COVID, clots, and contraception
Updated: Mar 16, 2021
Welcome to a bio-medical-social-rant edition of Microbial Mondays. This one is a commentary on the recent public fear about the 30 in 5 million (less than 0.001%) chance of getting blood clots with the AstraZeneca vaccine. I would like you to consider the case of birth control pills.
I found this interesting scientific review from 1978 that says, "Problems such as hypertension, increased tendency to clot, a rise in triglycerides, and a decrease in glucose tolerance occur in 5-10% of women of any age who take oral contraceptives for 5 years. These factors in turn are responsible for complications such as thromboembolism, heart attack, and stroke which occur with increased frequency among OC users. Most who take OCs suffer more subtle disturbances in blood pressure, and biochemical and hormonal levels which may pose additional risks for cardiovascular disease."
Sounds pretty bad, right? But when is the last time you heard somebody worry about making better birth control pills for women? If you're like most women, these side effects are something that your doctor mentions briefly in passing upon prescribing the medication. If you're like most men, you probably had no idea that these side effects even exist unless you've had a partner experience them.
So why is this? Well one answer is, as the same scientific abstract suggests, that "the risks of oral contraceptive use often outweigh the benefits, however, prudent use of OCs will improve the balance between risk and benefit." In plain language, the authors suggest that sometimes risk is necessary or desirable. You take a risk every time you get into a car. According to the Insurance Information Institute, your lifetime odds of dying in a car could be so high as 1 in 608. But people get into cars every day. Why do we do this seemingly illogical act? Because sometimes the risk of not getting into a car feels greater: the "side effects" of not entering your car could be things like not being able to get to work and losing your job, or missing out on social activities with friends or family.
My point is, whatever choices you make in life, there will always be risks involved. Many times we humans make emotional choices that prioritize immediate benefits over potential future harms. So to address this point, let's paint a picture of the risk of NOT getting the AstraZeneca vaccine. Some possibilities that could result from people avoiding this particular vaccine include:
There are bigger delays in getting the population vaccinated with other SARS-CoV-2 vaccines. This means that lockdowns are extended, more people die unnecessary because the population is not vaccinated as quickly, and more small businesses close with the extension of social restrictions.
By delaying getting vaccinated, you yourself have a higher chance of contracting the SARS-CoV-2 virus itself which leaves you with a much higher risk of death than that of the vaccine.
Besides getting infected yourself, delaying getting vaccinated also means that you put everybody whom you see on a daily basis at a higher risk of disease or death. In other words, by delaying vaccination, you increase the total risk of deaths amongst your loved ones.
In my opinion, these potential risks outweigh the very small risk of thrombosis. But that's just me.
There is still one other thing I would like to address. Personally, this recent outrage over the risk of thrombosis after vaccination has made me a bit mad. Maybe even more than a bit mad. I want to know, why has nobody been outraged over the fact that hormonal birth control pills greatly increase womens' risk for blood clots? Why, I ask, is this risk totally acceptable for women, but not society as a whole, as is the case for the AstraZeneca vaccine? At least in order to appear morally and logically consistent, I would request that if anybody is still concerned about the risk for blood clots following a prick with the AstraZeneca vaccine, please consider also advocating for research on new and improved oral contraception options. Maybe if there was equal public concern for women's health on this matter, we could try to achieve such low incidence of thrombosis after taking the birth control pill, as there is for getting the AstraZeneca vaccine.
That's all the sass and science I've got for you today.
Thanks for reading, and until next week - stay active! It reduces your risk of thrombosis.