, revealed four possibilities...

TPTB The Powers That Be
TPTB The Place to Be
TPTB The People to Blame
TPTB Too Poor To Be

The course of world history could be changed if we choose the wrong one.

TPTB TPTB - "To Poor To Be The Powers That Be"?
TPTB TPTB - "To Poor To Be The People To Blame"?

TPTB TPTB - "The Place To Be The Powers That Be"? Um...
TPTB TPTB - "The Place To Be The People To Blame"? Um...

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Re: Clots

#402249

Postby gryffron » April 7th, 2021, 11:24 am

I think the news reporting of this issue has been even worse than the pseudo-science:

Urbandreamer wrote:This link reports
Up to February 28, there were 38 reports from about 11.5million doses of Pfizer’s vaccine – compared to 30 from 9.7million AstraZeneca doses.


Over what time period? How many such clots would be expected normally? How many occurred in the "control group" i.e. The non-vaccinated?

Without such detail, the figures being quoted in the press are meaningless. About as useful as pointing out that "48 people died in car accidents following a AZ jab"

Gryff

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Re: Clots

#402251

Postby dealtn » April 7th, 2021, 11:34 am

Mike4 wrote:
UncleEbenezer wrote: Thereby implying the risk of catching covid is 100% with no vaccine and zero if vaccinated.



As I understand it the risk of unvaccinated people catching coronavirus is 100%.



I think you either need to carefully define what you mean by "risk", or with respect you aren't using it in the same way a mathematician would to arrive at 100%.

Unvaccinated people (as with vaccinated ones) have a 100% chance of dying.

Unvaccinated people have a 100% risk of being hit by lightning, or more realistically a car (as do vaccinated people), since lightning or cars can potentially hit anyone, and can't distinguish between vaccinated people and unvaccinated people. (They aren't immune to dying in this way).

A monkey has a 100% chance of typing a Shakespeare play, before he starts, but that chance diminishes very rapidly as he starts.

An unvaccinated person has a very high, lets say 100% (although some would argue some people have immunity from prior coronavirus exposure), of catching Covid-19, if exposed to the virus in sufficient quantity etc. But that is still a contingent statement (it has an IF in it). With no guarantees of ever being exposed to it in sufficient quantity (and that chance reducing all the while others in the community are being vaccinated, and R < 1 etc), then it isn't true to say they have a 100% risk of catching it, in the strict mathematical sense. Just as not 100% of deaths are by lightning strikes, or car accidents, despite "everyone" having the chance of being one of the unlucky ones that die in that fashion.

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Re: Clots

#402254

Postby Julian » April 7th, 2021, 11:40 am

gryffron wrote:I think the news reporting of this issue has been even worse than the pseudo-science:

Urbandreamer wrote:This link reports
Up to February 28, there were 38 reports from about 11.5million doses of Pfizer’s vaccine – compared to 30 from 9.7million AstraZeneca doses.


Over what time period? How many such clots would be expected normally? How many occurred in the "control group" i.e. The non-vaccinated?

Without such detail, the figures being quoted in the press are meaningless. About as useful as pointing out that "48 people died in car accidents following a AZ jab"

Gryff

Also, do all, or even any, of the 38 reported cases for the Pfizer vaccine also exhibit low platelet counts? (Urbandreamer did acknowledge that lack of that info when he posted the link.) It is that condition that, as I understand it, is the very specific type of clotting condition that is under investigation. Knowing that is also essential to answering your question since one needs to know exactly what condition is being investigated in order to determine the baseline "control" level that would be expected in the general unvaccinated population.

I agree that the reporting on this, at least the stuff that I have seen, has been frustratingly vague and imprecise and failed to ask and present answers to what seem to me to be very obvious questions. I really hope that in this new word when viruses and pandemics are more visible and newsworthy that at least some of the mainstream media outlets might start trying to recruit some medical correspondents that actually have some professional training in the areas that they are reporting on. I remember one of Dr John Campbell's videos a month or so back bemoaning the fact that the medical correspondents on CNN and I think most other US news outlets tend to be medical doctors whereas in the UK they don't.

- Julian

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Re: Clots

#402256

Postby XFool » April 7th, 2021, 11:45 am

dealtn wrote:
Mike4 wrote:As I understand it the risk of unvaccinated people catching coronavirus is 100%.

I think you either need to carefully define what you mean by "risk", or with respect you aren't using it in the same way a mathematician would to arrive at 100%.

Unvaccinated people (as with vaccinated ones) have a 100% chance of dying.

Unvaccinated people have a 100% risk of being hit by lightning, or more realistically a car (as do vaccinated people), since lightning or cars can potentially hit anyone, and can't distinguish between vaccinated people and unvaccinated people. (They aren't immune to dying in this way).

A monkey has a 100% chance of typing a Shakespeare play, before he starts, but that chance diminishes very rapidly as he starts.

Speaking as neither a mathematician nor a statistician - :lol: - I find your explanations just as unsatisfactory.

"Unvaccinated people have a 100% risk of being hit by lightning" - What does "risk" mean here? It seems to imply everyone has a "100% risk" of anything, that isn't impossible, happening to them!

Surely the probability of being hit by lightening cannot be meaningfully quoted without also quoting a period of time? Similarly with other such "risks"?

As for the monkey, I'd give him a zero possibility, given a finite lifetime of the universe - let alone of the monkey.

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Re: Clots

#402259

Postby dealtn » April 7th, 2021, 11:51 am

XFool wrote:
dealtn wrote:
Mike4 wrote:As I understand it the risk of unvaccinated people catching coronavirus is 100%.

I think you either need to carefully define what you mean by "risk", or with respect you aren't using it in the same way a mathematician would to arrive at 100%.

Unvaccinated people (as with vaccinated ones) have a 100% chance of dying.

Unvaccinated people have a 100% risk of being hit by lightning, or more realistically a car (as do vaccinated people), since lightning or cars can potentially hit anyone, and can't distinguish between vaccinated people and unvaccinated people. (They aren't immune to dying in this way).

A monkey has a 100% chance of typing a Shakespeare play, before he starts, but that chance diminishes very rapidly as he starts.

Speaking as neither a mathematician nor a statistician - :lol: - I find your explanations just as unsatisfactory.

"Unvaccinated people have a 100% risk of being hit by lightning" - What does "risk" mean here? It seems to imply everyone has a "100% risk" of anything, that isn't impossible, happening to them!

Surely the probability of being hit by lightening cannot be meaningfully quoted without also quoting a period of time? Similarly with other such "risks"?

As for the monkey, I'd give him a zero possibility, given a finite lifetime of the universe, let alone of the monkey.


Exactly you are proving my point. You need to define what is being meant when you use the word "risk". It is a completely different word to "probability"!

So there is 100% risk of something happening to someone (you aren't immune to it), but that something may have a very high or extremely low chance, of happening.

Maybe my explanation of that wasn't sufficient.

An unvaccinated person is not immune to catching Covid, but neither does he have a 100% probability of catching it. There is 100% risk, but not 100% probability of that outcome.

A mathematician wouldn't use "risk" as a word in that way, hence my saying you "either need to carefully define what you mean by "risk", or with respect you aren't using it in the same way a mathematician would to arrive at 100%".

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Re: Clots

#402299

Postby Urbandreamer » April 7th, 2021, 1:47 pm

As two poster have chosen to quote me and my links I think that I need to address their points.

UncleEbeneze asked about "clots", NOT the risk of death through a clot in the brain.
EssDeeAitch asked about Pfizer clots.

Neither asked about the risk of death from clots in the brain and the post that both gryffron and Julian quoted was not addressing that point.

Hence I reject any complaint about the relevance of the post to different questions.

My first link can not be used as evidence for that, or car accidents. Does it mean that the data was irrelevant to the question that it attempted to enlighten?

I have no real medical knowledge, but can use a search engine. Apparently the clots of concern are "cerebral venous sinus thrombosis events". The key word here in my opinion is not the one that you may think, but sinus. The NHS describes this as a clot that prevents an infection spreading from the sinus to the brain, with possible serious side effects. The AstraZenica vaccine is based upon a modified cold virus. Effectively we are artificially increasing the numbers responding to cold symptoms. From those facts it's possible to leap to a conclusion, though the emphasis might be on the word, leap.

I still feel that more research is required to obtain true answers. I'm still willing to take my chances with this vaccine.

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Re: Clots

#402338

Postby XFool » April 7th, 2021, 3:16 pm

Urbandreamer wrote:I have no real medical knowledge, but can use a search engine. Apparently the clots of concern are "cerebral venous sinus thrombosis events". The key word here in my opinion is not the one that you may think, but sinus. The NHS describes this as a clot that prevents an infection spreading from the sinus to the brain, with possible serious side effects. The AstraZenica vaccine is based upon a modified cold virus. Effectively we are artificially increasing the numbers responding to cold symptoms. From those facts it's possible to leap to a conclusion, though the emphasis might be on the word, leap.

Not sure I follow the above. There is that: "a clot that prevents an infection spreading from the sinus to the brain" then there is: "we are artificially increasing the numbers responding to cold symptoms". Which I think I understand even less.

My understanding is the chimp adenovirus vector has been 'disabled' in some manner so it doesn't reproduce in humans, so, apart from it being attacked by a human immune system for being 'foreign', why would it "increase the numbers responding to cold symptoms"?

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Re: Clots

#402352

Postby XFool » April 7th, 2021, 4:11 pm

So... anybody here under thirty? ;)

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Re: Clots

#402357

Postby WrongLicence388 » April 7th, 2021, 4:24 pm

XFool wrote:So... anybody here under thirty? ;)

Affirm.

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Re: Clots

#402366

Postby XFool » April 7th, 2021, 4:56 pm

...I hate you already! :lol:

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Re: Clots

#402369

Postby 9873210 » April 7th, 2021, 5:04 pm

gryffron wrote:I think the news reporting of this issue has been even worse than the pseudo-science:

Urbandreamer wrote:This link reports
Up to February 28, there were 38 reports from about 11.5million doses of Pfizer’s vaccine – compared to 30 from 9.7million AstraZeneca doses.


Over what time period? How many such clots would be expected normally? How many occurred in the "control group" i.e. The non-vaccinated?

Without such detail, the figures being quoted in the press are meaningless. About as useful as pointing out that "48 people died in car accidents following a AZ jab"

Gryff

I agree that baseline rates are very important.

But the data given are not quite meaningless. If the rates for AstraZeneca and Pfizer were statistically significantly different that would be evidence of some link, although without a baseline it would not rule out that we had accidently stumbled on an effective treatment for the clots.

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Re: Clots

#402375

Postby zico » April 7th, 2021, 5:15 pm

Having watched the UK's MHRA briefing on AstraZeneca safety, it was refreshing to hear scientists and experts giving their view, rather than reading nonsense from journalists.

Here's a summary and a few thoughts.

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.

Numbers of deaths is very low (19 deaths from 20m+ jabs). About 4 cases per million of serious symptoms (presumably ICU wards & including deaths).
Of 79 serious cases, 51 are women, 28 are men, but there may not be a gender difference, as high %age of women work in health and social care.
Seems to be fewer cases per million in UK than in EU and elsewhere, probably because UK concentrated on older age groups (and it's known that older people are much less likely to have strong immune responses).

Risk/benefit cut-off point is around age 30. Here's the key chart - which assumes current levels of Covid risk in the community. If Covid levels rise, than risk/benefit cut-off age rises, but if Covid levels fall, then the cut-off age falls. That's important because if Covid levels fall, the logical thing for younger people to do is to avoid AstraZeneca (and - possibly other vaccines if it turns out they have a similar effect). This could be very serious as it's reasonable to think "maybe all vaccines could be dodgy, so if I'm young and healthy, I'll just not bother". This would be pretty catastrophic for the plan to beat Covid by vaccination.

So what to do? I'll have no hesitation in having my second AZ vaccine. But if I was in my 30's or below, I'd be very keen to get an alternative vaccine, and probably be willing to wait a few weeks for it.

For comparison, the risk of serious blood clotting from the contraceptive pill is about 15 times the risk from the AZ vaccine. The UK has already vaccinated millions of health and care workers in the younger age bands, and if I was a 20-something nurse or care worker, I'd be pretty annoyed looking at the graph below, having previously been repeatedly told AZ was perfectly safe, and that other countries were just being malicious in investigating health concerns.

Does anyone here know health/care workers vaccinated, and which vaccine they were offered?

Interestingly, the European Medicines Authority also reported today, with similar findings to the UK authority, but different recommendations.
EMA says risk of serious blood clot is about 1 in 100,000 and they suggest that each European country should make it its own mind about which vaccine to use with which group, depending on their views of risks for their citizens.



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Re: Clots

#402377

Postby XFool » April 7th, 2021, 5:25 pm

zico wrote:Having watched the UK's MHRA briefing on AstraZeneca safety, it was refreshing to hear scientists and experts giving their view, rather than reading nonsense from journalists.

Here's a summary and a few thoughts.

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?

Interesting that the EMA's response has been: "Put it on the patient information sheet and carry on"
Last edited by XFool on April 7th, 2021, 5:34 pm, edited 1 time in total.

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Re: Clots

#402378

Postby zico » April 7th, 2021, 5:31 pm

Politically and practically, this could turn into a bit of a disaster for the UK government, because they've spent so much time and energy telling us all that the good old "Oxford" British vaccine was 100% safe, and the Europeans were just jealous and their cautious approach was completely unjustified. It now turns out that experts in most countries have similar views, but governments were making very different decisions and interpretations, with Macron and Johnson apparently on extreme ends of the spectrum.

There's obviously been a very important short-term benefit by insisting all vaccines are 100% safe, rather than pausing to check (which could have affected public confidence), but the long-term implications of overstating vaccine safety for months, followed by a climbdown, is that trust can be lost, and trust is really important in vaccination campaigns. If low-risk groups don't feel they can trust government messaging, lots of people will probably simply not get vaccinated, and probably in big enough numbers so Covid keeps circulating and mutating.

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Re: Clots

#402380

Postby zico » April 7th, 2021, 5:40 pm

XFool wrote:
zico wrote:Having watched the UK's MHRA briefing on AstraZeneca safety, it was refreshing to hear scientists and experts giving their view, rather than reading nonsense from journalists.

Here's a summary and a few thoughts.

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.


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Re: Clots

#402384

Postby Julian » April 7th, 2021, 5:52 pm

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

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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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