Norway Moves to Calm Vaccine Anxiety After Elderly Deaths

(Bloomberg) -- Health authorities in Norway sought to allay safety concerns raised by the death of some elderly patients after they were vaccinated against Covid-19, saying there’s no evidence of a direct link.

The initial reports from Norway raised alarm as the world looks for early signs of potential side effects from the vaccines. Although doctors say it’s possible that vaccine side-effects could aggravate underlying illnesses, they were expecting nursing-home residents to die shortly after being vaccinated because deaths are more common among the frailest and sickest elderly patients.

“Clearly, Covid-19 is far more dangerous to most patients than vaccination,” Steinar Madsen, medical director at the Norwegian Medicines Agency, said by phone on Monday, adding that a connection between the vaccine and the deaths is difficult to prove. “We are not alarmed.”

In Norway, 33 people aged 75 and over died following immunization, according to the agency’s latest figures. All were already seriously ill, it said. The Scandinavian country has already inoculated almost all of its nursing home population, with more than 48,000 people vaccinated as of Monday afternoon.

The reported fatalities are well under 1 out of 1,000 nursing-home patients to be vaccinated, he said. The side effects of immunization can, in some cases, “tip the patients into a more serious course of the underlying disease,” Madsen said. “We can’t rule that out.”

Hong Kong Request

Other countries, including Germany and Israel, have also reported deaths in people who recently were vaccinated, without identifying causal links. Hong Kong’s government-appointed vaccine advisory panel said Monday that it’s seeking more data from the Norwegian and German governments on incidents involving the Pfizer-BioNTech shot, which has been approved in the territory.

Experts on vaccines and aging had predicted early on that deaths after vaccinations in high-risk patients might cause confusion.

“Frail, older adults die, and die often, and I don’t think people realize that,” said Keipp Talbot, an associate professor of medicine at Vanderbilt University who advises the U.S. Centers for Disease Control and Prevention on vaccine use. “My concern was that we would introduce vaccine, and people would think it was killing people.”

Talbot was the only person on the CDC advisory panel to recommend against offering Covid-19 vaccines first to old and sick people in nursing homes -- not because she was concerned they’d be harmed, she said, but because she was concerned that inevitable deaths shortly after shots would lower trust in the vaccines. Talbot said she also thought it might be a better use of scarce supplies to immunize the people surrounding the old and sick.

One key metric would be to compare the number of people who would typically die in a nursing home with the number who die shortly after getting a Covid vaccine, Talbot said.

Daily Deaths

“It is important to remember that about 45 people die every day in nursing homes in Norway, so it is not a given that this represents any excess mortality or that there is a causal connection,” Camilla Stoltenberg, head of the Norwegian Institute of Public Health, said at a press conference on Monday.

Until Friday, Norway had only used the vaccine provided by Pfizer Inc. and BioNTech SE. The companies are now working with the Nordic country to look into the deaths. The first Europe-wide safety report on the Pfizer-BioNTech vaccine is due to be published at the end of January.

What Bloomberg Intelligence Says...

“The concept of limiting Covid-19 vaccinations to those below 75 years of age isn’t supported by the U.S. data covering over 14 million people inoculated, our analysis shows, despite Norway reporting a much higher death rate after using the Pfizer-BioNTech vaccine. Norway’s excessive deaths suggest they are in subjects with serious, uncontrolled illnesses.”

-- Sam Fazeli, Bloomberg Intelligence Senior Industry Analyst

--Click here for the full report

Madsen said he isn’t expecting a different outcome with another vaccine, from Moderna Inc., which was introduced in Norway on Friday. Like the Pfizer-BioNTech shot, it uses messenger RNA technology that teaches the body’s cells to fight off infection.

The Norwegian Medicines Agency says it made clear before the vaccination program started that “it is expected that deaths will occur in a time-related context with vaccination” for the “oldest and sickest” people receiving inoculation.