Our group has posted guidance for myeloma patients on COVID vaccination. I recommend the same for 𝙖𝙑𝙑 π™˜π™–π™£π™˜π™šπ™§ patients. msmart.org @MayoMyeloma @MayoCancerCare
Which vaccine? Whichever approved vaccine you are offered.
Should I worry about which day of chemo or should I hold chemo?

No. These chemo drugs work for a long time and you can never be fully free from their effect. You may lose your spot in line or keep waiting for the β€œperfect” opportunity. Just get the vaccine when offered.
Is it safe?
Yes. There is no reason to believe or cancer or chemo make the vaccine more risky.
Will it work as well?

We don’t know. But it will work way better than no vaccine. So just get it.
The only real contraindications are those in the FDA factsheets: Severe allergy to prior dose of the vaccine or severe allergy to any ingredient in the vaccine

Moderna is approved for 18 & older. Pfizer for 16 & older. Children won’t be able to access these vaccines at this time
If you have never had severe allergy to anything you don’t have to worry. If you have severe allergy to something discuss details with your healthcare provider.

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More from @VincentRK

7 Feb
Reading this WSJ headline, there is an important clarification:

SARS CoV-2 and its variants are here to stay. But if we vaccinate 80% of the population, which is totally doable, then COVID-19 the disease is NOT here to stay.

1/ wsj.com/articles/as-va…
COVID-19 the disease has brought about utter chaos & turned the world upside down because of its ability to kill 0.5 to 1% of the people it infects, put ~10% of people it infects in the hospital, & leave some with long term consequences.

This won’t happen after vaccination.

2/
A respiratory virus that can easily spread is not enough to cause this kind of life-altering chaos. We already have the flu, the regular corona viruses, the rhino viruses and such.

SARS CoV-2 was new. It was new to the immune system and our bodies were attacked by surprise.

3/
Read 12 tweets
5 Feb
Even yesterday I heard from a close friend who lost an elderly parent to COVID. They were just hoping to get vaccinated. But it was too late.

Every delay costs lives. There were over 3500 stories like this yesterday across the country.
15,000 across the world.
The new Administration took over only 15 days ago. They have a lot to deal with in terms of decisions that were already made. I have full confidence in their approach. I hope they can turn the vaccine situation around in a month.
But it’s not up to the federal government. It’s everyone from states to local governments to hospitals that have to gear up to 24/7 vaccination. Especially if J & J is approved and we have sufficient doses to dispense. Planning has to start now.
Read 4 tweets
3 Feb
If we focus on getting as many people vaccinated as possible, and continue basic precautions till each country reaches herd immunity, COVID will be history, mutants and all.
COVID minus its ability to make people severely ill or cause deaths is nothing. Vaccines work. And that’s what they will reduce COVID to.
Every month will bring news of a new variant or mutant. But for vaccinated people the chances of getting seriously ill will be very low. Not zero. But very low. In the range of what annual influenza outbreaks are. Time will tell. But I’m optimistic.
Read 4 tweets
3 Feb
I will repeat: Not having Astra Zeneca COVID vaccine approved in the US is a blunder. A huge blunder. bbc.co.uk/news/health-55…
See thread by @DrEricDing on how the Astra Zeneca vaccine can cut transmission. This was totally expected. Basic immunology.
Once we knew results of the RCT that the Astra Zeneca vaccine was safe and at worst was 60% effective we should have moved. We knew quite well that there simple wasn’t enough Pfizer and Moderna vaccine to get the vulnerable vaccinated quickly.
Read 4 tweets
2 Feb
Breaking: Over 50% of Delhi is seropositive for COVID. @ndtv @divyanshu @rishika625 @GargiRawat @nramind @bimalarya

This supports my earlier thread on protection through cross reactive immunity. Otherwise the loss of life would have been 50 times higher. ndtv.com/india-news/cor…
The population of Delhi is 20 million. So far estimated deaths is 10,000. If 10 million have had COVID, we cannot reconcile the two numbers.

What are the factors besides lower age, less obesity, & underreporting that results in so much asymptomatic & mildly symptomatic COVID?
Of these 4 factors, low viral dose is likely not operational in India because of the lack of masking and the impossibility of social distancing.

There is also no special reason why innate immunity will be stronger & no data on unique genetic factors that protect Indian people.
Read 9 tweets
30 Jan
What’s happening in India?
Is the pandemic burning out? How? Where is the post Diwali surge that we worried about? #COVID19

I wrote about India in August. I was convinced that cross reactive immunity was at play. Along with younger age & less obesity, this is protecting India
People are often quick to criticize the numbers. But keep in mind you can miss asymptomatic or mildly symptomatic cases. But you cannot hide 10 times more deaths or ICU admissions.

This is real. And is not explained by just younger age and less obesity.
This is more than that. Sometimes epidemiological observations are much more powerful and give better insight than lab studies.

India is a country where social distancing outdoors or indoors is not easy.

We are seeing this play out. It’s staring at us: Cross reactive immunity.
Read 7 tweets

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