'Overly cautious': Vaccine-hesitant Europe delays rollout further over blood clot fears

LONDON – Several European countries stopped launching the world’s leading vaccine against Oxford-AstraZenaca Covid-19 this week amid reports that some patients were suffering from blood clots.

However, some experts and regulators say these decisions were not only based on misunderstood evidence, but also put the risk of mounting fear in one of the most vaccine reluctant parts of the world.

“We have to be extremely careful – but this is too careful now,” said Mukesh Kapila, a former advisor to the Director General of the World Health Organization who held senior positions at a number of other United Nations agencies.

“We have real information from tens of millions of vaccinated patients and if this had been a serious problem it would have surfaced,” added Kapila, now Professor Emeritus of Global Health and Humanitarian Affairs at the University of Manchester in the UK.

The German police officer Dirk Moeller registered on Monday at the former Tempelhof Airport in Berlin for an AstraZeneca vaccination against Covid-19. Tobias Schwarz / AFP – Getty Images

On Thursday, Denmark announced that it would suspend the rollout of the vaccine developed by Oxford University and Anglo-Swedish pharmaceutical giant AstraZeneca. It came after reports from dozens of people who had blood clots after receiving the shots, including at least one person who died in the Nordic country.

Norway, Bulgaria and Iceland followed suit, while other countries including Estonia, Lithuania, Luxembourg, Latvia, Italy and Austria stopped certain batches that they said could be linked to the diseases.

These countries stressed that no link had been confirmed and that the move was a temporary measure until they could gather more evidence. Denmark said it uses the “precautionary principle” – the idea that it is better to play it safe than apologize until you have more evidence.

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However, some experts say this is a classic case of confusing causality with correlation: just because someone got sick after vaccination doesn’t mean the vaccine caused them, they say.

The European Medicines Agency, the continent’s main medicines agency, said 30 blood clots had been reported from 5 million vaccinated patients as of Thursday – about as many as would be expected in the unvaccinated population.

The UK, which has vaccinated more than 20 million people, most of them with the AstraZeneca shot, said similarly. Both the European Medicines Agency and WHO have announced that they will be investigating the cases, but stressed that this vaccine is safe and effective for them.

AstraZeneca said in a statement sent via email that its own data from more than 10 million patient records showed that the incidence of blood clots was actually lower than the general population rate.

According to a survey by the UK charity The Wellcome Trust, Europe is the most vaccine-reluctant continent in the world. In particular, AstraZeneca carried out a public relations campaign after several European regulators and political leaders, including French President Emmanuel Macron, warned that there was insufficient data to show effectiveness in people over 65 years of age.

Real evidence suggests it isn’t, but the damage to public trust has already been done. At one point in the past month, millions of AstraZeneca vaccines were unused in storage in countries like Germany and France, partly because people were not ready to take them, according to official reports.

Federal Health Minister Jens Spahn said on Friday that he “regretted” that neighboring Denmark had suspended the shooting despite a lack of evidence.

The United States has pledged around $ 1.2 billion to develop the AstraZeneca vaccine and ordered 300 million doses. However, it has yet to be approved in the US due to questions about the transparency of the first phase 3 trial data and a delay in the US trial.

At the heart of this debate is the delicate balance that needs to be struck by public health officials and governments: vigilance about possible side effects, transparency to maintain public trust, but also not to believe shaky claims that trust it in this could inappropriately harm vaccinations.

“It is a sensitive topic because there is also the risk of downplaying these concerns,” says Hajo Zeeb, professor at the German Leibniz Institute for Prevention Research and Epidemiology. “Do you say that you remain on the side of caution or say: ‘No, we don’t see anything unusual’ and continue to vaccinate like in Germany?”

A health care worker with a syringe filled with the AstraZeneca vaccine during a vaccination rollout for teachers in Ronda, Spain last month. Jon Nazca / Reuters file

One such debate arose in the UK in 2009 after a 14-year-old high school student died hours after being vaccinated against the human papillomavirus, also known as HPV, which can cause cancer.

David Salisbury, the UK government’s then vaccination director, said they had decided to withdraw that batch of vaccine but never abandoned the vaccination campaign.

Crucially, his team refused to comment on the media until the cause of death was known, which the next day turned out to be a malignant tumor and had nothing to do with the shot.

“The story fell off the news pretty quickly after that,” Salisbury told NBC News on Friday. Now he fears that stopping the AstraZeneca shot due to blurry evidence means “the story will spread and of course it won’t help” overcome the vaccine’s hesitation.

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