Thread by @MPaiMD

Long 🧵 on vaccines and blood clots (from somebody who spends an inordinate amount of time thinking about, preventing & treating blood clots). #COVID19 #COVID19vaccine #hemetwitter #thrombosis 1/n

Yesterday @GovCanHealth, @MHRAgovuk, @EMA_News and my profession's organization @ThrombosisCan made clear statements that risks posed by AZ vaccine are far outweighed by its benefits. Does that square with media reports? Should we really get the first shot available to us? 2/n

I love my job as a blood and blood clot specialist. (LOVE IT!) So much of it focuses on talking to people about risks & how to stay safe DESPITE those risks. A lot of common medical procedures, drugs & life experiences [aging, pregnancy] increase your blood clot risk. BUT... 3/n

… we take them on anyway, because we’ve weighed our individual risk and benefit in the moment. We do so because we've decided that what’s on the other side is worth it - a new hip, a new baby, prevention of pregnancy, the long plane ride, the limb saving cast… 4/n

Translating abstract risk data into meaningful action is HARD. But we do it every day, consciously & subconsciously, as we pursue that better thing on the other side. I keep this in mind when I counsel patients & loved ones who’ve come to me this week. 5/n

They’re worried about the risk of clots with AZ vaccine. Let’s use that awesome human instinct (caution) and look at the data. Here’s what we know, now: 1) AZ vax doesn’t increase the risk of blood clots beyond the general population signal; 6/n

2) Getting AZ vax reduces your risk, overall, of dying or hospitalization; 3) Our vaccine safety & surveillance system is SOLID. It picked up ~40 unusual serious clots (out of 20,000,000+ doses), some associated with low platelets [sticky cells that help your blood clot]. 7/n

These rare, serious clots are concerning. BUT if you’re eligible for AZ vax? Our province is saying you’re at risk for COVID-19. So that ultra rare risk is outweighed by the real & common risks of COVID-19… an illness that itself gives you a >1 in 100 risk of blood clots. 8/n

The biggest driver of blood clots in the COVID-19 landscape is not vaccine — it’s virus. This virus has wreaked havoc on every aspect of our life. It’s kept kids out of school, threatened small businesses, taken away hugs & smiles & backyard barbecues & drinks with friends. 9/n

The best way to see ourselves through this havoc remains the vaccine. The best way to prevent clots remains the vaccine. I trust our country’s health approval and surveillance process. I trust it to guide me, and guide people I care about (my patients and loved ones). 10/n

Scientists (including blood clot specialists) continue to collect and analyze data on vaccines, so we can detect, treat, and advise with confidence. We (your doctors) will continue to give you our best advice, based on the best evidence. 11/n

We must work with you to talk about risks, benefits, fears, hopes, and strategies to keep you safe & in tune with your body. We'll do that together. Take the first vaccine that is offered to you, and we will get through this together too. 12/n

And for up-to-date, clear, science based information about blood clots, #COVID19vaccines, best evidence, and #COVID19, visit @ThrombosisCan and @COVIDSciOntario. 13/13.