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.
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.
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.