The Death of Civil Rights Hero, Mr. Hank Aaron, After COVID-19 Vaccination: Coincidence or Causation?
Yesterday, January 22, 2021, Mr. Hank Aaron, a giant in the black American struggle and a hero to America’s civil rights movement died. The apparent cause of his death, at age 86, was a “massive stroke”.
But Mr. Aaron was a hero to the end.
Hank Aaron knew that his community, the black community, is disproportionately affected by COVID-19 illness and deaths. He also understood that, historically and justifiably, the black community is skeptical of medical science and practice — and especially of vaccines.
So, he took on the mantle of leadership again — at age 86. To demonstrate that the COVID-19 vaccine is safe, on January 5, 2021, seventeen days before his death, he received the first dose of the Moderna COVID-19 vaccine.
He did this to serve as a role model and to protect his people.
So how are we, and how is the black community, to interpret his death so close to the time of his vaccination? Did the January 5th vaccine cause the January 22nd death?
Mr. Aaron was 86 years old. He had medical co-morbidities. And he likely met the medical definition of “frailty”.
So, it is entirely likely that Hank Aaron’s death from a massive stroke has nothing to do with his vaccine dose. 86 year-olds with his health profile have massive strokes every day across the country.
But, because his death occurred so close to the time of his vaccination, it is easy to see how the very people he aimed to inspire to get vaccinated would believe that the vaccine was the cause of his death.
Now, to be clear, I do not personally believe that the Moderna vaccine caused Mr. Aaron’s death. I believe that these vaccines are highly effective and safe in the vast majority of people.
Personally, I’ve received the Moderna vaccine myself — and I supported and endorsed my parents to get it also — they are in their 70s. I did so, because as an immunologist and a physician, I know that vaccines work. And I know that in order to control this terrible pandemic, we need to achieve herd immunity to the virus by getting as many people vaccinated as quickly as is possible.
In fact, I would go as far as to state that it is the patriotic duty of every American who can safely and reasonably receive the vaccine, to do so.
But I do believe that we ought to take Mr. Aaron’s death following COVID-19 vaccination very seriously — and to do our best to help the public make sense of it.
But how do we do this?
We do this through logical, respectful and scientifically based discourse — not just with experts, but even more importantly, with the general public. And in the case of Mr. Aaron’s death, with the black community in America.
So here is my framework for making sense of Mr. Aaron’s death.
For starters, Mr. Aaron was 86 years old and based on his likely co-morbidities (e.g., obesity, diabetes, cardiovascular disease, hypertension, high cholesterol, etc.), he was already at high risk of developing a catastrophic cardiovascular event - like the stroke that killed him.
So Mr. Aaron’s death at 86, from an actuarial perspective, was not unexpected. It’s possible that, as sad as it is, his time had come irrespective of the pandemic or the Moderna vaccine he received.
Second, Mr. Aaron did not have a classical vaccine reaction in the form of an allergy or systemic inflammatory response — at least not one that’s been reported in the general press. So that should be reassuring, because vaccine reactions are commonly allergic or neurological in nature — NOT cardiovascular. And Mr. Aaron had a stroke, which is caused by blood clotting in his arteries.
Third, given the novelty of both this pandemic and the vaccines now being administered, we ought to determine if there might be any scientifically reasonable explanations that could link the virus or the vaccine to Mr. Aaron’s massive stroke.
In this last regard, I do think we can pause for a moment and take stock of what we know from a scientific and clinical perspective — no matter how many “experts” may tell us that this discussion might cause even more “vaccine hesitancy” in the black community.
After all, I have enough respect for my fellow countrymen to firmly believe that all people, and especially black people, deserve reasonable and cogent discourse and scientific explanations.
Could some folks not understand, or misunderstand me? It’s possible. But I believe that honest discourse and transparency in the practice of medicine, no matter the scale of challenge, are better than paternalism and cloistering of information in Ivory towers.
So here it goes…I hope and pray that black folks in America are reading this. Because I write it as a friend and admirer of your cause in America — and I do so at potential cost to my own professional reputation among academics.
As scientists and doctors we know that the SARS-CoV-2 virus targets the vascular endothelium and causes vasculitis — that is, inflammation of the lining of blood vessels. Here is a paper published in the prestigious medical journal Lancet showing this phenomenon of endothelial infection and vascular inflammation
We also know that many people with COVID-19 infection are “asymptomatic”. That is, though they have a viral infection, they do not show clinically visible signs like fever, shortness of breath or chest pain. Yet these asymptomatic carriers are actually infected with the virus.
So, it is entirely feasible that these asymptomatic folks might have subclinical vasculitides — that is, the virus, along with mild inflammation, is likely to be present in their blood vessels in a silent way.
Now, as an immunologist, when I think about what the COVID-19 vaccine is doing to the immune system, I know that it is activating immune cells specific for the SARS-CoV-2 virus. In other words, in a person who is an asymptomatic carrier of the SARS-CoV-2 virus, the immune cells the vaccine activates will efficiently go on to target any organ or tissue, where the virus is present — to kill the virus infected cells as is their job.
If it so happens that the lining of blood vessels is where the infected cells are located, damage to that endothelial lining could certainly cause blood clots to form, leading to cardiovascular catastrophe in the vaccinated person.
The bottom line is that it is an immunological possibility that Mr. Aaron was an asymptomatic carrier of SARS-CoV-2 — and that the vaccine may have exacerbated a local vasculitis that led to an acute thrombotic event — that is, a blood clot in the blood vessels to or in his brain — leading to his stroke.
Personally, I do think there is a reasonable scientific rationale for screening older and frail patients or those with co-morbidities (i.e, obesity, diabetes, hypertension, high Cholesterol or history of cardiovascular disease), like Mr. Aaron, for COVID-19 PRIOR to vaccinating them. If folks in these categories do turn out to be asymptomatic carriers, I would advocate for delaying their vaccination by 3–4 weeks with good social isolation instructions — followed by vaccination.
Can we now prove that Mr. Aaron was an asymptomatic carrier? NO, we can’t.
But I do believe it is a reasonable public health question for his family and community to ask his local health authorities, the FDA and Moderna to perform assays on his remaining tissues and see if he was a carrier of SARS-CoV-2.
In general, I believe that it is logical and safest to delay vaccination in any known asymptomatic carriers of the virus by a few months, especially if they are found to have antibodies— AND, certainly, I would screen all frail patients or those with cardiovascular co-morbidities for COVID-19, BEFORE vaccinating them.
Based on emerging data, I would even go as far as to say that asymptomatic carriers may be better candidates for the Regeneron or Eli Lilly antibodies, instead of the COVID-19 vaccine.
To be clear, the vast majority of people are NOT asymptomatic carriers — so, if/when implemented, my proposition to #ScreenB4Vaccine, should not prevent the vast majority of people from getting vaccinated.
To be clear, when it came to vaccinating my own parents in their 70s and with cardiovascular co-morbidities, I insisted on screening them for COVID-19 before vaccination — and we did so. They were negative and they got the vaccine with little to no side-effects.
If any of Mr. Aaron’s friends, fans or concerned members of the black community are reading this article, I hope you all see that there is a legitimate scientific question to ask: Was Hank Aaron an asymptomatic carrier of SARS-CoV-2 when he was vaccinated?
YES, he was 86 and had co-morbidities. And YES, he did not die of a traditional vaccine reaction or allergic response. And, YES, statistically he had lived well beyond the average life expectancy in the United States.
BUT, was Hank Aaron an asymptomatic carrier of SARS-CoV-2? I hope this question is asked and answered.
In truth, if Mr. Aaron’s death leads to more vaccine hesitancy in the African American community, it would be a profound tragedy. Certainly, if any otherwise young and healthy person of color reading my article here decides not to get the vaccine based on my writing, I will consider this writing a profound failure.
Because, vaccines DO work. And, as someone familiar with the development of mRNA vaccine technology over the past 3 decades, I am certain that these new vaccines are highly effective at causing immunity to the current dominant strains of SARS-CoV-2.
These vaccine work by eliciting an antibody and T-cell response to the virus. And those responses are very well protective in the vast majority of people.
If there is anything anyone should hesitate on, it is non-selectively vaccinating frail people with co-morbidities like obesity and cardiovascular disease, without screening them for the virus first.
The real question is this: Does our federal government and our elite academic medical establishment only care about “majority benefit”? Are these leaders willing to provide the resources necessary and put in the hard work necessary, especially to the underserved, to earn their trust and respect by making the vaccine maximally safe?
Can black people, all people, in frail and high risk categories get efficiently screened for COVID-19 before they are vaccinated?
Or, are we simply going to tolerate real or potential risks of harm, while accepting the collateral damage to minority subsets of people, whom we know are, or may be, at risk of harm from vaccination?
My dear friends, please…DO get vaccinated — especially if you are young and otherwise healthy.
But if you are obese, diabetic, have high cholesterol, high blood pressure and a history of cardiovascular disease, do so ONLY after you’ve been screened for COVID-19 — ASK to be screened, to make sure you are not asymptomatic carriers.
I write in friendship to all, and especially to black Americans, and in defense of public health in the United States and globally.
Hooman Noorchashm MD, PhD.
