By Roger Chriss, PNN Columnist

The Covid-19 vaccine rollout in the U.S. hasn’t been so smooth or fast. Fortunately, however, the vaccines are proving to be generally very safe. But there have been some serious allergic reactions associated with the vaccines. And in a few tragic cases, there have been deaths.

As a result, it is worth looking closely at what is now known about vaccine safety, in particular for high-risk people such as the elderly and those with compromised immune systems.

On January 3, Florida physician Gregory Michael died 18 days after receiving the first dose of Pfizer's vaccine. He was an otherwise healthy adult who developed acute thrombocytopenia, a severe shortage of platelets, soon after being vaccinated. Michael ultimately died of a brain hemorrhage after a two-week effort to raise his platelet count.

This is the only known case of a platelet crisis after vaccination, but it’s not yet clear if the two are connected. Work to understand what happened is ongoing.

“I don’t know what this is. We’ll keep our eyes open and see if it happens to anybody else,” vaccine expert Paul Offit, MD, told The New York Times.

The Platelet Disorder Support Association released a statement calling Michael’s death “tragic and concerning,” but said patients with immune thrombocytopenic purpura (ITP) “should not be hesitant to be vaccinated.”

“The relationship between the occurrence of severe thrombocytopenia and the vaccination, if any, is uncertain. To our knowledge, this is the first such event reported after over 5 million such vaccinations. Based on the available data, the benefit to risk ratio strongly favors vaccination of all adults, including those with ITP,” the statement said.

There have been a few other deaths worldwide. The Jerusalem Post reported in December on the death of an 88-year-old man who died just hours after being vaccinated, and a 75-year-old who died of a heart attack shortly after getting a shot. Both cases are seen as coincidental and no further deaths have been reported as Israel continues to vaccinate its population.

Norway, however, has seen 29 elderly people die after being vaccinated, all of them over the age of 75. The deaths prompted Norway to suggest that Covid-19 vaccines may be too risky for the very old and terminally ill.

“For those with the most severe frailty, even relatively mild vaccine side effects can have serious consequences. For those who have a very short remaining life span anyway, the benefit of the vaccine may be marginal or irrelevant,” the Norwegian Institute of Public Health said in a statement.

Information about vaccine safety for higher-risk populations is not easy to get at present. For instance, there is as yet no clinical data on what vaccine risks may exist for women who are pregnant or lactating. Without that data, STAT News says “it’s impossible for any organization or expert to say with absolute certainty that there are no risks.”

As of today, over 60 million doses of vaccine have been given worldwide and nearly 20 million in the U.S. Based on the small number of severe adverse events seen so far, this means that the vaccines are extremely safe for the vast majority of people.

Norway and Israel are reporting side effects and outcomes faster than most other nations. Consequently, the recent deaths may be nothing more than an artifact of good public health statistics offering a complete picture of all risks.

But precautions for people who are elderly, frail or otherwise high risk may turn out to be justified. As more data from vaccination efforts worldwide comes in, the risks will be better understood.

Roger Chriss suffers from Ehlers Danlos syndrome and is a proud member of the Ehlers-Danlos Society. Roger is a technical consultant in Washington state, where he specializes in mathematics and research.