Women and COVID vaccination

Vaccines are the best news to emerge from the ongoing COVID-19 pandemic. The rapid and successful deployment of the new vaccines offers a way to limit the devastating effects of the pandemic – for men at least. 

Unfortunately, the recent reports of thromboembolic events (clotting) may raise new concerns amongst the unvaccinated. These reports initiated with vaccines based on the adenovirus RNA, for example, the Johnson and Johnson/Janssen vaccine and the Oxford AstraZeneca (AZ), and now include the Pfizer and Moderna vaccines.

Vaccines were designed to minimise mortality and hospitalisations – not eradicate the virus


If it weren’t enough, as I wrote last month, that misinformation abounds about the effect of vaccination on subsequent pregnancy, women are now being targeted with scare tactics about clotting, especially in the brain, and breakthrough infections with the Delta variant.

The facts speak for themselves without the scare rhetoric. There is some risk in everything we do – that is called absolute risk. However, it is important to place the risk into perspective – that is called relative risk.  This is especially so for women because there is so little data specifically to help us. 

The relative risk of a brain haemorrhage following the AZ vaccine is approximately 5 per one million doses, which is lower than the number of brain haemorrhages observed in the last 3 years of influenza vaccinations. The AZ results are also much lower than the risk amongst current oral contraceptive and hormone replacement users. Women on hormonal products are three times as likely to suffer from clots than those not using these products.  

All of the 12 reported patients who had brain haemorrhages after vaccination were women younger than 60 years. Seven had known risk factors for clotting – obesity, thyroid disease and oral contraceptive use.  Whether they were using HRT was not reported.

It is a shame that the message of diversity in research is still in its infancy.  Now, more than ever, when vaccination can help limit mortality from COVID, very little attention is being paid to prevent women dying from COVID through protective vaccination. Perhaps the lack of specific data can work to our benefit. In addition to the groups already identified at risk, women on hormones should consider taking 325mg of aspirin with each dose of vaccine. That makes the platelets in our blood, which are largely responsible for the clots, less sticky and clotting in the short term.

Also, it is important to remember the limitations of COVID vaccination. The COVID vaccines were designed to minimise mortality, morbidity and hospitalizations from COVID infections. Besides, it is known that brain haemorrhage occurs as a result of severe COVID infection anyway. Seven percent of people who get COVID develop clots and that rises to nearly half in those patients who are admitted to intensive care units.

To that end, the vaccines are very effective – even against subsequent Delta variant infections after vaccination. The risk of death and hospital admissions from COVID were reduced by half in vaccinated populations. Women – and men – should consider all the facts when deciding to get vaccinated.

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