Restoring trust in the AstraZeneca vaccine is a job for doctors – not politicians

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Photograph: Ian Forsyth/Getty Images

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Neil Astles was only 59 when he died from a rare type of blood clot, which was this week linked to the Covid vaccine he had recently received. Like every death in this pandemic, this was one loss too many, and a tragedy for his family. But that’s what makes their bravery in coming forward now and urging others still to have the jab so compelling. Neil Astles’ sister, Dr Alison Astles, said the family were obviously suffering, but they recognised that her brother had been “extraordinarily unlucky”.

What they did not want, she explained, was for more people to die as a result of some panicking over whether the AstraZeneca jab was safe, and refusing vaccinations. As an academic specialising in pharmacy, Dr Astles is probably more used than most of us to weighing up medical risks. The challenge the government now faces, after Wednesday’s announcement that healthy under-30s should be offered an alternative to the AstraZeneca vaccine where possible, is getting the rest of us to see so clearly.


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As the behavioural scientist and government adviser Stephen Reicher has pointed out, if you had the jab yesterday, it was still probably one of the safest things you did. Statistically, you are more likely to die from falling downstairs or choking on your food. Yet knowing these facts won’t stop you coming down for breakfast tomorrow. Taking a long-haul flight or getting pregnant both carry higher risks of causing blood clots than receiving the vaccine, but we do these things for exactly the same reason that we get vaccinated: it’s so obviously worth the risk.

Yet if I was 25, the odds would be different, and that’s why the regulators acted as they did. The young and healthy are so vanishingly unlikely to die from Covid-19 (although they can develop complications from the disease) that they’re the only age group in which even a minuscule risk of harm from the vaccine potentially trumps the threat from the virus. (For all other age groups, the benefits are still deemed to outweigh the risks.) Since the golden rule is that drugs should be given only for the patient’s benefit, not for the convenience of those around them, carrying on vaccinating the young just to protect the rest of us would be frankly unethical. Still, doctors are probably braced for a flood of anxious questions.

Some will wonder whether Britain should have acted sooner to offer under-30s alternative jabs, yet leaping ahead of the evidence carries risks of its own. It’s a quarter of a century since the pill scare of 1995, which saw women ditching their contraception overnight after studies suggested a higher-than-expected risk of blood clots, but it sticks in public health experts’ minds for good reason. A surge in unwanted pregnancies and abortions followed, only for it to emerge later that the danger had been overstated.

Gallery: Coronavirus outbreak around the world (Photo Services)

A yellow COVID-19 warning sign is seen near a police car in Cardiff, Wales, on Dec. 17, 2020

A man dressed as Santa Claus distributes face masks as part of an awareness campaign against the spread of coronavirus, at a traffic junction in Ahmedabad, India, on Dec. 17.

A man wearing a face mask as a preventive measure against coronavirus travels on a passenger bus in Karachi, Pakistan, on Dec. 17.

A health professional disinfects their mobile testing unit before conducting tests for the COVID-19 coronavirus in Pretoria, South Africa, on Dec. 17.

Two people rest in their car shortly after being injected with their first dose of the Pfizer-BioNTech COVID-19 vaccine at a drive-in vaccination center in Hyde, England, on Dec. 17.

A woman wearing a face mask to help curb the spread of coronavirus walks on a street during the morning rush hour in Beijing, China, on Dec. 16.

A medical worker pauses outside of a Brooklyn hospital that has seen a rise in coronavirus-related cases in New York City, New York, U.S., on Dec. 15.

Police officers patrol through the almost deserted shopping streets in the city center in Leipzig, Germany, on Dec. 14.

Shoppers wearing face masks to protect against COVID-19 crowd Divisoria market in Manila, Philippines, on Dec. 13.

People walk by a banner that reads “Happy Holidays” outside the Beacon Theatre on the Upper West Side in New York City, New York, U.S., on Dec. 11.

A person dressed as Santa and wearing a protective face mask waves to passing cars at Starlight Lane, a drive-through Christmas event, at the Lumen Field Event Center Parking Garage in Seattle, Washington, U.S., on Dec. 10.

A robot dispenses sanitizer as a preventive measure against COVID-19 to a voter at a polling station during the local state body elections in Kochi, India, on Dec. 10.

A lab personnel prepares to perform rapid antigen swab tests for COVID-19, on passengers who just landed from New York on an Alitalia flight, at a Rapid Test Area set up at Fiumicino Airport in Rome, Italy, on Dec. 9.

Nurse May Parsons administers the Pfizer-BioNtech COVID-19 vaccine to Margaret Keenan (L) at University Hospital in Coventry, central England, on Dec. 8. making Keenan the first person to receive the vaccine in the country’s biggest ever immunization program.

An International traveler is seen carrying their luggage off the bus as they enter hotel quarantine guarded by police and hotel quarantine workers in full personal protective equipment (PPE) in Melbourne, Australia, on Dec. 7.

People wearing masks walk in Jakarta, Indonesia, on Dec. 7.

Ethiopian Jewish immigrants making their Aliyah (immigration to Israel) arrive at Ben Gurion International Airport in Tel Aviv, Israel, on Dec. 3.

Skiers wearing protective face masks ride a ski lift before hitting the slopes with the Matterhorn mountain as landscape above the ski resort of Zermatt in Switzerland on Nov. 28.

Brazilian artist Mundano works on a graffiti called “Heroinas Invisiveis” (invisible heroines), a tribute to the women during the outbreak of the coronavirus disease, at Heliopolis slum in São Paulo, Brazil, on Nov. 28.

Men wearing protective masks walk in Tokyo, Japan, on Nov. 26.

Cheerleaders wearing face masks perform during Game 6 of the Korean Series, the Korea Baseball Organization’s championship round, between Doosan Bears and NC Dinos at Gocheok Sky Dome in Seoul, South Korea, on Nov. 24.

A volunteer from a health association sprays disinfectant to sanitize the area during a rapid antigen testing campaign for the COVID-19 disease, at a basilica in Naples, Italy, on Nov. 23.

Travelers wearing face masks are seen at Beijing Capital International Airport in China on Nov. 22.

A member of the staff disinfects the stands before the start of a soccer match of the Mexican Apertura tournament between Guadalajara and Necaxa at the Akron Stadium in Zapopan, Mexico, on Nov. 21.

People walk through the city center on the first day of Level 4 coronavirus restrictions in Glasgow, Scotland, on Nov. 21.

A nurse holds a placard reading “For my rights and for your health” during a demonstration in front of the Healthcare Ministry where nurses are protesting demanding better working conditions and against the mistreatment of their sector during the pandemic, in Madrid, Spain, on Nov. 15.

A resident (L) of the Domenico Sartor nursing home in Castelfranco Veneto, Italy, hugs her visiting daughter through a plastic screen in a so-called “Hug Room” on Nov. 11.

People wearing face shields, masks and rubber gloves wait to vote at a polling station in Yangon, Myanmar, on Nov. 8.

A health worker, clad in her personal protective equipment (PPE) suit, falls asleep after tending to patients at a public health center in Bandung, Indonesia, on Nov. 6.

A customer pushes a trolley past the closed toy department of a supermarket in Bordeaux, France, on Nov. 4.

A mask-wearing student puts on plastic gloves as a precaution during class in Havana, Cuba, on Nov. 2.

Students listen to a teacher while sitting behind glass dividers on their desks in a classroom in the Maadi suburb of Cairo, Egypt, on Nov. 1.

A mask-clad woman stands in front of a pair of wings painted onto a wall near Friars Walk shopping center in Newport, Wales, on Oct. 30.

A couple wear protective face masks as they cross a street on the first day of the second national lockdown in Paris, France, on Oct. 30.

Spectators maintain social distance inside individual plastic cabins as they watch a play in São Paulo, Brazil, on Oct. 28.

A man in a costume adjusts his face mask as he attends a protest by people working in the entertainment and event industry against the German government’s economic policies to combat the spread of COVID-19 and demand more support for their business, in Berlin, Germany, on Oct. 28.

People wait in a line to vote at the Queens Public Library during early voting for the U.S. presidential election in the Jackson Heights neighborhood in the Queens borough in New York City, New York, U.S., on Oct. 24.

A staff member marks seats for social distancing at a movie theater in Jakarta, Indonesia, on Oct. 21.

A man walks past a mural in Dublin, Ireland, on Oct. 21.

A man wearing a protective face mask looks on during Mercedes-Benz Fashion Week Russia in Moscow, Russia, on Oct. 20.

Volunteers prepare food parcels before a distribution led by the international NGO ‘Gift to the Givers’ in Johannesburg, South Africa, on Oct. 14.

People wearing personal protective equipment (PPE) sanitize a “pandal,” or a temporary platform, next to an idol of Hindu goddess Durga for the Durga Puja festival in Kolkata, India, on Oct. 12.

A man wearing a protective face mask looks through the window of a temple in Kathmandu, Nepal, on Oct. 9.

Women perform the “Morenada” dance at an exhibit of folk costumes during the partial lifting of restrictions amid the COVID-19 pandemic, in La Paz, Bolivia, on Oct. 2.

A steward walks amid empty seats inside the arena during a rain delay at Roland Garros during the 2020 French Open in Paris, France, on Sept. 27.

First-year students wearing masks attend a commencement ceremony at Wuhan University in China on Sept. 26.

Members of a church choir parade during the celebration of the eve of the Ethiopian Orthodox holiday of Meskel, in Addis Ababa, Ethiopia, on Sept. 26.

Nuns wearing face masks walk across a street in Rome, Italy, on Sept. 25.

Workers wearing personal protective equipment (PPE) suits attend to customers at a salon in Ahmedabad, India, on Sept. 20.

A worker wearing a protective suit sprays disinfectant at a sauna and spa center in preparation for its reopening, in Hong Kong on Sept. 16.

A teacher checks the body temperature of students at a government school in Lahore, Pakistan, on Sept. 15. Educational institutes were reopened in the country nearly six months after the spread of the coronavirus.

New York City firefighters wear face masks as they pause outside of Engine Company 10 and Ladder Company 10 across from One World Trade Center, the Freedom Tower, in lower Manhattan, New York, U.S., during commemoration ceremonies for the Sept. 11, 2001, terror attacks on Sept. 11. Due to COVID-19 pandemic restrictions, only family members were allowed to gather at the 9/11 Memorial plaza. 

Municipal employees greet during a campaign to promote the keeping of safety distances against the spread of the coronavirus in Santa Tecla, El Salvador, on Sept. 10.

Participants in protective face masks attend the 4th Edition of the Equality Parade in Katowice, Poland, on Sept. 5. 

Employees of the Delhi Metro Rail Corporation (DMRC) sanitize a coach during a media preview as the Delhi Metro network prepares to resume services partially after more than five months shutdown, in New Delhi, India, on Sept. 3.

Residents of the highland city of Puno wait to be tested for free for COVID-19 during a municipal campaign in Peru on Sept. 2.

Workers of the local government disinfect a woman and her house as a preventive measure, in the municipality of Xochimilco in Mexico City, Mexico, on Aug. 26. 

Santas have their temperature taken as they attend a socially distanced Santa school training at Southwark Cahedral in London, England, on Aug. 24.

A sign outside the Hollywood Hotel in Surry Hills warning people to keep their distance, in Sydney, Australia, on Aug. 22.

Public officials disinfect pews at the Yoido Full Gospel Church in Seoul, South Korea, on Aug. 21. 

Military personnel from the Brazilian Armed Forces sanitize a bus at the Santa Candida bus terminal in Curitiba, Brazil, on Aug. 10.

A teacher, wearing a face shield as a precaution against the coronavirus outbreak, speaks to her students in a makeshift classroom at her residence in Tangerang, Indonesia, on Aug. 10.

A Vietnamese woman carries a stuffed animal while boarding a repatriation flight from Singapore to Vietnam, at Changi Airport in Singapore on Aug. 7.

Two women in traditional kimonos wear face masks as they visit Sensō-ji temple in Tokyo, Japan on Aug. 7.

An artist gives finishing touches to a mural depicting frontline workers, in Kolkata, India, on Aug. 5.

Pilgrims wearing face masks and keeping social distance perform Tawaf around Kaaba during the annual Hajj pilgrimage in the holy city of Mecca in Saudi Arabia on July 31.

Bar and restaurant owners demonstrate asking the government to allow them to reopen their businesses given the difficult economic situation they are going through during the COVID-19 pandemic, in Cali, Colombia, on July 31.

A healthcare worker passes paperwork to a woman in a vehicle at a COVID-19 testing site outside of Marlins Park in Miami, Florida, U.S., on July 27.

Customers sit with a teddy bear used to keep social distancing measures at a restaurant in Polanco neighborhood of Mexico City, Mexico, on July 26.

Nurses in PPE kits discuss before they start their duty of door-to-door screening in Pune, India, on July 20.

A woman wearing a face mask walks at the Trocadero Palace near the Eiffel Tower in Paris, France, on July 10.

Paramedics gather outside the North Melbourne public housing complex, where nine towers had been placed under hard lockdown, in Australia on July 8.

A doctor clad in protective gear measures the temperature of a woman during a house-to-house new coronavirus testing campaign in Avircato, Bolivia, on July 7.

A view of a newly built hospital to treat COVID-19 patients at the Mahalaxmi Racecourse in Mumbai, India, on July 7. India on July 6 became the country with the third-highest coronavirus caseload in the world.

Women eat lunch in a social-distancing greenhouse dining pod in the former parking lot of the Lady Byrd Cafe in Los Angeles, California, U.S., on July 7.

Visitors hold reproductions of the Mona Lisa outside the Louvre Museum as it reopens its doors following a 16-week closure due to lockdown measures, in Paris, France, on July 6.

Serbian army soldiers prepare a makeshift field hospital to accommodate patients infected by COVID-19 inside the Belgrade Arena in Serbia on July 6.

A clown, wearing a face shield, welcomes visitors at Tibidabo Amusement Park on the first day of its reopening in Barcelona, Spain, on July 4. The amusement park reopened for the first time since March 14 under strict sanitary security measures, including mandatory wearing of face masks, maintaining of social distancing between people or family units, following hand hygiene protocol and capacity restrictions with tickets booked in advance.

A social distancing sign warning of keeping two meters apart is seen in Porthcawl, Wales, on June 24. 

Personnel of the National Health Service perform Polymerase Chain Reaction (PCR) tests on the population to detect COVID-19 cases in San Cristóbal, Dominican Republic, on June 13.

A worker sanitizes the railings surrounding the General Hospital’s triage area for COIVD-19 patients in Mexico City, Mexico, on June 12.

A firefighter sprays disinfectant as a preventive measure against the spread of the COVID-19 in a containment zone in Chennai, India, on June 11.

Health workers from the city of Melgaço arrive at a small riverside community, where families live without electricity, to give medical care to its residents, in Brazil, on June 9.

A caretaker cleans the floor at the Durgiana Temple after the government eased a nationwide lockdown, in Amritsar, India, on June 7.

A traveler queues for check-in on an Air Austral flight to Paris, France, from Dzaoudzi–Pamandzi International Airport on the French Indian Ocean island of Mayotte on June 5, as measures to curb the spread of the COVID-19 are maintained on Mayotte over concerns about the continued spread of the virus there.

A member of the ‘Torcida Urubuzada’ (soccer fans) of Flamengo delivers food donations amid the coronavirus pandemic, in Rio de Janeiro, Brazil, on June 5.

An organ grinder waits for a delivery of donated groceries in Mexico City, Mexico, on June 4.

Local authorities interview residents at the Santa Cruz neighborhood in Medellin, Colombia, on June 1, during the COVID-19 coronavirus pandemic.

People are seen inside a movie theater during its reopening, in Bangkok, Thailand, on June 1, after the Thai government eased isolation measures put in place to prevent the spread of COVID-19.

People sit in circles painted as guidelines for social distancing at the Domino Park in New York City, New York, U.S., on May 24.

Staff at Suleymaniye Mosque perform a morning prayer in Istanbul, Turkey, on May 24.

Empty chairs are placed for worshipers on Notre Dame de la Garde basilica’s terrace before the first public mass after France eased lockdown measures, in Marseille, France, on May 24.

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Conversely, some on the Tory right are already grumbling that the Medicines and Healthcare products Regulatory Agencyhas gone too far, and risks playing into the hands of anti-vaxxers. Their time would perhaps be better spent explaining to constituents why they don’t need to panic rather than treating such panic as inevitable. Iain Duncan Smith, the former Conservative leader, says he doesn’t understand what the regulators think they’re doing, but the answer is that you don’t build trust in a vaccine by refusing to admit there might ever be any downsides to it. If fear can be dangerous, so can the kind of misplaced chest-beating that led some to bristle at the very idea of foreign governments questioning the safety of a British vaccine, as if it were some kind of insult to the national psyche.

What we’re seeing now, in other words, is a regulatory system doing exactly what it’s supposed to do: working methodically through the evidence and ignoring political noise as best it can. That won’t stop the noise coming, or colouring what are already fraught debates over whether vaccine passports might be a way of getting theatres, music festivals and other crowded venues back on their feet. Anything that smacks, however faintly, of compelling people to have the vaccine has now arguably become more politically difficult than it was a week ago. But the priority right now should be shoring up public trust and priming GPs to identify the early signs of vaccine complications quickly – and that’s a job for medical professionals, not opinionated backbenchers. The best thing politicians can do now is avoid getting in the way.

  • Gaby Hinsliff is a Guardian columnist

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