Where is the data for Covid-19 vaccine safety in medium term and/or for people with chronic health conditions?

Question

I have several middle-aged relatives which are... let's say postponing their vaccination due to fears of their safety. Now, I know there are some people who will never be convinced by anything, however in conversations with them I have learned about some concerns which seem legitimate to me and to which I cannot find satisfactory answers anywhere.

In particular, they know of several people who, after receiving the first or second dose of the Covid-19 vaccine, experienced rapid deterioration of their health or even died. Of note is that this did not happen within the 7-day period after receiving said doses, and/or that these people did have existing health conditions that seemed to suddenly worsen a lot without any discernible reason. Most of them were also over 50 years old.

If this was an isolated case then - well, who can say, but if you personally know several people with this outcome, then it's becoming hard for me to blame them for their hesitancy to get the jab themselves. Especially if they are 50+ years old with health conditions of their own. Sure, Covid is even worse, but if the vaccines also seem deadly, then the rational course is to stay home, suffer through all the limitations and lockdowns, and pray not to get infected.

I would like to be able to lessen their fears even a little bit, by showing them some hard data that the vaccines are safe after all, even after 7 days and even if you are middle-aged or elderly with chronic health problems. But I cannot find any. Well, not on Google anyway. I'm not a medical professional, so I don't even know the right places where to look.

Can you help me please?

P.S. I understand that this is vaccine-specific. I don't know which vaccines the deceased people had and it would be weird if I tried to dig in their personal lives, especially since I myself don't know them or their relatives. However the vaccines currently available here are Pfizer, Moderna and Janssen, so those are the ones I'm primarily interested in. But I'm sure that other people will be interested in other vaccines too, so I welcome data on all of them.

Answer 1

Finding data on effects with specific comorbidities is difficult, there are some data out there for obesity (which often, but definitely not always, goes with heart disease, blood pressure problems, breathing problems etc.). I have not found any with age and comorbidities separated out. I have found one with comorbdities alone, with specific risks for each potential side-effect of the vaccine.

New England Journal of Medicine has the paper¹ that describes the risks associated with the vaccine in Israel for over 2 million people, which means that it covers the gamut of the population, including those with illnesses such as heart disease, cancer etc. These comorbidities were case-matched for the treatment (vaccine) and control (placebo) groups, aiming to match location, age, BMI, health condition etc.

Table 2 shows the number of adverse events in the treatment and control groups for a list of potential side effects of the vaccine:

Figure 4 shows a simplified version of these data in a graphical form:

However, the real data is in the supplementary appendix. You want to look at tables S3-S6 to see that the data is all population matched and that the numbers/risk ratios (S6 for events in each group) show that the risk from the vaccine is very small for almost all conditions compared to the risks from COVID-19.

Unfortunately for you, as you have found out, anecdote != data and "personal" experience often outweighs the real evidence in the minds of most. The numbers out there (e.g linked paper) are quite complicated and confusing for non-scientists. I wish you well in your endeavour to provide some real information to your friends and family.

1: Barda et al. Safety of the BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting. New England Journal of Medicine. 2021. 385:1078-1090