Is AstraZeneca losing the PR war surrounding its vaccine and potential blood clots?

Astrazeneca COVID-19 vaccine - blood clots
Photo via Marco Verch Professional Photographer/Flickr (CC BY 2.0)

AstraZeneca has been plagued with bad press in March 2021. All the negative attention, particularly around the issue of blood clots, has potentially resulted in a loss of confidence in the AstraZeneca vaccine. Some experts fear the concerns are overblown, however, and that parts of Europe will lose precious ground in the race to get people inoculated and end the pandemic.

The AstraZeneca vaccine, which was first authorized for use in Europe at the end of January, began a gradual rollout in February. With an inexpensive price tag, it had distinct advantages over the Pfizer and Moderna vaccines, including the ability to quickly manufacture doses in large amounts and distribute through existing supply chains.

The problems began in early March when authorities in Austria, Denmark, and Norway all began investigating possible vaccine-related deaths due to blood clots. Pending the investigation of three deaths and four separate, but potentially related, incidents, Germany suspended use of the AstraZeneca vaccine on March 15.

All seven of the initial cases were found in people between ages 20-50 who had previously been healthy. Of the 20 million people who have received the AstraZeneca vaccine in Europe, just 25 total people have since developed blood clots following vaccination, and nine have died. Given that blood clots are a relatively common condition, however, this number is actually lower than what would be found among unvaccinated people under normal circumstances.

The vaccine is still new, so all reported side effects are taken very seriously. Due to this, more than 20 European countries temporarily suspended the distribution of the AstraZeneca vaccine, citing blood clots as the reason.

Halting the vaccine could not come at a worse time, as COVID-19 cases are currently surging across Europe. On March 18, the European Medicines Agency published a statement noting that the benefits of the AstraZeneca vaccine still outweigh the risks “despite possible links to rare blood clots with low blood platelets.”

In an article for the Guardian, statistician David Spiegelhalter argued that while it’s “human nature to spot patterns in data,” the controversy over blood clots demonstrates our “basic and often creative urge to find patterns even where none exist.”

“There is no proof that this vaccine causes blood clots. It’s a common human tendency to attribute a causal effect between different events, even when there isn’t one,” Spiegelhalter wrote. “Someone is diagnosed with autism after receiving the MMR vaccine, so people assume a causal connection. And now, people get blood clots after having a vaccine, leading to concern over whether the vaccine is what caused the blood clots.”

It is still unclear if there is any correlation between the vaccination and blood clots, but the news has served to undermine vaccination efforts in Europe. Nearly 60% of French adults now say they have little or no confidence in the AstraZeneca vaccine, and polls in Germany, Italy, and Spain report similar numbers.

“It’s easy to scare people, [but] it’s very hard to unscare them,” Dr. Paul Offit, director of the Vaccine Education Center and an infectious disease specialist at Children’s Hospital of Philadelphia, told USA Today. “It creates the perception that these vaccines are dangerous. The only way out of this pandemic is by vaccination, and if we make people reluctant to be vaccinated, we’re going to have a hard time getting out of this pandemic.”

Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, said European countries may have created a new problem by “unnecessarily suspending” the AstraZeneca vaccine.

“This will erode vaccine confidence across Europe, and it could extend into Africa,” Hotez said. “The vaccine ecosystem is fragile, and it doesn’t take a lot to get a vaccine voted off the island.”

AstraZeneca likewise pushed back against the claims in a March 14 statement on the safety of its COVID-19 vaccine.

“Around 17 million people in the EU and U.K. have now received our vaccine, and the number of cases of blood clots reported in this group is lower than the hundreds of cases that would be expected among the general population,” AstraZeneca Chief Medical Officer Ann Taylor said.

“The nature of the pandemic has led to increased attention in individual cases, and we are going beyond the standard practices for safety monitoring of licensed medicines in reporting vaccine events to ensure public safety,” she continued.

The statement also pointed out that in clinical trials, the already small number of thrombotic events were even fewer among the vaccinated group. There is no evidence of increased bleeding in over 60,000 enrolled participants.

A non-peer-reviewed study released by Oxford University in April also showed that a person was eight times more likely to suffer a clot in the brain from COVID-19 than they were from getting the vaccine.

In the United States, where AstraZeneca will reportedly file for emergency use in April, a damning New York Times report further complicated the vaccine’s reputation. The pharmaceutical company was accused of “cherry-picking data to make its vaccine look better” when announcing new data from clinical trial results.

Researchers at Oxford University reported on March 22 that the AstraZeneca COVID-19 vaccine was 79% effective at preventing symptomatic infection. An independent panel found that a 69-74% efficacy rate was more accurate.

Almost immediately, the National Institute of Allergy and Infectious Diseases addressed the issue in a statement expressing concern that “AstraZeneca may have included outdated information from that trial, which may have provided an incomplete view of the efficacy data.”

The agency’s head, Dr. Anthony Fauci, said that he was “sort of stunned” by the discrepancies, particularly when the updated data was already so encouraging.

“If you look at it, the data really [is] quite good, but when they put it into the press release, it wasn’t completely accurate,” Fauci told Good Morning America on March 23. “We have to keep essentially trying as hard as we can to get people to understand there are safeguards in place.”

Despite these missteps, the AstraZeneca vaccine remains an affordable and easily distributed vaccine option. Most importantly, it is effective at halting the spread and transmission of COVID-19.

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Sources: The Atlantic, USA Today, Good Morning AmericaNew York Times

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