Vaccination policy – risks and benefits


Sir, – Many of your letter writers (April 15th) are presenting the low risks of harm from the AstraZeneca Covid-19 vaccine without considering its benefits.

These benefits vary significantly by age group and depend on the community prevalence of Covid-19 as this substantially impacts on the risk of infection with Sars-CoV-2 and subsequent risk of hospitalisation and death. In younger people, the individual risk of an adverse event from the vaccine is approximately equivalent to the benefit. The risk of harm from the vaccine in healthy people under 30 is 1.1 per 100,000 people compared to the benefit from the vaccine of reduced Covid-19 ICU admission of 0.8/100,000 when community prevalence is low or 2.2/100,000 when prevalence is moderate.

The risk-benefit balance shifts dramatically as people get older, with a risk of harm of 0.2/100,000 compared to a benefit during low exposure periods of 14.1/100,00, or 41.3/100,000 when prevalence is moderate.

The multidisciplinary experts on the National Immunisation Advisory Committee (Niac) have considered this data very thoroughly and made recommendations on that basis.

We should only give vaccines when the benefit clearly outweighs the risk, and the difficult process we are going through should reassure us that safety concerns are guiding our decision-making so that we can trust our Covid-19 vaccine system. – Yours, etc,


GP and Professor

of Primary Care


Royal College

of Surgeons in Ireland,


Sir, – “80 per cent of adults will receive a first dose of a vaccine by the end of June” (News, February 21st). “80 per cent of adults will receive an offer of a first dose of a vaccine by the end of June” (News, April 14th).

Spot the difference. – Yours, etc,



Co Dublin.

Sir, – I belong to the age cohort that can take the Astra Zeneca vaccine but I don’t want it. I have watched a parade of experts on TV in recent days explaining that getting Covid-19 is a much more risky prospect than taking the vaccine and while I understand the point, I still don’t want the AstraZeneca vaccine.

The reason is that there are other perfectly good vaccines available that don’t have this clotting problem.

I grant you the risk is small but why would I take even that tiny risk when I can take Pfizer or Moderna without any?

Of course, will I ever get the choice? – Yours, etc.




Co Kildare.

Sir, – I was shocked and disappointed to hear the Minister for Foreign Affairs Simon Coveney warn those considering refusing the AstraZeneca vaccine that they will be “putting themselves to the back of the queue” (News, April 15th).

Is the way to address venerable and concerned citizens of this country, who have continually been the subject of mixed public health messaging?

It certainly calls into question the “We are all in this together” mantra. Well apparently not if you’re over 60 years of age.

The Minister might note Denmark’s decision to permanently stop administering the AstraZeneca vaccine. – Yours, etc,




Dublin 18.