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Thanks. Agreed that vaccinating the elderly first is a reasonable strategy, though it would also be smart to hit the people that spread the most (the "hubs" in a graph of physical interactions). I'm trying to go through the rough numbers of risk/reward:
Consider the potentially affected group with the lowest COVID death rate - women 20-29 years old. If all get the AZ vaccine, ~10 per million would have a CVST , and 3 would die, using the German numbers, which are higher than other countries. [1] (double these numbers to assume the side effect only affects women, and doses have been evenly distributed. Double them again to assume that this side effect only affects <65 years old, and doses have been split between the elderly and younger medical workers [2]). If the COVID IFR is for 20-29 year olds is 0.01% [3], that's 100 per million that would die if infected. Maybe the IFR is lower for women, and with some effective treatments (dexamethasone, early recombinant antibodies) becoming available, but maybe it will be ~50% higher with prevailing variants. So this vaccine may kill 12 per million women but save 100 per million. But the 100 per million is an unfair comparison - presumably less than the entire population will be infected while waiting for a different vaccine. Assuming 1/4 of infections are detected, there are 1000 new infections per million in Germany each day. It would take 120 days to infect 12% of the population and kill as many with this side effect as would have been saved by the vaccine, so if it will be a delay of less than four months to switch vaccines for this group, stop giving AZ and wait for another vaccine! Huh, I didn't really expect this result, and for older age groups, the crossover point will come much sooner. Germany has decided that it only makes sense to only for 60+ year-olds, and maybe that's the right call, but I really wish they would be transparent about the reasoning. [1] https://www.pei.de/EN/newsroom/hp-news/2021/210319-covid-19-...
[2] https://www.statista.com/statistics/1195611/coronavirus-covi...
[3] https://pubmed.ncbi.nlm.nih.gov/33289900/ |