Edit: yes I'm aware they have only a dozen or so dead per week but that also translates to hundreds of severe cases, missed elective surgeries, etc. For what would most likely result in zero side effects in the elderly group.

Which then raises the question, why did these professionals make a decision so different than the "obvious" opinion here?

It's difficult to see how Denmark isn't failing its population with this decision.

https://www.sst.dk/en/English/news/2021/Denmark-continues-it...

The main takeaway is:

"In the midst of an epidemic, it has been a difficult decision to continue our vaccination programme without an effective and readily available vaccine against COVID-19. However, we have other vaccines at our disposal, and the epidemic is currently under control. Furthermore, we have come a long way towards vaccinating the older age groups where vaccination has a tremendous potential impact on preventing infection. Age is the main risk factor for becoming severely ill from COVID-19. The upcoming target groups for vaccination are less likely to become severely ill from COVID-19. We must weigh this against the fact that we now have a known risk of severe adverse effects from vaccination with AstraZeneca, even if the risk in absolute terms is slight,"

The risks of blot clotting from a variety of other sources are orders of magnitude higher (looking at you hormonal contraception) but those are risks that large sections of the population gladly accept.

In the trolley problem, the people on the tracks have no choice! With regards to vaccines, we can give people a choice. A competent government would respect people's agency. It would say "Hey folks, the virus kills 1/N and the vaccine kills 1/M, take your pick."

When people learn the M is several orders of magnitude greater than N, they will act accordingly.

Also, since experts have said that the side-effects occur because of an immune-reaction to the adenovirus that is used as the delivery mechanism of the vaccine, what are the chances that the people who have side-effects would die (or at least have the same kind of complications) from covid?

The numbers (77% of vaccinations were with the BioNTech vaccine) suggest that they are doing just fine with the much more expensive but less controversial option.

Which is cool, but some countries are just looking for raw vaccine for now, no matter which one it is.

[1] https://www.reuters.com/article/us-health-coronovirus-eu-vac...

I wonder if this provides some insight to which societies will be more or less likely to allow driverless vehicles, which suffer conceptually from the same type of trade off.

There is no “safe drug”, “unsafe drug”. It’s a continuum and it’s balanced by the benefit.

I find it hard to believe there isn’t a subgroup where the benefit of the vaccine doesn’t outweigh the risk.

Perhaps they have the luxury to choose which jab to use, in which case it seems logical to prefer the safer one. TFA mentions that the decision would delay vaccine rollout by 4 weeks.

What is the impact of that delay?

These decisions are being made by professionals. They have been trained to do exactly this kind of decision. They have access to the best possible data on both the risks of the vaccine, the risks of Covid in their local context, and the impact these decisions have on the national vaccination schedules.

But everyone in the comments is just absolutely sure that the experts are totally incompetent, and a HN reader with access to Wikipedia is better equipped to know what the right decision is. Why?

Are people already forgetting how masks were actively disrecommended by 'professionals' at the start of the pandemic while plenty here and in other places were similarly saying that masks are obviously good?

But we do give them the power to ban medicines and that's where actual trouble can start.

And it's understandable. If every time a Japansese person stole something you heard about it sooner or later your intuition would be convinced that they're all a bunch of thieves. If you heard about every bicycle accident you'd be scared to ever ride. US cops do hear about it every time one of their number is killed and we can see the resulting paranoia with which they treat the public. And the people at health regulatory agencies get fed a constant stream of medical mishaps.

To counteract this bias any organization really needs to make explicit cost benefit analyses with real numbers if they're going to make sensible decisions. We force highway safety and toxicology regulators to do this. We really ought to have the medical regulator do it as well but for some reason we don't.

-Risk of death from side effects in <65 patients is estimated at 3x higher than the international consensus, based on local observations. Unknown why this is the case, but seems unlikely to just be a statistical anomaly.

- >65 population is largely vaccinated already

-Vaccines from other manufacturers are expected to be available for everyone shortly

-Covid is under control and new cases are few. Risk of dying from infection in a given month is extremely low. When risk of death from vaccine is estimated at the order of 1 in 50.000, (ballpark figure based on memory), the vaccination risk outweighs Covid risk by far. Would be a tough call if other vaccines wouldn't be available, but they will be. It's not a long delay.

-Given the above, it's crucial to make sound ethical decisions to maintain public's trust in vaccinations and health authorities. This is not the last time we need to trust health authorities with our wellbeing.

In closing, summarized very briefly: there is a lot of orthodoxy regarding vaccination strategy in the community of science-interested folks. It's very fascinating to watch part of this consensus being challenged with good scientific arguments.

Because they may see that clotting worries would harm public trust in vaccines, delaying or preventing us from getting to herd immunity.

Because they may see the number of people tested for blood clots, indicating the number is much higher than 1 in a million.

Because they may see that trading a week of paused administration at this point is a reasonable price to pay to ensure we get to herd immunity.

mRNA vaccines are apparently better and don't seem to have serious side effects, so only using those is correct if it doesn't delay immunity too long.

According to the article, this might cause a 4 weeks delay: currently Denmark has around 2 deaths per day, thus possibly causing 60 additional deaths, which would match a vaccine death rate of 1/100000.

Denmark has a 6 million population, and it seems AstraZeneca kills around 1/1000000 so it seems COVID is only 10x more lethal than the vaccine in the general population.

However death rates for COVID are much higher in the elderly while vaccine clot rates are much higher in young people, so the AstraZeneca vaccine might be more lethal in present day Denmark for young people.

Even among elderly people they can eliminate their COVID risk by isolating but they would be forced to take the vaccine risk if the government only offers the AstraZeneca vaccine.

Finally any vaccine deaths can be more easily attributed to the person who made the decision to continue using the vaccine thon COVID deaths.

https://en.wikipedia.org/wiki/Trolley_problem

(a) The reasoning is often either not communicated, or is poorly communicated.

(b) It takes away a risk/benefit decision from people that are mostly capable of making on their own. Don't want to take the risk of a rare side effect? Wait for an mRNA vaccine. Think the risk of COVID for your particular scenario is higher? Let me accept the risk.

There isn't a way that a single model of the scenario produces the 'correct' or 'safest' decision for everyone. Also, there is no good reason that a person of sound reasoning cannot make this decision for themselves.

The decision was made by politicians who only consider public reaction. Public reaction which is decidedly uninformed, and without all data in front of them.

I wish you were right. What you say should have been the case. All over the world though, we see the true nature of high-level decisions.

1. Professionals might have data we don't have - maybe they've used up their stock of AZ but have plenty of other vaccines.

2. They might be making more nuanced calculations. For example, if they've already vaccinated all their high-risk groups, the risk-to-reward trade off for younger groups might be worse.

3. Alternately, they might be being more conservative than you and I. I'm expecting the end of vaccine roll-outs to mean lockdowns and masks end permanently and the entire economy comes out of hibernation, which is a big pay-off. But between the vaccine's less-than-100% success rate, the risk of new variants, people who can't be vaccinated, international travel and so on, they might feel my benefits are too speculative to have a place in their calculations.

4. Healthcare ethics can be a complicated matter, and they've probably spent longer agonising about it than we have. After all, you and I are talking about pulling a hypothetical lever - they're the ones who'll actually be pulling it and cleaning up the splattered blood.

5. They might be particularly worried about the vaccine-hesitant, feeling hesitancy is a bigger risk than the deaths caused by vaccine rollouts taking a few months longer. They might feel the best way to reassure the vaccine-hesitant is to be demonstrably extra-vigilant, rather than providing reassurance that might sound like denial or cover-up.

6. Public health comms has to be inclusive of even the dumbest people in the population. Nuanced, complex messages might get lost in the mix. With this, the message is "WE NOT GIVE YOU BAD VACCINE. YOU GET VACCINE WE GIVE YOU GOOD VACCINE." - very simple!

"Science is the belief in the ignorance of experts. When someone says ‘science teaches such and such’, he is using the word incorrectly. Science doesn’t teach it; experience teaches it" - Feynman.

What you have here is the European "precautionary principle" in action. Whatever you do, don't get blamed for anything - whether you make any forward progress or not.

At 60 you have a 1 in 100 chance of being dead in the next year anyway. A 1 in a million extra risk on top of that is a rounding error.

The zero extra risk option is no longer available.

I've had the AZ jab. It's perfectly fine and does the job. And those downvoting this post are saying that I should be dead instead.

In Denmark, at least among the people I talk to, there isn't much confidence in AZ. The feeling is that Moderna or Pfizer are safer with higher protection (also against mutations).

So the common feeling here is really that the government would fail the population by using AZ instead of the (possibly better) alternatives.

But if the alternative is no vaccine or AZ then it is indeed vastly better to continue using AZ.

Denmark's population is also less than 6 million so they don't need a massive supply compared to larger countries.

I do know one or two things about supply chains. And that knowledge tells me, that German authorities have zero idea what they are doing. If there is a vaccination schedule, I doubt there is one, it is not taken into account during these decisions. Because after ever such decision, nobody talks about the impact on the schedule. Seems to be different for Denmark so.

sure, but there are "professionals" on the other side of the debate that say the opposite. thus, discussions will happen.

also, these kinds of bans automatically lead to people across the planet not getting the vaccine due to fear.

case in point: a hard-hit European country got 1.3 million AZN doses. 800k are unused as no one wants to use them. the population would rather wait for the "good" vaccines :)

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0...

> Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas.

(PS: also, why would they miss a cancer screening when it's literally the only pastime that isn't shut down?)

It assumes that the numbers caused by the lock-downs are bigger than the numbers caused by Covid.

It assumes that there is not positives to the lock-downs (maybe some people is less depressed at home than at their work, not deaths by flu, etc..) and, most important, it assumes that not lock-downs would not increase deaths by other causes (intensive care overworked).

I completely understand the initial lockdowns when we had no data. I would have done that too, although I would have acted sooner because I saw this threat clearly in January - why our governments were less competent across the board than some rando programmer is something I haven't forgiven.

What I don't understand is now that we have data, we're still doing lockdowns with no attempt to publicly weigh the pluses and minuses and justify three decision logically. I mean maybe it's the right thing to do, but I want to see them put some real thought into the decision, and not do it because it's what they're before, or what's politically viable.

There should be a clear logical argument being made, weighing the harms on both sides and choosing the lesser evil.

Enough for what? Hospital capacity was wildly sufficient for regular times, but the pandemic turned that around. Even Germany, which has multiple times the capacity per capita than France, is struggling in that regard. What is "enough"?

> but also to avoid superspreader events

Lol. Events with more than 2000 people outside ( at the best of times, usually it has been flat out forbidden), and 6-100 inside have been forbidden in France since last year. That obviously didn't help.

> Most other lockdown measures are questionable at best, including mandatory mask usage. They are clearly symbolic tools for the political class to signal that something is being done, but the data to support them is not very strong considering that there is not much of a control group.

There is, check the US and Brazil.