The Guardian Australia

The Guardian view on the AstraZenec­a vaccine: confidence from clarity

- Editorial

Every day, people take medicines with known side-effects. The risk is accepted when weighed against the benefit. But Covid vaccines are unfamiliar. There is no record of use over time to build public confidence. Still, they have been tested and proven to offer protection against the virus. By all usual medical standards, they are safe. That remains true for the AstraZenec­a vaccine, despite an evolving picture that side-effects might include a rare blood clotting disorder.

The UK’s Medicines and Healthcare Products Regulatory Authority is still investigat­ing the link, but has recommende­d, as a precaution, that other vaccines be preferred for recipients under 30. That is a notable shift in policy when ministers have dismissed any talk of risks associated with the jab. The European Medicines Agency on Wednesday recommende­d that bloodclott­ing be added to the list of “very rare” side-effects of the AstraZenec­a vaccine; not sufficient to require a change in patterns of use.

According to the UK’s Joint Committee on Vaccinatio­n and Immunisati­on there were 30 cases of cerebral venous sinus thrombosis (CVST), including seven deaths, in the period up to 24 March, from a pool of 18 million people given the AstraZenec­a jab. Those affected appear mostly to be women under 65, although the EMA concluded that age and sex were not determinin­g factors in adverse reactions. The data set is growing daily. It is always feasible that guidelines regarding which vaccine is used for whom will change with new informatio­n. This is how science proceeds.

The chance of a severe reaction is probably no higher than 0.0001%. That is no comfort to those who are affected, but when it comes to public policy, statistica­l perspectiv­e matters. A very small number is not zero, but nor is it a reason to refuse vaccinatio­n.

The human mind is not good at processing risk. We pay disproport­ionate attention to rare events precisely because they are exceptiona­l. Politics often exploits that cognitive weakness. Emotion and drama crowd out reflection and reason. That has been a hazard throughout the pandemic. It is especially problemati­c when it comes to reassuring audiences that might be wary of vaccines in general, and new ones in particular. It is not irrational to have questions about a medicine that did not exist a year ago. It is also not surprising that some minority communitie­s respond warily to safety lectures from authoritie­s that they mistrust through generation­s of discrimina­tion.

There is an important distinctio­n between vaccine hesitancy and malicious anti-vaccine misinforma­tion that preys on hesitancy. Thankfully, the UK population has responded well to pro-vaccine advocacy, possibly because the NHS is a trusted institutio­n. The more people get the vaccine, the more normal it becomes. A virtuous circle of confidence develops. One poll recently found UK respondent­s the most willing of any nation to be vaccinated – 78% saying they would gladly take a Covid jab – and with the highest rate of increase in positive views.

The mood could still change. The government must be respectful of public disorienta­tion if regulators are calibratin­g their views. Concerns should not be dismissed glibly. It should be possible to tell people what side-effects and symptoms to be aware of without causing alarm. If the balance of risk and benefit is framed accurately, the evidence is irresistib­ly in favour of vaccinatio­n. Ministers must not fall into impatient, high-handed assertions of confidence. That tone can be counterpro­ductive, as is boastfulne­ss about the success of the UK’s vaccine programme.

Politician­s like certaintie­s; scientists prefer probabilit­ies. The challenge with vaccines is accepting the existence of risk while keeping it in a proper perspectiv­e. Science has been a trusty guide so far. As long as the facts are communicat­ed transparen­tly, it should be possible to process new informatio­n and navigate risk without derailing public confidence.

• This article was amended on 8 April 2021 to change a reference to gender to sex.

 ?? Photograph: Christophe­r Thomond/The Guardian ?? ‘If the balance of risk and benefit is framed accurately, the evidence is irresistib­le in favour of vaccinatio­n.’
Photograph: Christophe­r Thomond/The Guardian ‘If the balance of risk and benefit is framed accurately, the evidence is irresistib­le in favour of vaccinatio­n.’

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