George Delgado, MD
Reports are all over the Internet today regarding up to 33 patients in nursing homes in Norway who died soon after receiving the Pfizer-BioNTech COVID-19 vaccine. Some in Germany and other countries have also reportedly died. [1, 2]
While the causes are not known, we can assume that some had fever, malaise, muscle aches and diarrhea, known vaccine adverse effects. Perhaps some frail elderly cannot tolerate and push through the vaccine’s side effects the way younger people can.
Only 4.3% of the patients in the Pfizer-BioNTech study, that led the US Food and Drug Administration (FDA) to issue an Emergency Use Authorization (EUA), were age 75 and older. The vaccine package insert does not even list how many were age 80 and older.  According to Children’s Health Defense, only about 2% of those in the study were age 75 years old and older and had pre-existing medical conditions (2.1 percent in the vaccine group and 1.8 percent in the pace group). 
It is unfortunate and somewhat ironic that those at highest risk for severe COVID-19 and death — those over age 80 with medical conditions— were not thoroughly studied. In a sense, we are now experimenting on our frail, sick elderly nursing home residents.
I think we should be hesitant in recommending vaccination to the very old, the very frail and those with three months or less to live. They may not survive the side effects. Perhaps a more reasonable approach would be to vaccinate all of those around them, developing a protective cocoon. That same strategy is utilized when fathers and other family members receive the Tdap (whooping cough) and influenza vaccines in anticipation of the birth of a baby.
Meanwhile, in San Diego, there was a cluster of severe allergic reactions in six people who received the Moderna vaccine in the last few days at Petco Park. The epidemiologist for the State of California, Dr. Erica Pan, has urged vaccine administrators not to use the lot (lot 041L20A) until an investigation is completed. 
The vaccination picture is fluid because the vaccines were approved after limited study and rapid development. This is not a criticism; it is a statement of fact. The severe COVID-19 pandemic, which has left 400,000 Americans dead, demanded a swift response. I still recommend that those with medical conditions such as obesity, diabetes, heart disease and COPD strongly consider getting vaccinated. They have the most to lose if they get COVID-19. However, once we get to the sickest and the oldest, we should pause and thoughtfully reconsider.