Why I would say yes to the AstraZeneca vaccine despite the risk of blood clots

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Life is complicated and messy and so is science and healthcare. The idea that any vaccine is 100 per cent effective and safe before being rolled out to a population has never been the case and is pure science fiction.

We all live with risk every day, from choosing fried bacon for breakfast instead of fruit to staying by the pool or jumping out of a plane at 15,000ft on holiday. Risk is a part of life and healthcare is an especially risky area. Hospitals are very risky places to be as a patient unless you really need to be there.

If you’ve ever paused to read the side effects on the medicines routinely stocked in most houses you’ll know that many come with myriad potential risks. A vaccine against coronavirus was never going to be any different.

It is always the case that vaccines cannot be considered completely safe, even when shown to be so in randomised control trials, until we have rolled them out at population level.

Yesterday’s news on the emerging risk of rare blood clots from the Oxford/AstraZeneca vaccine needs to be seen in the context of a raging pandemic that can kill even healthy young people or leave them with debilitating consequences such as long Covid.

There have been just 79 cases of these rare blood clots and 19 deaths after more than 20 million doses. The affected patients were aged from 18 to 79, with more women than men. But the numbers are so small it’s hard to draw scientifically safe conclusions.

Before yesterday’s press conference, frustration with the MHRA, the UK regulator, had been growing. A number of clinicians I spoke to were raising concerns about the increased blood clot disorders they were seeing and felt the MHRA was not being transparent enough about the patients involved, their ages and so on. There has been a welcome increase in detail, but we still lack clarity on whether, for example, the patients had underlying conditions and other factors that might help us all feel a little less worried.

That being said, highlighting this emerging risk with more detail in the context of the threat from Covid was welcome. The regulatory and vaccine surveillance systems are working. They have spotted a potential risk that appears to happen in four out of every million doses, or one in 250,000. Apparently slightly more risky than being struck by lightning – that should give us all a degree of confidence in the vaccines.

This is not just about our individual risk but the risk to society as a whole. Vaccination is about protecting you and those around you. We have a social responsibility here too.

Would I prefer the Pfizer vaccine over AstraZeneca? Being honest, if I had the choice, probably yes.

But let me be clear, offered the AstraZeneca vaccine and no alternative I wouldn’t hesitate. Neither should you.

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After a year described as "the greatest public health emergency in NHS history" by NHS England's chief executive Simon Stevens, the health service has only just begun the process of picking itself up after coronavirus.

With more than 120,000 deaths and many more people suffering long-term complications and disability, the full consequences of the virus may not be fully apparent for months, even years to come.

It will be one of the biggest post-war public policy challenges any government has faced.

And beyond Covid, the pandemic has had ramifications on cancer care, waiting times, community healthcare and mental health services.

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