When U.S. health agencies recommended pausing the use of Johnson & Johnson’s COVID-19 vaccine after six women who had received it developed rare blood clots, some scientists tried to offer reassurance. Similar to someone saying “You have a greater chance of being involved in an automobile accident than a plane crash,” some scientists pointed out that being on hormonal contraceptives carried a much greater risk of developing blood clots than taking this vaccine did.
But rather than reassuring women, it stirred up a lot of anger: Why hasn’t anyone told us about those risks?
In fact, the risk is detailed in medical information inserts provided with the product. But who reads those long inserts, with their fine print?
It must be pointed out that the blood clots that might have been associated with the vaccine are more dangerous than the ones associated with birth control pills. While the former are blood clots showing up in the brain, the latter are clots in the legs that can travel to the lungs. But the risk of clots from the pill is much higher.
There was enough anger on the part of women who have found out about the pill’s risk, both before and after news that the COVID vaccine might lead to clotting, that the New York Times reported on it.
“Part of my anger was that a medication that I took to control my fertility ended up threatening my mortality,” Kelly Tyrrell, a runner who was 37 when doctors discovered potentially fatal blood clots in her lungs, told the Times. “I’m angry that I hadn’t been counseled better about that risk, or even what to look for.”
Mellissa Moschella, who has done research in contraception from a biomedical ethics standpoint, spoke with Aleteia this past week about the issue and some of its implications.
“I think that what we found in the wake of the Johnson & Johnson vaccine concern about possible connections to blood clots, and people bringing up the fact that, ‘Hey, women on the Pill have been dealing with much higher increased risk of blood clots, and nobody seems to worry much about that. What’s the double standard?’ and it’s true,” Moschella said. The one-in-a-thousand risk for women on the pill is “a whole lot higher than the [possible] one-in-a-million risk of the Johnson & Johnson vaccine, even if the type of blood clot is somewhat less dangerous than the brain blood clot that was associated with the vaccine.”
“A lot of women were mad, number one, because they were not often informed clearly about the side effects of the pill, including the risk of serious side effects like blood clots,” said Moschella, associate professor of philosophy at the Catholic University of America. “Obviously these risks are on the label, but doctors don’t emphasize them. They are relatively low, but nonetheless, they are serious risks that many women, if they were made aware of that, might prefer another method of contraception or another way of dealing with the underlying health issues that the pill is often prescribed for.”
Double standard
Moschella charges that contraception is “the only area of medicine where doctors routinely prescribe the same thing for a huge variety of issues with a huge variety of underlying causes, instead of actually treating the underlying causes.”
“The pill is prescribed for everything from polycystic ovarian syndrome to bad mood fluctuations related to women’s cycles to very heavy or painful periods to acne or all sorts of other things,” she said. “These all are generally indicators that something is going wrong with the woman’s cycle, and there are actually ways that those underlying causes can be treated to help the woman feel better instead of just shutting down a whole major aspect of a woman’s biology and masking underlying problems that then may resurface years later when a woman comes off the pill and may want to conceive.
“So I think this also points to a larger underlying issue in women’s health, that it’s the only area where we have settled for a one-size-fits-all solution that just masks the problem and sometimes exacerbates it,” she continued. “And it has a lot of negative side effects,” including blood clots.
Moschella also pointed out that while in the early years of development of hormonal contraceptives, women in trials for the pill suffered “extremely severe health consequences” and some actually died, in attempts that have been made to develop a birth control pill for men, trials have almost always been stopped because of relatively mild side effects, such as loss of sex drive or minor mood swings.
Moschella contends that most women on the pill are “pretty ignorant of any of the potentially serious side effects: blood clots, increased risk of breast cancer, various ways in which being on the pill, particularly long term, can cause fertility problems later on.”
“Most women don’t know about this or aren’t informed about it,” she said. “Part of it’s political: that with anything that relates to reproductive health, the sense is that sexual freedom and the ability to have sex without consequences trumps every other consideration, and sensible warnings about health risks are seen to be contrary to the ethos of absolute sexual freedom.”
