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Which COVID vaccine should I get?



Too long, didn't read: whichever one you can get first.


We're getting this question often lately, and I do speak for all of our physicians when I tell you we are happy to have this discussion. There is a lot of media buzz around the vaccinations for COVID, in particular the AstraZeneca vaccination.


To start with here's a brief primer on the data:



To summarize, every vaccine works well, and so the choice should not be based of of efficacy. Yes, even Johnson & Johnson and AstraZeneca.


More pressing on many people's mind is: "Am I going to get a blood clot?".


Fair question, but the short answer is probably not. The highest statistic I found on a brief literature I performed as of Apr 14, 2021 indicated 5 cases in 130,000 doses given (Roughly 0.000038), and the bulk of those cases noted to be in an already high risk group (women under 55 years of age).


Governmental authorities have made a muck of the public relations regarding the vaccines by pausing and restarting the AstraZeneca vaccine over safety concerns, and have done a great disservice to the public as a result. People SHOULD be getting that vaccine based on the data we have, and now they are hesitant. They have restricted it to certain age groups out of an "abundance of caution", but this is where politics and medicine collide poorly yet again.


Check out what the Canadian Medical Association Journal states about the clot risks associated with COVID itself:


E583.full
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You read that right. We find 20-55% of people hospitalized with COVID have some evidence of coagulopathy. A wide statistical range; I think it's probably closer to the 1 in 4 quoted in the admissions to ICU later in the article.


Fun fact; remember the "COVID toes" everyone was talking about a year ago that seems to have fallen off the radar? Yeah, that's clot-mediated.


So comparatively; the risk of getting a significant clot of some variety from COVID infection (25%) is 6500 times more likely as opposed to the AstraZenica vaccination (0.0038%). Rough math, and the statistics may change as we learn more.


As I've told many of you before; my standard for giving you advice is whatever I would tell a relative sitting the the chair across from me. My father got his AstraZeneca vaccine this week. Perspective.

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