Is the Astra-Zeneca vaccine killing people?

Poor Astra-Zeneca. The covid-19 vaccine that they had hoped would generate an endless tide of goodwill is instead turning in to one long public relations disaster. First it was the case of transverse myelitis that caused them to have to halt their vaccine trial temporarily. Then it turned out that they had given the wrong dose of vaccine to a bunch of participants in the trial. Then, when the preliminary trial data was published, the vaccine only appeared to be 70% effective at preventing covid-19, while vaccines by competitors Pfizer and Moderna were more than 90% effective. And now, perhaps worst of all, it appears that their vaccine has killed several previously healthy young healthcare workers. Poor poor Astra-Zeneca.

I am, of course, being facetious.

Two case series were published in the New England Journal of Medicine this week. A case series is basically just a collection of case reports, that have been gathered together in to one article because they are similar in some important way. The first case series comes from Norway. It concerns five patients who became acutely ill between seven and ten days after receiving the Astra-Zeneca vaccine. The patients were health care workers aged from 32 to 54 years old. All were fundamentally healthy before receiving the vaccine. One had mild asthma, and another had high blood pressure.

All five developed thrombocytopenia. Four out of the five developed cerebral venous sinus thrombosis (the fifth had clotting in veins at the base of the skull and in the abdomen instead). Three out of the five died. By the time these cases reached the Norwegian authorities and the dots were put together that this might have something to do with the Astra-Zeneca vaccine, 132,000 people in Norway had received the Astra-Zeneca vaccine.

The second case series comes from Germany. It concerns eleven patients, aged from 22 to 49 years, who became ill between five and 16 days after receiving the Astra-Zeneca vaccine. Like in the Norwegian case series, all of the patients had thrombocytopenia, and at least nine of the eleven had cerebral venous thrombosis. Six of the patients died.

Blood from both the Norwegian patients and the German patients was subsequently tested for the type of antibodies that are typically seen in heparin induced thrombocytopenia. Every single test came back positive. Note that none of these people had been treated with heparin before the onset of symptoms, and several didn’t receive any heparin at any time point during their hospital stay.