Thread by @ChomiloMD

I have enrolled in a #COVIDvaccine trial & last week got my first shot!!

But this wasn’t always my plan. I had a surprising amount of hesitancy early on. So I want to share how I worked through it.

This will probably be my longest thread ever. But stick w/me! (1/)

An avid advocate that #vaccinessavelives I found myself personally & professionally skeptical about the speed with which vaccines were being developed & politicized.

So I read about #COVIDvaccine development & listened to @NEJM’s podcast weekly podcasts.apple.com/us/podcast/new… (2/)

I also found this @nytimes #COVID19 vaccine tracker helpful

nytimes.com/interactive/20…
(3/)

Additionally, in talking to Infectious Disease colleagues of mine previous vaccine trials for SARS-CoV & MERS-CoV (Covid’s “cousins”) were referenced as a foundation for the science behind many #Covid19 vaccine trials. Here is a nice review of that:
ncbi.nlm.nih.gov/pmc/articles/P…
(4/)

Following these resources helped me overcome my initial hesitancy based on the speed w/which these vaccines have been developed.

Ive shared my path of gathering info w/my patients/parents & lately Ive been using this analogy (s/o @Theresa_Chapple🙌🏾)

https://twitter.com/theresa_chapple/status/1333742074496225281?s=21

So next was concern about the mRNA vaccine specifically, as it has not yet been rolled out to millions of individuals.

Learning more about the history of #mRNA technology & the companies utilizing it has helped. This is a particularly good piece: statnews.com/2020/11/10/the…
(6/)

However we still don’t know what the possible short/medium/long term side effects, although likely rare, could be when this is administered to millions.

That said, vaccines have always been about decreasing risk & #COVID19 presents a significant risk to many of our communities.

Additionally, most proven vaccine-related long term side effects have shown up within months, not years.

So I am reassured that we haven’t yet seen any significant number of side effects in thousands of participants who received their vaccine 4+ months ago
(8/)

Given the risk of getting #COVID19 & what we don’t know about its longterm effects; when family/friends/patients ask about mRNA vaccines, my response is:

“the unknown short/long term risk of a mRNA vaccine is still much more acceptable to me than the risk of getting COVID”
(9/)

Once ready to get my vaccine I had a decision: wait for an early approved vaccine as a health care worker likely to get early priority?

Or participate in a #CovidVaccine trial?

In the Twin Cities, my employer was the 1st to begin enrolling participants in a #COVID vaccine trial. You may have heard of the AstraZeneca/Oxford trial that had to be paused. That is the one.

The other current option in the Twin Cities is with Janssen Pharmaceuticals.
(11/)

Both use a more “traditional” approach of a genetically modified virus to teach the immune system how to make a protective response against SARS-CoV-2.

In addition to the global pause the AZ/Oxford trial also realized there had been a mistake in some of the initial doses with some participants getting a 1/2 dose.

Thing is those participants actually had a better response.

Yet it remains that a miscalculation was made.
(13/)

So to some the answer may seem obvious, go w/the trial that hasn’t had to be halted or had a mistake, right?

But yet, to me, those steps means those running the trial aren’t cutting corners & are willing to admit missteps.

Appropriate transparency is paramount. You know why.

Here’s where the AZ/Oxford trial has 1 thing in MN that the Jansssen trial doesn’t - @ZekeMD

Zeke & I go back to medical school where we worked together @SNMA helping fill our fellow students’ gaps in education around #SDOH before it became a more regular part of the curriculum

.@ZekeMD continues that education today as chief medical editor of @mnmed’s MN Medicine, member of @MNAADocs & is a lead investigator of the MN Oxford/AZ trial🙌🏾

He spoke about how #COVID19 vaccine trials help protect human rights in @MNSpokesman
(16/)
spokesman-recorder.com/2020/12/05/cov…

Although most of my time, focus & energy has been on #COVID19 here in the US, as someone w/family around the world, & particularly in Cameroon, I also wanted to support a vaccine that could truly be global.

Ultra low freezers & cold chains aren’t going to work in much of Africa.

Knowing the Oxford scientists used their leverage to get AZ on board with making their #COVIDvaccine on a not-for-profit basis worldwide, for the duration of the pandemic, & always at cost to low- & middle-income countries, was also a critical factor👏🏾
#HealthIsAHumanRight
(18/)

This recently published piece does a great job looking at the timeline, stumbles & promise to date of the Oxford/AZ trial - bbc.com/news/health-55…

& lastly before any 1st step could be taken I wanted to get Wifey on-board. Given the rising #COVID19 cases throughout November & the fact she is a public health-trained RN this wasn’t too hard, but a required step 🙏🏾🙂

To recap, I was:
🔹 reassured about speed of #COVIDvaccine development
🔹comfortable w/risk:benefit of mRNA vaccines if offered
🔹considering 2 trials

& decided on Oxford/AZ bc I:
🔹trusted their scientific process & @ZekeMD
🔹wanted to contribute both locally & globally
(21/)

I was also inspired by several docs who shared their experiences enrolling in a #COVID19 trial including one of my mentors @navsaria - madison.com/ct/opinion/col…

As well as these Black women MDs
@Gradydoctor -

https://twitter.com/gradydoctor/status/1324762224192331778?s=21

@DrChrisMD -

https://twitter.com/hereandnow/status/1338552334562041862?s=21

So on to my Phase 3 clinical trial experience thus far!

Citing another inspiring Black woman MD I’m going to link @drfna’s excellent thread here because there are a lot of similarities that I’m going to try & not dwell on again too much -

https://twitter.com/drfna/status/1337814573341151235?s=21

(23/)

I submitted a prescreen questionnaire that asked about my baseline health, occupation/exposure risk, age, gender & race/ethnicity. Based on those answers I was deemed to qualify for participation.

I then scheduled an appointment & was sent a thorough consent packet via email.

There I learned that I had a 2 in 3 chance of getting the actual vaccine vs placebo. As well as the frequency with which I’d have to check in-person vs virtually & the planned length of the trial - 2 years.
(25/)

I also learned participants get $100 for every in-person visit. Of note, this was not advertised at all.

Bc of a change in my schedule I had to delay my appointment. More info came out about Pfizer/Moderna. I could now wait & likely get a vaccine for sure in months, maybe weeks.

However my mind was set. The day came. I showed up to my appointment & answered some of the same questions from the screening. I also asked several of my own:
🔸were they doing a 1/2 dose 1st shot as part of their protocol given the early results? - No, not yet planned in the US

🔸could I get results of my SARS-CoV-2 antibody tests (part of the blood draw they did)? - No, they go to a 3rd party vendor

🔸did I really need another nasal swab PCR (joking, but that was now my 5th one since #COVID19 arrived, not a fan)
(28/)

🔸any discussions about ending the trial early if efficacy & safety are significant given the ongoing #COVID19 surge to allow those who received placebo to get an actual vaccine? - nothing concrete, they are monitoring closely & participants can leave the trial when they choose

So after getting clearance to have my pic taken by one of the study coordinators (apparently I was the 1st participant to ask) my arm was prepped & in went the needle!

It was as routine as my annual flu shot (which I got back in September 🙌🏾)
(30/)

Since then I’ve felt some notable fatigue but otherwise my arm wasn’t even sore (which also is how I feel after the flu shot).

I now answer a questionnaire on an app setup to monitor symptoms & call in any to the clinic. I will then go back in ~30 days for shot #2

As vaccine advocates wrestle w/the impact of the medical community’s violation of trust I wanted to heed @CamaraJones words:

“part of being trustworthy is not trying to convince or coax or cajole anybody into taking a vaccine; it is to hear people’s questions & then answer...”

“...their questions truthfully & clearly, where some of the answers right now may be “We don’t know”

We know a lot more than we did at the beginning, but we have to continue to hold that knowledge w/humility. #COVID19 & 2020 have certainly taught us that

democracynow.org/2020/12/14/cam…

That said, if there is a question or concern I didn’t cover here you are likely to find an answer (or the start of an answer) in this well done, thorough piece:

elemental.medium.com/every-covid-19…

I truly believe #VaccinesSaveLives.

A #COVIDvaccine trial may not be for you but hopefully everyone, whether it be by masking, socially distancing or getting your own #COVID shot, finds ways to help protect our communities from #COVID19
🙏🏾🙌🏾✊🏾
(End, whew!)