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Abraar Karan Profile picture
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31 Dec 20, 7 tweets, 4 min read
As a healthcare worker, I think there is a big assumption here that all healthcare workers have familiarity with vaccines, vaccine research, virology, or even clinical trials & how to read or interpret them etc

That is frankly not the case, nor is that a reasonable expectation.
2/ The hospital is a complex place. There are healthcare workers of all different backgrounds w/ different levels of expertise & knowledge. The vast majority of us are not experts in mRNA vaccines. Blaming healthcare workers for hesitancy is uncalled for.
3/ We (public health experts) have warned for months & months that vaccine deployment would be extremely complicated. I have had numerous healthcare worker colleagues ask my opinion of the NEJM trials for Pfizer & Moderna, & I have shared my interpretations of the data.
4/ I received my vaccine earlier this month. I would urge all colleagues & friends/family to do the same.

The benefits are immense, the risks of #covid19 are grave (both morbidity + mortality; have taken care of patients that have died + many that survived w/ ongoing symptoms
5/ BUT I also would hesitate to stigmatize or belittle healthcare workers who have questions or want more info. It is so critical that hospitals hold informational sessions for their own staff to be able to ask questions & voice concerns. @BrighamWomens has been great w this
6/ Granted we are also lucky to have a number of vaccine experts on our staff, incl Dr. Baden who was the lead author on the Moderna @NEJM paper this week.

The info sessions that we have held should be made publicly available @BrighamWomens

nejm.org/doi/full/10.10…
cc @FranciscoMarty_ @roby_bhatt @sigal_md @IngridKatzMD

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More from @AbraarKaran

Abraar Karan Profile picture
2 Jan
THREAD
1/ Important article by @skarlamangla

Some of the key factors with what went wrong in LA

Fundamentally, LA county was set up to do poorly- structural inequities (surprise) were almost a guarantee of this

But this is unacceptable

#covid19

latimes.com/california/sto…
2/ “But in L.A., it is common for a working-class family of four, five or even more to share a costly one-bedroom apartment.

Among the 25 biggest metropolitan areas in America, L.A. has the highest percentage of overcrowded homes”

*Need safer isolation options*
#covid19
3/ “L.A. County has a huge manufacturing sector and two of the biggest ports in the nation — industries staffed by people who work in the kind of close quarters that can facilitate spread of the virus”

Article notes big outbreaks here. Why weren’t these workers protected?
Read 4 tweets
Abraar Karan Profile picture
1 Jan
Spending this New Years Eve in my apartment getting ready for several days back on the medicine wards starting tomorrow morning. Grateful to have a roof overhead, to have health, to have received the vaccine. So many of the patients we care for don’t get any of these luxuries.
2/ The perspective that we get in caring for people who are sick & struggling is so important. In a year when we have been primed to judge others & fight w/ one another, the hospital reminds me what humanity & empathy look like. We need these values front & center, which is hard
3/ It’s hard bc lives are on the line- many of us have lost loved ones to the epidemic already, & many others will in the coming weeks. I understand this; there were times I have wanted to judge or shame people for making “selfish” decisions when I had to go work in a hospital
Read 8 tweets
Abraar Karan Profile picture
31 Dec 20
1/
mRNA1273 (Moderna) vaccine- Phase 3 trial

2 doses, 28 days apart (black arrows)

28,207 in per-protocol analysis

Primary end-point: preventing symptomatic infections w/ onset at least 14 days after 2nd dose

Overall: 94.1% vaccine efficacy

nejm.org/doi/full/10.10…
2/ Key secondary end-point: preventing severe #Covid19 disease

Vaccine group- 0 severe cases

Placebo group- 30 severe cases

Vaccine efficacy of 100% in preventing severe disease
3/ "In addition, although our trial showed that mRNA-1273 reduces the incidence of symptomatic SARS-CoV-2 infection, the data were not sufficient to assess asymptomatic infection" (cont)

#covid19
Read 7 tweets
Abraar Karan Profile picture
29 Dec 20
First reported case of #COVID19 #B117 variant in the United States in a Colorado man with no relevant travel history to UK. What this suggests is community transmission of new variant.

latimes.com/world-nation/s… Image
2/ New variant is thought to be more transmissible but not more severe in terms of the disease it causes. BUT- more transmissible can very much be more problematic than more fatal (see thread/tweets below)

3/ Longer thread here linking to a number of articles as well as different responses by various countries in terms of travel restrictions (which ultimately make less sense/are less efficient for control when you already have community transmission) re #b117 #covid19 variant
Read 6 tweets
Abraar Karan Profile picture
29 Dec 20
THREAD

1/ Read this. This is "global health"? This is our "solidarity"? This is extractive.

Vaccines produced in South Africa & tested on South Africans are then deemed safe, & first given to Americans, British, & others in wealthy countries.
nytimes.com/2020/12/28/wor…
2/ "Poor & middle-income nations, largely unable to compete in the open market, rely on a complex vaccine sharing scheme called Covax."

But as the article mentions, this 'aid' is conditional; some countries are not "poor enough" to qualify, but also can't afford enough vaccines
3/
Within South Africa (& many countries), the wealthy will buy vaccines to protect themselves.

The poor are in a gamble w/ their lives.

**“We’ll all be dead then,” said Prudence Nonzamedyantyi, 46, a housekeeper from the same township.** (quote from the article)
Read 10 tweets
Abraar Karan Profile picture
29 Dec 20
Check out this new piece from Ed Yong in @TheAtlantic on pandemic year two

Thanks to Ed for having me share some of my thoughts here alongside a number of colleagues

We have an immense year ahead of us

#covid19
2/ “There will be a whole lot of pain in the first quarter” of 2021 --Anthony Fauci told Ed in this piece.

I agree. I am hopeful that summer 2021 will be our first major exhale in a while.
3/ One of the most consequential parts of reaching a better summer 2021 is going to be our vaccination strategy, which we aren't doing well right now. Read this thread below

Read 7 tweets

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