After the deaths, the Norwegian Institute of Public Health updated its Covid-19 vaccination guide with more detailed advice on inoculating frail or terminally ill elderly people.
The new guideline says that doctors should evaluate each patient individually to determine whether the benefits of vaccination outweigh the risks of any potential side effects.
As of last Thursday, 42,000 people in Norway had received their first dose of the vaccine. As is the case in many other countries, the elderly and those in nursing homes with underlying health problems are the first in line to be vaccinated, because they face a much greater risk of becoming seriously ill because of Covid-19.
NOMA noted that all deaths that occur in the first days of vaccination “are carefully assessed” and submitted to the Norwegian health record of ADR.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Monday that the deaths must be contextualized with the population in which they occurred – a nursing home with extremely fragile individuals.
Speaking at the Conclave Choosing Healthy Lives of the Black Clergy, Fauci said his understanding was that deaths occurred after the booster dose of the vaccine when there are more nonspecific symptoms, such as pain, fever and malaise.
“It is conceivable that when you have a very fragile individual, like many who are in nursing homes, even that amount of stress for him can put you on alert,” added Fauci.
Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine, said that so far there was “no evidence that any link between vaccination and death in these vulnerable patients is causal”.
Evans told the UK’s Science Media Center that when people at high risk of death are vaccinated, “there will be a number of coincident deaths that will occur shortly after vaccination.”
Regulatory bodies around the world are closely monitoring these fatalities, Evans said, and can calculate the “expected number” of deaths over various time periods.
“We don’t know yet, but it appears that the number of deaths observed is not noticeably above the expected numbers,” he said, adding that “there is no need for anxiety, but complacency is just as wrong.”
Fauci agreed with that assessment, saying the first question is what was the death rate in nursing homes for individuals who never received the vaccine. “Once you do that, you will get the true denominator,” he said.
Of the 23 deaths, 13 have been assessed so far by the Norwegian Medicines Agency and the National Institute of Public Health, the institute said in a statement on Friday.
Sigurd Hortemo, chief physician of the Norwegian Medicines Agency, said the assessments suggest that common adverse reactions to mRNA vaccines, such as fever and nausea, may have contributed to a fatal outcome in some fragile patients.
“We cannot rule out that adverse reactions to the vaccine that occur in the first days after vaccination (such as fever and nausea) can contribute to a more serious course and fatal outcome in patients with severe underlying disease,” added the statement.
Pfizer said in a statement sent to CNN on Saturday that it was aware of the reported deaths and “our immediate thoughts are with the bereaved families”.
Pfizer added that it is working with NOMA to gather all relevant information.
“Norwegian authorities have prioritized the immunization of residents in nursing homes, most of whom are very elderly with underlying medical conditions and some who are terminally ill,” Pfizer said in a statement, adding that NOMA said “the number of incidents so far is not alarming and in line with expectations. “