Reports of approximately 30 deaths among nursing home residents who received the Pfizer vaccine have been international headlines.
With the Australian Therapeutic Assets Administration (TGA) expected to approve the vaccine imminently and launch next month, this development may seem a cause for concern about vaccine safety.
But there are some reasons why it shouldn’t be.
What we know
We have not seen this problem reported in any other country that is implementing the Pfizer vaccine.
Norway has reported that so far about 45,000 people have been vaccinated against COVID-19 across the country. His immunization program has focused primarily on residential residents.
In other countries, in the first instance more focus may be on front-line health workers. Therefore, if there is any association between deaths in the elderly and this vaccine, it may not yet be evident.
It also depends on surveillance. Norway may have a particularly fast surveillance and notification system in place, which will monitor all vaccinated people efficiently and report adverse results quickly.
We would soon expect surveillance reports from other countries with an active vaccination program to increase key data to build a more accurate picture of vaccine safety among different populations.
Norway’s reports will raise awareness among other countries to closely monitor vaccine recipients, particularly those in older and vulnerable nursing homes. We may see more reports on this in the coming weeks from other countries.
But also maybe not. We have limited information on these cases in Norway. The people who died were old and very fragile. Many had significant underlying diseases, common in old age, and were perhaps about to end their lives regardless of the vaccine.
While being investigated, it is important to note that deaths have not been conclusively related to vaccine complications. Meanwhile, Australian experts have called for calm.
Vaccines and the elderly
In the recent history of vaccines, we have not seen any trend showing death in the elderly after vaccination. For example, there is no evidence that the annual flu vaccine has been associated with deaths in the elderly, or at any age.
However, it is important to note that when making a comparison with the flu vaccine or another vaccine and the Pfizer vaccine for COVID-19, we are comparing apples and oranges.
The Pfizer vaccine is based on mRNA technology, which is completely new in a human vaccine. This technology introduces part of the genetic material of the SARS-CoV-2 virus in the form of messenger RNA (mRNA). This tells the cells to be part of the virus, which stimulates an immune response that inhibits infection and protects against disease.
All vaccines are designed to generate an immune response, albeit in different ways, to prepare our bodies to fight the virus if and when we meet.
Creating an immune response leads to inflammation of the body. Some people will not experience side effects from a vaccine, but inflammation can manifest in different ways in different people and between different vaccines. This can mean a reaction at the injection site, or fatigue, or feeling unwell.
Deaths in Norway were reportedly associated with fever, nausea and diarrhea, which, although at the severe end of the vaccine’s side effects spectrum, would be tolerable for the vast majority of vaccines. people.
How we are beginning to understand now how different people will respond to mRNA. This vaccine may have more serious effects in the elderly and vulnerable, where the initial inflammatory response could be overwhelming.
But it is still too early to draw conclusions.
Side effects show that a vaccine generates an immune response
Vaccines must generate an immune response to function and side effects are a byproduct of our body producing an immune response.
While the deaths are sad, they should not be cause for alarm. In fact, this tells us that the vaccine stimulates an immune response. For most people, this response will be fully tolerable and will lead to the development of immune memory that protects you from severe COVID-19.
The big challenge of any vaccine is to generate a sufficient immune response to protect you from the disease in question, but not too much that you experience serious side effects. Where this line exists in the sand will vary from person to person, but older, more fragile vaccine recipients are likely to have the highest risk of serious and life-threatening reactions.
So for those who may be more susceptible, we might want to be a little more cautious. When approving the Pfizer vaccine, the TGA may consider advising this particular vaccine for very old and frail people, particularly those who have other conditions and who are potentially nearing the end of their lives.
Ideally, the vaccine should be considered on a case-by-case basis for this group, carefully weighing the risks and benefits of each situation, based on the best available data. 
Nathan Bartlett, associate professor in the School of Biomedical Sciences and Pharmacy at the University of Newcastle.
This article is republished from The Conversation under a Creative Commons license. Read the original article.