As part of the Cause and Effect forum, I interviewed William by video in February 2022. Prior to the interview, he and Kate, his wife, had prepared an intake form laying out William’s prior history and his reactions to the vaccines he had. They gave me a letter from his family doctor outlining his prior medical history and discharge summaries from recent admissions to hospital.
William was 65 at the time of his first vaccination. He had retired from business a few years before but both he and Kate were physically and socially more active than ever, with multiple interests, one of which was travel.
Prior Medical History
William has been fit, slim and healthy with no significant diseases. Like huge numbers of us he has been on prior treatment for cardiovascular risk factors, mildly raised blood pressure and lipids, perhaps started because he had been a smoker 15 years previously but abstinent since.
Ten days prior to vaccination, he developed cellulitis in his right foot and was treated with cephalexin 500mg.
He has had all prior vaccines with no history of difficulties. William and Kate were happy to get the vaccine, as travel is important to them.
William and Kate had a first dose of the Moderna vaccine in April 2021. She had some pain in her left arm, he had no problems. She had a follow up dose in early August with a sore arm and feeling slightly worse the day after. He had his second dose two weeks later and had a sore arm and was achy.
Shortly after the first dose, they had a phone call to tell them that a restaurant they had been in after vaccination had reported a case of Covid. Five days after the vaccine, William showed signs of a Covid infection, with Kate showing something similar the day after.
They initially thought they had an allergy rather than Covid and got tested because of the contact tracing. Kate recovered quickly but William got worse and was admitted to hospital and subsequently to ICU where he spent nearly 2 months in a semi-coma. It was a worrying time for his family.
But he emerged remarkably well. He was discharged with the expected symptoms of fatigue, progressive weight loss and with occasional oxygen supplementation for a week. But with physiotherapy and osteopathy input, he regained strength and got back to walking energetically and engaging with life again. His blood pressure was monitored regularly and was stable and normal.
A medical friend suggested that the natural immunity he had from his Covid infection should mean he didn’t need the second dose. But Kate had also had Covid and a successful second dose and both were aware that vaccine passports were required for travel. There was also growing anxiety about the threat the new Delta variant posed. William opted to have the second dose.
Two days later, he developed a weakness of his right side and language difficulties. He was brought to the ER, where a scan was done that showed a left-sided intracranial bleed. His blood pressure was raised at the time and he was told that the bleed was caused by his blood pressure.
On the other hand, William’s blood pressure had been stable all August, and he has white coat syndrome and was frightened at being back in hospital. His blood pressure settled even while he was in ER.
The neurological ward was full – more patients than usual were having strokes and an overflow ward was opened up.
William was transferred from neurology to Rehab two weeks later and spent two months working on recovering. He made remarkable progress and has continued to do so. His blood pressure remains stable.
William and Kate have been of the view that it is difficult to establish a firm link to the vaccine but equally that this cannot be ruled out.
There are a growing number of reports of haemorrhagic stroke following vaccination with mRNA agents.
It is more likely that this haemorrhagic episode was triggered by the second dose of vaccine rather than by blood pressure risk factor. Remember a risk factor is not a disease.
In William’s case there is of course the extra element of a severe Covid infection which may have been a predisposing factor. Given the infection was so recent, it may also have been a contributory factor leading to antibody overload.
Given the substantial case that can be made that vaccination caused William’s problem, he felt threatened by doctors, all of whom he liked, advocating he have a booster dose when it became available. It’s a jungle out there.
William will not be having a booster. See Strangers in the Room on RxISK.
In July 2021, the San Francisco Chronicle published a striking article by Michelle Mello, a Stanford law professor. The similarity in the medical event and the question her story raised about further vaccination maps onto William and Kate’s story.
Michelle is a believer in vaccine mandates and her article has stumped many anti-mandate people because of the argument she offers against making a link between vaccines and injuries.
A few days after receiving his second COVID vaccination, my husband woke up seeing double. He’d been feeling unwell, but this new symptom seemed odd.
Should we come into urgent care, we asked our doctor. No, the emergency room, we were told. Twelve hours later, a brain MRI showed a tiny white spot. My otherwise healthy 45-year-old husband had had a small stroke.
Even after what one doctor called “a million-dollar workup,” no one can figure out what happened. The hunt for some underlying condition turned up nothing. The vaccine he got hasn’t been associated with stroke.
Maybe we should report it to the Vaccine Adverse Event Reporting System, the database that tracks events possibly related to vaccines, I said. The hospital care team shifted uncomfortably.
As a health policy professor who works on vaccination issues, I knew why: Anti-vaccination groups are combing those reports looking for tidbits to support their claims that the vaccines are unsafe. They’re wildly misconstruing the data, leaping to unfounded conclusions about causality — and the Tucker Carlsons of the world are helping them. Still, I worship in the church of data. The report went in.
A harder decision lay ahead. The same day my husband checked into the hospital, the vaccine was recommended for my son’s age group — and he was eager to get it.
A year of Zoom school, canceled vacations, and staring at his aquarium instead of playing with friends had made him uncharacteristically excited at the prospect of a needle jab. But even though I’m a vaccine proponent, the thought of putting this thin, pale boy at the front of the line was unnerving.
The scientist in me knew I should be hesitant to surrender to my hesitancy. I had just finished teaching a class on biases in risk assessment, discussing research on how humans tend to err in sizing up risks and making decisions. People give too much weight to rare risks that happen to be top of mind because we’ve just heard a news story about them or we know someone they happened to.
We’re also prone to omission bias, or higher tolerance for risks arising from inaction than for those arising from affirmative acts. And then there’s hindsight bias — the tendency to see things differently from the rearview mirror, believing past events were more predictable than they really were. My husband pushed the mirror aside and said he’d still make the same decision if he had to do it over. For me, it was hard to look away.
I also knew estimates of vaccine risks represent average risks in the population. What if our family wasn’t average?
A vaccine expert and two other doctors told me they couldn’t imagine how our genes might elevate risk for our son. It would be reasonable to go ahead, they said. But it would also be reasonable to wait. More data on teens would be coming as the first wave of them got vaccinated. But as far as we know, the doctors said, the risk your son faces from COVID is higher than the risk from the vaccine.
Michelle went ahead and got her son vaccinated. There were no problems. The Full Story is Here.
Thinking Fast and Slow
What we now know about the failings in our assessments of risks that Michelle refers to began with the work of Daniel Kahneman and Amos Tversky, whose Judgement under Uncertainty: Heuristics and Biases, was published in 1982. Kahneman won the Nobel Prize for this work in 2002. Most people probably know him for his book Thinking Fast and Slow which was a recent non-fiction best-seller.
As Michelle mentions, when faced with events we tend to make snap judgements and in all sorts of ways these are influenced by things that we have just heard or seen. When health comes into the frame, having our judgements shaped by factors like these can lead to psychotic behaviour, or hysteria, otherwise called illness behaviour.
I was rather pleased with myself that my first book The Suspended Revolution, published in 1990, imported Kahneman and Tversky thinking into mental health before anyone else. It was an obvious way to illustrate how psychotic or hysterical thinking might make more sense than people usually figured – the key chapter is Dynamics.
The bizarre thing is doctors don’t appreciate this, even though many of us going through medical school develop multiple sclerosis and other terrible conditions regularly as a result of just this kind of thinking. Michelle also jumped into thinking fast like this, before settling down to thinking more slowly.
The implied message here is that our immediate probability thinking (fast thinking) needs to give way to large scale epidemiological studies (slow thinking), which may demonstrate for instance that there is no increase in rates of strokes following the vaccinations. If the epidemiology does show this or can be twisted to make it look like it does, some doctors might argue for booster doses.
This message is wrong. Epidemiology (including the subset we call RCTs) is not good ‘slow thinking’. Its poor thinking that throws up correlations that might or might not be helpful. In the case of plane crashes, we need to look closely at each crash and work out what happened. We would not let Boeing get away with saying there is no increase in risk from their 737 Max planes just because the number of plane crashes each year remains roughly the same.
In the same way, with an injury after a drug or a vaccine, slow thinking means getting the person themselves thinking with others, their family, a doctor or several doctors, and trying to come to a verdict the way Boeing had to do in its plane crashes.
As it turns out when Michelle’s husband, along with Michelle and his doctors thought slowly about it, with the benefit of more medical tests over time, they came to the view that the vaccine had triggered an auto-immune condition that had led to his stroke.
For someone, like Michelle, who believes in mandates, the way out of this is a medical exemption but the extraordinary situation we have been in means that most doctors are unwilling to support exemptions and without exemptions people are losing jobs and even with exemptions have been barred from travel.
A key element of the problem is something that Kate drew to my attention. When she and William went along to ask about an exemption and got turned down, she had the strong impression that they and their doctor were not the only people in the room.
When there are strangers in the room who can’t be engaged with – ghosts – no-one can think either fast or slow. The strangers’ message is you’re not supposed to think.
In a life and death crisis, such as being in mid-stroke, mid-heart attack, or mid-psychosis, we want and need strangers to do the thinking for us but this is not the case when the crisis has abated – as it had for William and Kate when they visited the Family Doctor.
But what would we or our partner do if in mid-heart attack we are faced with a stranger whose thinking is based on corrupt and fraudulent evidence – as found in the New England Journal of Misinformation. If the strangers don’t have a basis for what they are proposing to do, what then?
See Strangers in the Room.
Two Years Later
William still has the speech problems that stemmed from his stroke. But otherwise he is fine. He had Covid since without it causing problems. There are no other consequences of having Covid or the Vaccine that Kate picks out.
Kalevala Wampum © Nina Otulakowski April 2022