More than 72 hours after receiving the Covishield vaccine, a 44-year old man died in Gelephu last week.  Health officials said his death was not triggered by the vaccine.

The man received his first dose of the vaccine on March 30.  Dr Sonam Wangchuk of the national immunisation technical advisory group (NI-TAG) said the man did not report any adverse reaction following the vaccination.

However, three days later on April 2, the man complained of shortness of breath and was brought to the hospital.  Dr Sonam Wangchuk said that the man had pre-existing medical conditions including an alcoholic liver disease.

“He was in distress and was disoriented when he was brought to the hospital. It was also quite late when he reached there which is why the doctors couldn’t do much,” he said.

NI-TAG member, Dr GP Dhakal said that, considering the symptoms, the cause of the death was the complication of his cirrhosis and not the vaccine.  Cirrhosis is a chronic liver disease marked by degeneration of cells, inflammation, and fibrous thickening of tissue.  It is typically a result of alcoholism or hepatitis.

This marks the third death reported to the NI-TAG following the nationwide vaccination campaign.  NI-TAG’s investigation established that none of the deaths was related to the vaccine.

Dr Sonam Wangchuk said that any severe adverse reaction triggered by the vaccine should manifest immediately after the vaccination.  

He said that, even without the vaccine, people, especially with comorbidities, are likely to die due to their own deteriorating health conditions.

To put it into context, the 2020 annual health bulletin records the death of 1,108 people in 2019 due to their pre-existing medical conditions.  Every year, more than 1,000 people died in the country due to one or more medical conditions.  The national referral hospital, on average, records over 600 deaths annually.

Dr Sonam Wangchuk said, given that majority of the population was now vaccinated, it would be wrong to associate every death hereafter to the vaccine. “However, any case reported to us, NI-TAG would be investigating it thoroughly.”


Why give the vaccine?

Following the two earlier incidences in Pemagatshel and Bumthang, many have raised issues about why vaccinate those chronically ill patients.

Dr Dhakal said that the Covishield vaccine guideline, the health ministry and NI-TAG follow, approves the vaccine’s use on these comorbid individuals explicitly.

“The guideline says that these categories of people — those with lung, kidney, or heart disease — have been studied during the phase three clinical trials of the vaccine,” he said. “Meaning, there was no adverse effect or contraindication found in these groups of people during the phase three trials.”

Also, initially, the AstraZeneca vaccine was not recommended for pregnant and lactating mothers.  It was done mainly because these groups of people were not included during the clinical trials of the vaccine.  However, global experts concluded that, if the benefits of the vaccine outweighed the risk, these groups of people could be vaccinated.

Dr Dhakal said that the only exception was for those, who were severely ill and those with blood cancer currently undergoing active chemotherapy. “And for those, who experience an anaphylactic reaction during the first dose, they can’t take the second dose. These are the only exceptions.”

Besides the guideline, Dr Sonam Wangchuk said that people with comorbidities are the priority group to receive the Covid-19 vaccine across the world. “In case of an outbreak, these groups of people would be the most vulnerable, which is why we have to vaccinate them.”

Dr Dhakal said that people with compromised immunity have more chances of getting a severe form of Covid-19 disease during an outbreak. “They are the priority group in countries where the vaccine is in shortage.”

Younten Tshedup