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Vaccination is the fastest way to return to a more peaceful life

There have been a lot of misunderstandings about the AstraZeneca COVID-19 vaccine, but it is clear that vaccination is the fastest way to prevent particularly serious cases of illness and to alleviate the overload in the healthcare system. The benefits of any vaccine outweigh the very low risk of serious side effects. 

Kai Kisand, Uku Haljasorg

There have been specific reasons for the conflicting vaccine messages.The vaccine (new name Vaxzevria), which was developed in collaboration with researchers at the University of Oxford and AstraZeneca, was first recommended for younger people because of a lack of data on how the vaccine works in the older people. It is known that older people generally do not have as effective protection after vaccination as younger people. Fortunately, what COVID-19 vaccines have in common, is the fact that they offer protection against the most serious cases of the virus for all age groups. As soon as the AstraZeneca vaccine was proven to be effective in the older people as well, it was only wise to extend the use of the vaccine to them.

Unlike AstraZeneca, the logistics of mRNA vaccines are complex. Approving AZ to the risk groups is a great relief for family health centres. Probably nobody doubts that older people need the protection first. The sooner we get the older people vaccinated, the faster the burden on the medical system will get lighter and we will not have to fear that those in need of help with other diseases will be left without help due to the restrictions on basic treatment. The same is true of people who perform strategically important tasks in society. The continuation of important functions in society depends on the vaccination of health professionals, teachers, police officers and rescue workers.

The impact that vaccination has on controlling the epidemic can be seen clearly in countries where the majority of risk groups have already received their protective injections. In the UK, for example, both Pfizer and AZ vaccines are used. Vaccination has led to a substantial drop in the number of people infected. The fact that is particularly remarkable is that although AZ vaccine may be slightly less effective than Pfizer or Moderna in preventing asymptomatic or mildly symptomatic COVID-19, in the more serious cases of COVID-19 that require hospitalization, it’s effectiveness is 94% after the first injection already.

In Israel, 75% of people over the age of 60 were vaccinated in three weeks. In the same time window, the number of infected patients needing hospital care for this age group decreased by three quarters. Today, almost two thirds of the population of Israel (9 million people) have received the vaccine. Due to rapid vaccination, the daily number of infections there dropped significantly faster than initially predicted. While in Estonia more than 10% of primary tests are currently positive, in Israel this number has been 0.5% for a week. Therefore, it can be seen that the vaccine works. Be it Pfizer, which is used in Israel, or AstraZeneca, which is used in England.

The probability of a serious side effect of the vaccine is as likely as getting struck by a lightning

Every medicine and vaccine has side effects. They should to be talked about and they are talked about. A good example here is the AstraZeneca vaccine, which had an extremely rare side effect, that has already been added to the vaccine leaflet. The prevalence of thrombosis in cerebral veins or veins in the abdominal cavity is less than 1 case per 100,000 vaccinated people. It is more likely in women under the age of 55. In other words, there may be one person in the whole city of Tartu and its vicinity who would experience such a side effect.

Today, doctors know how to help people with these kinds of side effects. It has been found out that interfering may worsen the patient’s situation and should be avoided. People who are vaccinated will also be better prepared to notice the signs of this side effect.

Why does this unusual thrombosis occur?

How the immune system progresses from vaccine injection to an autoimmune response is still being studied. However, this immune response is known to be mediated by autoantibodies, which activate platelets excessively. The patient can recognize it 4 to 20 days after the vaccine injection if they get constant and severe headache, visual disorders, weakness of the limbs or sensitivity disorder, shortness of breath, severe chest or abdominal pain or swelling and bruising of the limbs. If you experience such symptoms, be sure to see a doctor who can prescribe treatment.

The current recommendation to use AstraZeneca especially in people over the age of 60 is based on a risk/benefit assessment. COVID-19 is associated with a significant risk of thrombosis, which is many times more likely to occur in that way than as an extremely rare side effect of the vaccine. In other words, depending on the severity of the coronavirus disease, a maximum of one in every 100 people with the infection can get a thrombosis (the number of thrombosis occurring in every 100,000 vaccinations is 1).

After injecting tens of millions of doses of AstraZeneca, studies show that people over the age of 60 have not shown an increase in thrombosis compared to the average frequency of the population. By now it is also known that previous thrombosis or treatment with blood thinners is not contraindication for getting the vaccine.

It would also be beneficial to review the risks of AstraZeneca for younger people.

Astra Zeneca vaccine4 – 10 cases per million doses of vaccine0.0001 – 0.0004%
Hormonal contraceptives500 – 1200 cases per million women0.05 – 0.12%
Smoking1,763 cases per million smokers0.18%
Long flights1000 cases per million passengers0.1%

What to keep an eye on after the vaccination?

Now, that the extremely rare side effect of AstraZeneca is known, we can give patients recommendations on what to keep an eye on after the vaccination. Fever, weakness and headache 2 to 3 days after the vaccination are normal. For AstraZeneca, these reactions are more severe after the first dose. This is a normal reaction and indicates that a person is developing a proper immune response.

You should contact your doctor if you experience severe headache or abdominal pain later than four days after the vaccine injection, as the symptoms of the thrombosis indicated before.

The immune response matures over time, i.e. it’s quality becomes better. Repeated introduction of the pathogen components or antigens contributes to this maturation. Therefore, it is necessary to receive a second dose of the vaccine after a certain period of time.

If you have already received your first dose of AstraZeneca and did not experience any serious side effects, then there is no reason to hesitate before getting your second dose. The risk of a dangerous side effect after the second dose is even lower than with the first injection. We do not yet have data on the combination of different vaccines, as studies are still ongoing. Therefore, the combination of different vaccines cannot be recommended at this time.

However, we strongly recommend vaccinating at the earliest opportunity, as this is the only way to get rid of the virus and return to a normal life with peace of mind: go to school and to work, communicate with friends and loved ones, and refresh your tired body and mind on a holiday or a cultural event.

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