Risk!

Ragnar Lofstedt (King's College London) looks at public perceptions of risk surrounding the perceived 'dangers' of the Oxford/AstraZeneca Covid-19 vaccine (https://www.theguardian.com/commentisfree/2021/apr/09/covid-vaccine-safety-risk-perception-reality-az-jab). Lofstedt essentially considers whether the UK decision to offer alternative vaccines to the under 30s, is the right one (spoiler alert! yes and no). The current concern was generated by 79 reports of a rare clotting event with 19 deaths. Lofstedt applauds the clarity of Professor Jonathan Van-Tam who described the clotting events as a "vanishingly rare but sadly quite serious adverse effect". The conundrum is that the under 30's are a) apparently more likely to get blood clots and b) very unlikely to have a life-threatening infection with Covid-19. The costs versus benefits calculation is different than in the case of older cohorts. But we need young people to be vaccinated, to reduce chances of new variants and waves of infection in our populations. A variety of sources have pointed out that people are much more likely to die by falling downstairs or by choking on their breakfast. I well remember a lecture, where I was told that the most dangerous thing I did each day, was to put my trousers on (there is a serious chance of breaking a leg in the process). Taking a long-haul air flight, is much more likely to cause deep vein thrombosis (a clotting event) than any event linked to the vaccine jab. The risk of blood clots is also much, much higher in women, when they take the contraceptive pill or become pregnant. Lofstedt reiterates that people have a very imprecise understanding of risk. For example, they assume that car journies are less dangerous than air travel (the opposite is true, based on a mile for mile comparison). Lofstedt notes, however, that people respond differently to risk when it is voluntary or involuntary. Novelty also magnifies the perception of risk. Unfortunately, the perceived risks associated with receiving the vaccine are both involuntary and novel. Lofstedt emphasises that Public Trust is paramount, if we want to maximise the uptake of vaccinations (it's the only way we can ever hope to be free of Sars-CoV-2). As Public Trust has to be protected, he feels the decision was broadly right, even when the risks are "vanishingly rare". There is, of course, always the possibility that some of the alternative vaccines offered will come (but which will be only seen with increased use) to also be associated with adverse effects. So, clarity and honest dialogue are needed to maintain Public Trust.