Oxford AZ vaccine: Clots or plots?

By Dr Upul Wijayawardhana

I chose to delay taking the Covid-19 vaccine as I preferred to have a vaccine with a whole virus in it rather than a tiny part. Perhaps, it reflects my conservatism; having faith in a vaccine made in the traditional manner. The vaccine developed by the researchers at Oxford University, marketed by the Anglo-Swedish drug giant AstraZeneca (AZ), fitted the bill and there was an added bonus––the Oxford group collaborating with AZ on the express understanding that it would be a no-profit venture. In the biggest health emergency facing us, such a noble gesture deserved recognition and I should play my little part, I thought.

Trapped in the UK, where the severity of the epidemic is far more serious than in Sri Lanka, with deaths exceeding thousand a day being the norm, most of the time, anything to protect should have been welcome. However, when I got the appointment for my jab, I requested a postponement. At the time of my first appointment, only the Pfizer jab was in use. The moment I learned that the AZ jab was being widely used in our area, I requested an appointment and had mine after a delay of about six weeks. However, the present furore over the AZ jab in the European Union (EU) raised doubts in my mind whether I had taken the wrong vaccine! I am sure many in Sri Lanka, too, would think the same as the only vaccine used, so far, is the Oxford AZ vaccine manufactured by the Serum Institute of India, one of the biggest vaccine manufacturers in the world.

In my article ‘Playing politics with science’ (The Island, 5 March 2021) I referred to how the European Union started playing politics with the AZ vaccine by withholding it from those over 65, blaming AZ for not supplying adequate stocks and trying to impose a barrier between Ireland and Northern Ireland, which is a part of the UK. With the real-world data confirming what clinical trials and antibody studies suggested, one would have expected things to settle down, with EU accelerating its vaccination programme, which was trailing behind that of the UK. It did not happen that way, as EU politicians seem determined, for whatever reason, to stigmatise the Oxford AZ vaccine!

The latest battle is about the formation of blood clots, and that has resulted in many EU countries, 13 at the last count, starting with Germany, stopping the use of the Oxford AZ vaccine, in spite of many countries including Germany, Italy and France, declaring that they were experiencing a third wave of the epidemic. This has resulted in further slowing down of vaccinations in the EU, and this could have a disastrous effect. Even before this happened, BBC Europe Editor, Katya Adler had this to say about lagging vaccination rates, in her article “EU closes ranks over Covid surge and vaccine delays” (BBC website, 13 March 2021):

“This was certainly not what the European Commission had in mind, back in June, when it announced a “European strategy to accelerate the development, manufacturing and deployment of effective and safe vaccines against Covid-19. At the time, the UK was derided by many, at home and abroad for not accepting an invitation from Brussels – even as a departing member state – to jump aboard the EU vaccine procurement scheme. Boris Johnson’s Brexit-focused government prefers to go it alone? More fool them,” was the sentiment of many in the EU.

“But fast forward to late February, and take a look at the front-page headline of Germany’s popular Bild newspaper. In a mixture of German and English and with the union flag as a backdrop, it reads in bold print: Liebe Britain, We Beneiden You (Dear Britain, we envy you). This was from a country with the famously level-headed scientist Angela Merkel at its helm and which, at the start of the pandemic, seemed to lead the way in how to deal with the virus effectively.”

Blood clots form in leg veins for many reasons including severe illness and prolonged bed rest. The danger is that they grow, if untreated, with parts getting detached and blocking the arteries that take blood to the lungs from the right side of the heart––pulmonary embolism, which can kill. Rarely other veins like those in the brain also can get affected. During clinical trials none of the vaccines showed any evidence of blood clots and there is no underlying process to explain blood clot formation. Interestingly, Covid-19 infection causes blood to be more coagulable. Most patients who die of Covid-19, do so due to severe pneumonia, and one of the features of lung damage is the development of blood clots. If any vaccine leads to the increase of blood clots it would certainly be a paradoxical reaction.

How big is the problem for some EU countries to have taken this drastic action and what about the Pfizer vaccine? The UK has already vaccinated almost 25 million, and up to the end of February, around 30 cases of blood clots were detected among 9.7 million people given the Oxford AZ vaccine. Interestingly, in comparison, the figure was slightly higher for the Pfizer jab; there were 38 cases among the first 10.7 million recipients. Most experts opine these figures are lower than what would be expected in the general population, suggesting neither one ‘causes’ blood clots. It probably is an association needing further investigation.

Echoing what the WHO and the British Authorities have stated, at a press briefing on 16 March, the head of the European Medicines Agency (EMA) Emer Cooke said she was still “firmly convinced” of the benefits of the AstraZeneca drug and pointed out that blood clots highlighted by some countries were relatively common in the general population. “I want to stress at present there is no indication that vaccination has caused these conditions,” she added. Asked about reports of blood clots in relation to the Pfizer and Moderna vaccines she said: “We are looking at adverse effects associated with all vaccines.”

The EU seems to be in total disarray. Whilst the EMA recommends continuation of the Oxford AZ vaccines, political interventions seem to have divided the EU. Is it bitterness over Brexit that is driving this agenda? Perhaps, there is another more sinister explanation. To quote from Katya Adler’s article, previously referred to:

“But EU insiders say a number of countries originally favoured AstraZeneca as a cheaper option. The Pfizer vaccine was seen as pricey and I’m told a number of member states were suspicious that Germany had an agenda: to make money for the German business BioNtech behind the vaccine.”

Is capitalism attempting to thrive on the woes of the masses?