Extract from ABC News
The mortality rate from a rare blood-clotting disorder linked to the AstraZeneca COVID-19 vaccine is nearly a fifth of what experts originally thought it could be.
Key points:
- Experts say widespread awareness of the symptoms of clots means people are seeking medical help quickly
- They say it means treatment, even of severe cases, is more effective
- People are more likely to get blood clots from COVID-19 than from the vaccine
Earlier this year, as data emerged from overseas about the disorder — called TTS for short — it was estimated that the chance of dying if you developed a clot was about 25 per cent.
In Australia, 11.3 million doses of the AstraZeneca vaccine — now called Vaxzevria — have been administered, with a total of 141 people developing a confirmed or probable case of TTS linked to the jab.
Out of those 141 cases, eight people have died of the clots, or around 5.6 per cent.
In the UK, the rate of dying from TTS was 17 per cent. However, research published in August showed in one study it was as high as 22 per cent.
So, how has Australia kept its rate so low?
Learning from overseas
The head of the national medical regulator, the Therapeutic Goods Administration (TGA), John Skerritt, thinks it is a combination of a few things.
First, we were given a heads-up by what was happening in the UK and Europe.
"They'd vaccinated more than 10 million people before we had started to see possible cases," Professor Skerritt said.
"We also have been able to pick up more less mild cases."
Professor Huyen Tran, a haematologist at Monash University, agreed having information from other countries early on made a big difference.
"I think initially following what we were seeing in Europe I was expecting a higher fatality rate, but I think I'd caveat that by saying they had a much longer run-in," he said.
"So that awareness, that understanding, is difficult early on, so we had that luxury of learning from other places."
Having a national hospital system that has not been completely overwhelmed by COVID-19 cases has also been crucial, allowing people who need treatment to access it quickly.
At the time of writing, 121 people have been discharged from hospital after being treated for TTS, 12 are still currently receiving treatment, but none are in ICU.
Both professors reiterated that the likelihood of even developing a clot is extremely rare and the benefits of protection from COVID-19, and its potentially long-lasting impacts, for most people, outweigh the risk of TTS.
Media coverage raised awareness
Professor Skerritt pointed out the extensive coverage of the rare clotting disorder early on may have played a role in reducing the fatality rate too.
"We are talking about something that is still extremely rare," he said.
"The chance of death after a COVID vaccine in general is still well less than one in a million and there are things like being hit by lightning which are more common than that.
"So, they'd go and see their doctors and hospitals early if they had, say, a really bad headache after getting the vaccine."
Professor Tran also believes the heightened awareness of symptoms has played a role in the successful treatment of clots in younger people, which tend to be more severe.
"I can think of an immediate example. The youngest individual that I've been involved with is actually a 22-year-old female," he said.
"She presented to the emergency room within about 18 hours of the onset of symptoms with some insistence from her family. We picked up [on signs of TTS] that day and it was critical.
"She's done remarkably well so I think early diagnosis … is really, really important."
The other piece of the puzzle is that, according to both Professor Skerritt and Professor Tran, our ability to treat the disorder has also meant fewer deaths.
"It's a condition that we now know we can treat really well," Professor Tran said.
"The combination of education, early recognition, has meant early therapy [which] has led to a really good outcome."
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