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Making sense of most recent AstraZeneca vaccine' news

I've been busy (sadly, too busy to write more thorough posts) - yet, nevertheless, I've been paying close attention to more recent AstraZeneca COVID19 vaccine reports and recommendations. That said, I have full understanding there is a lot of confusion, and I'll do my best to separate myths from facts.

(1) Association of AstraZeneca vaccine with thrombotic events
There is an association of AstraZeneca vaccine with unusual clotting disorders, now also known as "vaccine-induced immune thrombotic thrombocytopenia" (see article below). Yet, if you have been listening to the various "experts", you could hear there is "no evidence of direct causal relationship between vaccine and unusual clotting disorder". Now, for a moment I will confuse you a bit more by saying - both of those statements are true.

How?

Well, if you are lacking means to prove "direct causal relationship" - and we are in this context - then we cannot have an evidence of direct causal relationship, can we? And because we cannot prove it that also means that we do not have to. We only have to find evidence to support association - which we have - and then figure out what that means from the aspect of treating patients.

(2) "Benefits still outweigh the risks..."
Recently, my very dear friend and scientist tried to "inform" me that percentage of so-called uncommon adverse events is "very rare". My only (and I'll dare to say winning) argument was a following question: "What does that mean for a healthy 30-year-old and his/her family?"

There is lack of understanding, especially within stricly academic community that how often something occurs in population is not sufficient argument when it comes to public health and administration of drugs/vaccines. While it is important argument, it is not sufficient.

Let me put it in the perspective; does every stage of cancer treatment require equally aggressive therapy? Does doctor adjust treatment on a case-to-case basis? Would you give perfectly healthy patients aggressive chemotherapy?

No, yes, and no.

The same principle is applied when it comes to vaccination. This is why various countries have limited the vaccination with AZ vaccine to the specific age groups. Unusual clotting is rare? Alright - if I am perfectly healthy 30-year-old - how rare is my risk of disease? How rare are my "benefits"?

It is complicated question with complicated answer - and it can only be answered by health professionals who are familiar by the health status and history of the patient. It is not one-size-fits-all. Benefits outweight the risks of some. For others, they do not.

https://www.nejm.org/doi/full/10.1056/NEJMoa2104882?query=featured_home

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Great interview. Highly recommended.
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