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Editor’s note: Here’s an excerpt from an article in The BMJ. To read the piece in its entirety, click here.

Doctors in Norway have been advised to assess severely frail and terminally ill patients to determine whether the benefits of vaccination outweigh the risks of possible side effects, after reports indicated that vaccine side effects may have led to deterioration and death of some patients.

Reports of 33 suspected adverse drug reactions with fatal outcomes after administration of the Pfizer and BioNTech vaccine had been received by the Norwegian Medicines Agency as at 17 January. All the people who died were over 75. Around 42 000 people are believed to have received the first dose of the vaccine so far in Norway.

The agency has investigated 13 of the deaths so far and concluded that common adverse reactions of mRNA vaccines, such as fever, nausea, and diarrhoea, may have contributed to fatal outcomes in some of the frail patients.

Although for most elderly frail people any side effects of the vaccine will be outweighed by a reduced risk of a severe COVID-19 disease, for those with the severest frailty even relatively mild side effects can have serious consequences, the Norwegian Institute of Public Health said. And the benefits of the vaccine to those with a very short life expectancy may be marginal or irrelevant, it said.

Read the entire The BMJ article here.