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> Just yesterday I had to accompany my sister to the phlebologist, because of severe side-effects from Pfizer, he told us he was seeing troves of patients for similar reasons even though officially no causal-link was established.

This is the issue with correlation vs causation. When you look at sufficiently large group, like tens of millions of people, some percentage of them are going to die for various reasons. Some will have medical emergencies. Some will get cancer. So, you can’t just say “these people got the vaccine and then had this effect”. You have to look at how many were effected and compare that with the “normal” rate.

For instance, venous thromboembolism (VTE) already effects 2 out of every thousand Americans (600,000 cases a year) [1]. So, many people that get a vaccine will also experience some form of VTE because they were going to anyway. However, preliminary information is showing that the mRNA vaccine does cause about a 3 times increase in the risk of VTE, while covid causes about a 15 times increase [2]. For reference, taking hormonal birth control causes a 1.5 to 7 times increase risk of VTE [3]. So just taking birth control can be far more “dangerous” than the vaccine, so I wouldn’t beat yourself up.

[1] https://www.ajpmonline.org/article/S0749-3797(09)00946-5/ful...

[2] https://www.news-medical.net/news/20210801/Risk-of-venous-th...

[3] https://helloclue.com/articles/sex/hormonal-birth-control-an...

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You compare the vaccine to birth control to dismiss the risks of the vaccine, however birth control is taken by sexually active and mature women.

That is people who have a real probability risk and want to avoid getting pregnant. You don't give birth control to 10 year old girls or to boys.

In the OP’s case his sister was in the low risk category (quite young). So its not obvious that a priori the vaccine outweighed the risks. Nor is it obvious that the young have a moral responsibility to to society to take on a personal risk to ameliorate a risk that doesn't affect them (this is unlike a defensive war where, presumably, the defending youth will also suffer devastation if their country is overrun)

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>You compare the vaccine to birth control to dismiss the risks of the vaccine

Or I compare it as a reference to a commonly taken medication to contextualize the risk. I also included a comparison to the disease it is vaccinating against, again, to contextualize. It is also worth noting that the absolute risk amounts to about 4 additional cases of VTE per 100,000 people that are vaccinated.

>In the OP’s case his sister was in the low risk category (quite young). So its not obvious that a priori the vaccine outweighed the risks.

Between 12 and 115 children end up hospitalized with covid per 100,000 total child population, not per 100,000 that catch covid (which is 1,900 per 100,000 infected children) [1]. So the risk of catching covid, and having a case severe enough to end up hospitalized, is far higher than your chance of VTE from the vaccination. So I find it odd that you would describe those odds as “low risk” for covid. And yes, its pretty obvious the vaccine outweighs the risk.

[1] https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19...

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I'd imagine a phlebologist is in a good position to know the difference between correlation and causation with regards to their practice and their patient population.

Thanks for the links about VTE, that's interesting, I don't know if it's precisely what my sister has. Though I don't remember reading about it on any of the official websites I consulted regarding possible side-effects.

I'm mostly feeling dumb about convincing her using incomplete data at an age at which I'm not sure the vaccine is critical, the doctor having told me these side-effects are common and not being reported.

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>I'd imagine a phlebologist is in a good position to know the difference between correlation and causation with regards to their practice and their patient population.

Well, you would be wrong. Someone’s intuitive estimation of a section biased sample from an unknown total sample size compared to their memory from years ago is basically guessing. That is exactly why studies need to be conducted, with literally millions of people, and differences measured in a handful of people per 100,000, it is the only way to get any sort of useful data.

>the doctor having told me these side-effects are common and not being reported.

I don’t even understand what they mean. They or you can and should report it to VAERS. Its entire function is to collect data on these things so scientists can look into possible causations.

[1] https://www.cdc.gov/vaccinesafety/ensuringsafety/monitoring/...

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> Well, you would be wrong.

You're overly confident for an assertion that relies on your belief that someone with decades of medical experience would be ignorant of these basic statistical pitfalls. Not that all doctors do research but I learned that stuff in my first year in the health industry and I can assure you that doctors are in general very knowledgeable about their patient base and the diseases they treat.

A symptom with a 1 in 100 000 occurrences would result in about 800 cases in my country. Arranged according to demographics, divided by the number of phlebologists in these areas, and the baseline prevalence of these symptoms you can start to make an informed guess as to what amount is "normal".

I don't know if we use VAERS at all being in Europe. I know there was some talk of our reporting system not being interested in non-severe symptoms because of the labour cost of evaluating reports. In truth I don't know exactly what they meant, drugs aren't my domain of expertise and they didn't elaborate. But assuming this doctor is trustworthy in their assessment and intent when they speak of troves of patients with these symptoms and complain of this lack of reporting, it's evidence of a dysfunction somewhere seeing as those side-effects aren't advertised on official channels.

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>A symptom with a 1 in 100 000 occurrences would result in about 800 cases in my country. Arranged according to demographics, divided by the number of phlebologists in these areas, and the baseline prevalence of these symptoms you can start to make an informed guess as to what amount is "normal".

But things aren’t normal. Travel patterns have completely changed due to covid, so less or more people might be visiting a clinic than previously. People have been far more sedentary compared to previous years, a key risk factor for VTE, which could increase individual risk by as much as 30%. Covid itself causes VTE, so people with diagnosed and undiagnosed earlier cases of covid would increase the numbers.

> You're overly confident for an assertion that relies on your belief that someone with decades of medical experience would be ignorant of these basic statistical pitfalls.

Even in well thought out, carefully conducted studies, biases and confounding factors can cause serious issues. These aren’t “basic statistical pitfalls”. These are things that even the smartest people cannot account for without conducting an actual study with actual controls and randomization, actual statistical analysis, actual identification of confounding factors, actual reanalysis accounting for those, and actual peer review to make sure there were not issues you did not think of. I’m confident because I know that we do medical studies because we know that even the smartest people cannot just eyeball changes in incidence rates and cannot know which of many factors is likely causing the change. Even experts have human biases and we require the structure and rigor of studies to help mitigate them. I’m not confident that I am more knowledgeable than a doctor, I’m confident that the people much smarter than me developed evidence based medicine because they understood that no one is above bias, even your doctor.

>I don't know if we use VAERS at all being in Europe.

For Germany, you can report possible side effects here [1] which goes to the Bundesinstitut für Arzneimittel und Medizinprodukte (Federal Institute for Drugs and Medical Devices) and The Paul-Ehrlich-Institut (Federal Institute for Vaccines and Biomedicines). If I was incorrect and you are in another European country, you can find your reporting agency from the EU website here [2].

[1] https://nebenwirkungen.bund.de/nw/EN/home/home_node.html

[2] https://www.hma.eu/nationalcontacts_hum.html