We’ve lost our ability to put risk in perspective when it comes to AstraZeneca COVID-19 vaccine

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After more than a year of soul-battering pandemic life, every molehill is starting to feel like a mountain.

We’ve reached the point where we seem to have totally lost our ability to judge risk rationally.

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A striking example is the reaction to news that some coronavirus vaccines may cause blood clots in rare instances. Day after day we read headlines about the AstraZeneca and Johnson & Johnson vaccines, each more alarming than the last.

The U.S. paused use of the J&J shot; Denmark stopped using AstraZeneca vaccines altogether.

Anecdotally, we know that a growing number of Canadians are refusing the AstraZeneca vaccine, or simply staying away from clinics.

All this because of very rare side effects. Out of 6.8 million J&J recipients, six women suffered blood clots; there have been 222 reports of clots among 34 million recipients of AstraZeneca jabs.

As many scientists have observed, you have a greater risk of being badly injured in a car crash while driving to your vaccination appointment than actually being harmed by a COVID-19 vaccine. Drugs we take every day – Tylenol, birth-control pills, heart medications, sleeping pills – all have potentially severe side effects. We generally accept those risks, or at least don’t think of them. Why do we expect vaccines to be magically problem-free when we don’t expect that of other drugs?

Part of it is human nature. We don’t worry about common risks because it would drive us crazy. We fret about rare problems because, well, they’re rare. For example, people are far more fearful of being attacked by a shark than they are of drowning, although the latter is far more likely than the former.

You have to feel for regulators trying navigate the not-shark-infested waters because they find themselves in a no-win position.

We can, like Denmark, toss the AstraZeneca vaccines overboard because of our trust issues. Doing so leaves the impression it’s unsafe, which it’s not.

We can, like Canada, stay the course and continue using the vaccines. The risk there is people having doubts and staying away from vaccination clinics.

Perception matters. So too does the situation on the ground.

The large majority of shots in Denmark are Pfizer, which has no reports of clotting issues. Abandoning the use of AstraZeneca’s shot will delay the vaccination campaign by a couple of weeks, which is not a big deal in a country where virus spread is minimal right now.

Canada is a different story, sort of. The large majority of our vaccinations to date have been Pfizer and Moderna, and we have contracts for 120 million doses in total. If we abandoned use of AstraZeneca and J&J, we would still get everyone vaccinated, but do it more slowly.

Is that politically palatable in this country, especially as a third wave rages? Likely it is not.

So the best we can do is forge ahead, as Health Canada has wisely decided. Keep using the vaccines we have, and urge people to get whatever vaccine is available, with few exceptions.

As with everything COVID-related, messaging matters. Politicians, public-health officials and media should not stop talking about these safety issues, as some have demanded. Sticking our heads in the sand is not the answer. We should always err on the side of transparency.

But we also need to do a better job of providing context and nuance.

“The benefits of vaccination far outweigh the risks” and “COVID-19 is far more likely to cause blood clots than a COVID-19 vaccine” are phrases that have been repeated like mantras. That needs to continue.

Similarly, we have to clearly state the trade-offs. If we don’t want a specific vaccine, individually or collectively, then the result will be waiting longer.

Humans don’t like uncertainty. Never knowing what’s coming next – our COVID-19 reality – is unnerving.

Dan Gardner, author of the book Risk: The Science and Politics of Fear, states the problem succinctly: “Monsters are scary. Not knowing if there is a monster is even scarier.”

This pandemic may be monstrous, but the vaccines that are our best hope of getting out of it are not. So keep rolling up those sleeves – and drive carefully on the way to the clinic.

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