(Image: ABACA Press/Robin Utrecht)

The Norwegian Institute of Public Health has updated its COVID-19 vaccination guide for inoculating the elderly or frail after 30 aged care residents died shortly after receiving the Pfizer vaccine.

Investigations have so far found common adverse reactions of mRNA vaccines like fever, nausea, and diarrhoea may have contributed to 13 of those deaths. The residents were all aged over 75 and had either months or weeks to live. More than 42,000 people have received the vaccine in Norway.

It’s not yet known whether these deaths are directly linked to the vaccine, or whether there’s cause for alarm. Similar outcomes have not been reported in other countries where the Pfizer vaccine has been widely distributed, including the UK, US and Israel.

Coincidence or connection?

Norwegian Medicines Agency medical director Steinar Madsen told medical journal BMJ the link between the deaths and the vaccine wasn’t clear. 

“It may be a coincidence, but we aren’t sure,” he said. “There is no certain connection between these deaths and the vaccine.”

Australian National University Professor of Immunology David Tscharke told Crikey there were a lot of factors to consider.

“The problem is in the period of time after someone is vaccinated all sorts of things can go wrong,” he said, pointing to pneumonia and issues around care.

“Just because you get vaccinated doesn’t mean all of the other reasons go away as to why you might die or get ill.”

But, he added, the fact deaths had only been reported in Norway was unexpected.

“It is surprising to find a single location where something happens,” he said.

Australian regulator on alert

Health Minister Greg Hunt has said the government has requested the Therapeutic Goods Administration (TGA) seek extra information from Pfizer and the Norwegian medical regulator.

Foreign Minister Marise Payne has also tasked the Department of Foreign Affairs and Trade with seeking advice directly from the Norwegian government, and Acting Prime Minister Michael McCormack has also been briefed. 

Based on that information, the TGA “might choose that a vaccine would apply in certain age groups or not to people in certain immune conditions,” Hunt said.

The vaccine rollout timeline is not likely to be affected and Hunt stressed that the US, which has administered over 1.8 million doses, had been reporting very positive safety and efficacy results.

“But we’re proceeding with an abundance of caution,” he added.

Transparency is crucial

While the deaths might be shocking, La Trobe University social psychology lecturer Dr Mathew Marques tells Crikey transparency in reporting even possible connections was important.

“Keeping the public informed is crucial,” he said.

Marques, who studies conspiracy theorists, said while the deaths might be used by some vaccine hesitancy groups to support their arguments, these groups remain in the minority, especially in Australia.

“Being clear about efficacy and concerns people have had in the past with other vaccines are likely to be much more influential factors in terms of public trust,” he said.