How has extensive media coverage of AstraZeneca COVID-19 vaccine-related fatal events impacted healthcare services in Norway?
Scientists from Sweden and Norway have recently investigated how media reportage on fatal side-effects of the Oxford-AstraZeneca vaccine has impacted the use of healthcare services among newly vaccinated healthcare workers. The findings reveal that the media reporting has caused a sharp increase in primary and specialist healthcare service utilization by healthcare staff. The study is currently available on the medRxiv* preprint server. Background  Because of high media reporting on fatal side-effects, the Oxford-AstraZeneca coronavirus disease 2019 (COVID-19) vaccine has been suspended by several European countries. In the European Economic Area, about 30 severe thromboembolic events have been observed among 5 million individuals who received the AstraZeneca vaccine. This indicates a very low probability of developing fatal complications because of vaccination. In Norway, about 121,820 healthcare workers under the age of 65 years have received the AstraZeneca vaccine between February and March, 2021. Among them, several cases of thromboembolism and four deaths have been observed. Because of these events, Norwegian health authorities permanently terminated the use of this vaccine in May 2021. In the current study, the scientists have aimed to evaluate how high media reporting of very low-probability fatal side-effects may influence the behavior of health-literate personnel toward utilization of healthcare services. Specifically, they have evaluated the frequency of healthcare service utilization by vaccinated healthcare workers before and after the media-generated information shock. Moreover, they have investigated whether observed changes differ by age, gender, or occupation. Study design  The scientists obtained nationwide individual-level data from various Norwegian registries. They have included all Norwegian healthcare workers under the age of 65 years who did and did not receive the AstraZeneca vaccine before the media reportage. The primary aim of the study was to determine the frequency of utilization of primary and specialist healthcare services. Primary care included medical attention without hospitalization, and specialist care included overnight hospitalization. Since fatal side-effects from the AstraZeneca vaccine were reported to have occurred soon after vaccination, the scientists focused mainly on the daily healthcare utilization in the first 14 days after vaccination. Important observations  The study included a total of 87,632 vaccinated (with the Oxford-AstraZeneca model) and 175,264 unvaccinated healthcare workers, including cleaners in healthcare sectors. Before media reporting, the rate of healthcare utilization among vaccinated workers was around 1%. However, soon after high media reporting, a sharp increase in healthcare utilization was observed among them. In contrast, no such change was observed for unvaccinated workers. This indicates that the sudden rise in healthcare utilization is not due to any other acute health complications occurring during the same period. Compared to the rates of primary care utilization before media reporting, a 66% and 62% induction was observed among vaccinated workers in the 1st and 2nd weeks following media reporting, respectively. Similarly, a 20% and 61% induction in specialist care utilization was observed among vaccinated workers in the 1st and 2nd weeks following media reporting, respectively. Regarding gender-related variation, vaccinated women aged 18  44 years showed an 82% induction in primary care utilization following media reporting. Similarly, the induction was more than 45% for women above the age of 45 years. However, for vaccinated men, the average utilization of healthcare services was relatively lower than women. Regarding occupation-related variation in primary care utilization following media reporting, cleaners in healthcare sectors showed the highest induction of 103% compared to physicians, health professionals, health associate professionals, and personal care workers. Even for the specialist care utilization, cleaners showed the highest induction of 123%. Study significance  The study demonstrates how excessive media coverage of negative incidents can influence healthcare workers toward higher utilization of primary and specialist care services. Importantly, the study highlights the need for preparedness by health authorities to affirmatively respond to future information shocks about very low-probability fatal events. The sharp rise in healthcare utilization observed in the study also highlights the need for an upgrading of services to deal with such situations. *Important notice  medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.