An unsettling report claiming 23 elderly deaths in Norway after receiving COVID-19 vaccine doses made headlines that sow fears among older adults most vulnerable to SARS-CoV-2. The report, downright disturbing as it was, didn’t tell the full story.

What came next were scathing commentaries harping on COVID-19 vaccine safety and how the global vaccine push is apparently losing its momentum.

The deaths of elderly vaccine recipients occurred during vaccinations of Pfizer-BioNTech COVID-19 vaccine, BNT162b2, in the Nordic country – where over 400 deaths from COVID-19 are being recorded weekly. Experts surmised the elderly may not have been accorded enough immunity from circulating high viral load within days of their first doses.

Dr Steinar Madsen, medical director at the Norwegian Medicines Agency,  downplayed the reports saying there is no evidence of a direct link between the string of elderly deaths and the BNT162b2 vaccine. “COVID-19 is far more dangerous to most patients than vaccination.”

He said all those seniors were 75 years and older, with serious underlying diseases, and health authorities made it clear from the start that deaths will occur –  in a time-related context with vaccination – among the oldest and the sickest individuals receiving the jabs. Madsen is not expecting a different outcome with other vaccines.

No cause for alarm, says WHO

Following a review of the deaths, the WHO GAVCS COVID-19 Vaccine Safety subcommittee also ruled out unexpected or untoward increases in the deaths of frail, elderly individuals after receiving the jabs. “The reports are in line with the expected all-cause mortality rates and causes of death in the sub-population of frail, elderly individuals,” it announced on the WHO website. “Available information does not confirm a contributory role for the vaccine in the reported fatal events.”

The committee affirmed the benefit-risk balance of BNT162b2 being favourable to the elderly, hence no revisions to the recommendation around the safety of the vaccine were suggested. 

“Countries should continue to monitor the safety of vaccines, and promote routine after-care following immunization, consistent with good immunization practices for any vaccine,” the committee said, adding it will continue to look for early signs of potential adverse events as the COVID-19 vaccines are rolled out globally.

High chances ‘they’ve missed the boat’

Dr Sharon Inouye, a geriatrician at Harvard Medical School, Boston, Massachusetts US, has sounded the alarm early in the vaccine trials. “A substantial proportion of studies may be excluding older subjects, purposely or inadvertently,” she said matter-of-factly. “When these trials are over, I don’t want to see that there’s no one in them over 75. If they create a vaccine or a drug that works well [only] in healthy 50- and 60-year-olds, they’ve missed the boat.”

Elsewhere, many complained of vaccination chaos amid competing imperatives – getting  as many doses as possible out quickly and getting those at most risk protected first. The Philippines will not be able to choose which vaccine to get, and trust over vaccine safety may be the  biggest hurdle for the country.

In Hong Kong, health authorities warned of rebound infections, noting a slight jump in COVID-19 cases recently. Malaysia also grapples with a surge in cases, recording a new daily high of 4,275 cases on January 23.

100 million cases, 2 million deaths worldwide

The global case count has already passed 100 million on January 26, with more than 2.1 million reported deaths, according to Johns Hopkins University’s COVID-19 dashboard.

More than 71.3 million vaccine doses in 57 countries have been administered as of January 27, roughly 3.57 million doses a day on average.

Countries are doing their best to make vaccination efforts up to speed and get the pandemic under control. In the direst of situations, any delay in the vaccine roll-out will have enormous human costs.