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On Tuesday (March 2) night, Hong Kong health authorities announced that they were looking into the death of a chronically ill man two days after he received China’s Sinovac Covid-19 vaccine, but cautioned that no connection had been established yet.

The 63-year-old man got the shot on February 26 at Kwun Chung Sports Centre in Jordan, one of the government’s designated vaccination sites, according to the Department of Health.On February 28, he was admitted to Queen Elizabeth Hospital with shortness of breath.

According to a source, the man went into cardiac arrest shortly after being admitted and died the next day after resuscitation efforts failed.“At the moment, the causal relationship with the vaccination cannot be ascertained,” the department said in a late-night statement, adding that it was seeking more information from the Hospital Authority.

The source said that when the man was admitted to hospital, clinicians were notified that he had been vaccinated with the Sinovac jab, but at that time they thought the conditions were unrelated, as the patient suffered from chronic illnesses.

The department, meanwhile, said it would also pass the case details to a new expert committee for assessing clinical events to establish the causal links and publish a report in due course.

A hospital spokesman said the man, who also had a record of respiratory tract diseases, was admitted at about 1.30am on Sunday (Feb 28). He was transferred to a medical ward at about 3am but his condition deteriorated rapidly and he died at around 6am. The Coroner’s Court would follow up on the death, the spokesman said.
In a press briefing at about 12.30am on Wednesday (Feb 24), hospital deputy chief executive Dr Johnny Chan Wai-man said the patient told emergency unit staff he had received a jab, but personnel in the medical ward were not aware of the vaccination as they focused on his rapidly deteriorating condition.

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Chan said no signs of allergic reactions were detected during resuscitation attempts and staff believed from clinical judgments the patient had chronic bronchitis, for which he was treated. None of the patient’s conditions that day could be associated with inoculation, he said.

The hospital alerted the health department the following day after reviewing his record and realising he had been vaccinated.

The controller of the Centre for Health Protection, Dr Ronald Lam Man-kin, stressed that it was too early to draw any conclusions about a causal association, and that the incident would be investigated by an expert committee.He said the vaccine was still approved because the benefits outweighed the costs, and the department’s testing system met international expectations.“A vaccination programme cannot be arbitrarily stopped before a causal relationship is established,” Lam said.
Chan, on the other hand, agreed that contact could be better.Professor David Hui Shu-cheong, a respiratory medicine specialist at Chinese University and a government advisor on the pandemic, said a postmortem test would determine if the man’s death was linked to the vaccine.

He said the man had four coronary artery disease risk factors, including smoking, high blood pressure, hyperlipidemia, and high blood glucose levels, all of which could endanger his health even if he didn’t get the vaccine.The diabetic man had gone to a government outpatient clinic for treatment and was taking two different medications. When he was admitted to the hospital’s emergency room, his blood glucose levels were normal.
“If the [diabetes] is well controlled, there is no problem in getting the vaccine,” Hui said.

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Experts had said adverse reactions reported by several people after receiving shots of the mainland-made Sinovac vaccine were unlikely to be linked to the jab. Some 40,000 people have received the jab so far.Meanwhile, bookings for the Pfizer-BioNTech vaccine, which was jointly developed by German and US firms, will open on Wednesday (March 3) at 9am. With 140,000 slots available for priority residents, the jabs will be offered from March 10 to 30 at seven vaccination centres operated by the Hospital Authority.

With another vaccine option available, Hui said earlier, one of the factors in choosing which jab to go for would be the recipient’s travel habits.

He said people who needed to travel overseas frequently could benefit from the potentially greater protection offered by the BioNTech vaccine. Sinovac shots, he added, would be adequate for those who usually stayed in Hong Kong or only travelled to the mainland, where mutated strains of the virus were not yet prevalent.

“The BioNTech vaccine could neutralise the mutated strains that emerged in Britain and South Africa,” Hui said. “The coverage of protection could be wider.”Over the past few days, at least seven people have been admitted to hospitals after experiencing symptoms such as a rapid pulse, dizziness, and high blood pressure after receiving Sinovac shots.

Professor Ivan Hung Fan-ngai, co-convenor of the expert committee on adverse reactions to vaccines at the University of Hong Kong, said the symptoms described by the patients were also normal in other situations.“Dizziness is a common response among some people who get injected for vaccinations or blood-drawing. Many people also have palpitations,” he said, referring to the condition of a fast-beating or fluttering heart.

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He said the committee would meet on Wednesday to look into the adverse events.

Hui also said those reactions were likely to have been caused by unconscious responses in the nervous system, such as rising heart rates due to a fear of needles or blood.
“If you are afraid of needles, maybe don’t look at the needle,” he told a radio programme. “There’s no need to worry, the needle is there to help you develop immunity.”Each inoculation center will be fitted with two pharmaceutical fridges to store the vials at temperatures between two and eight degrees for no more than five days in order to administer the BioNTech shots, which must be stored at minus 70 degrees Celsius and thawed and diluted until injection.

According to Angela Liu Hor-ki of the Hospital Authority’s Hong Kong East cluster, which operates the vaccination centre at Sai Wan Ho Sports Centre, the jabs will be prepared in batches during the day to avoid spoilage, depending on booking demand.“We will prepare the vaccines according to the bookings, we won’t [dilute] the vaccines all in one go,” she said.
Each vial contains five doses, and the shot in each syringe must be administered within six hours and held at room temperature no higher than 30 degrees. A maximum of 200 syringes could be prepared every hour with four to six pharmacists assigned to each vaccination center, according to Liu.

Despite the many technical issues involved in handling the BioNTech jabs, Dr Luk Che-chung, chief executive of the authority’s Hong Kong East cluster, said health workers were confident in providing a smooth vaccination program.

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