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Monica Gandhi MD, MPH Profile picture
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26 Mar, 5 tweets, 2 min read
Wanted to address "vaccine hesitancy" as supply expands. I truly believe they are safe and profoundly effective but an infection will still go down to low-grade endemicity (very low cases) if many are vaccinated; thereby keeping unvaccinated safe. Vaccinated safe from vax. So, ok
ok if you want to wait & see. I go to same tiny grocery store a lot & person at counter says he is waiting to see others get vaccinated first. That is of course okay. Just like yelling at someone about masks, yelling at someone about getting vax is so wrong. As more sheep turn
pink, nonimmune not as likely to encounter each other & spread. We know these vaccines reduce transmission 80-94% (previous threads, real-world data), so not everyone needs to get vax. Israel case curve below at 56% fully vaccinated; looks like 60% if going to be herd immunity.
We recently reminded ourselves that cases went up in Israel at beginning of vax campaign before vaccines crushed it. Same thing happening in US now- here is an article. Peel off restrictions slowly as laying down vaccine veneer; will come down soon
yahoo.com/entertainment/…
And will we be done with masks & distancing soon. ABSOLUTELY. Those are measures only to be applied now that we have this incredible vaccine solution in the short-term now. Get ready to wear lipstick again (oh that's me; I have been waiting to get them out)

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More from @MonicaGandhi9

Monica Gandhi MD, MPH Profile picture
27 Mar
GREAT NEWS on what we are all eyeing carefully as scientists, public, media: Are hospitalizations per case decreasing in light of vaccines which defang virus . YES, massively. Let's look at statistics from two data sources
healthdata.gov/Health/COVID-1… and
cdc.gov/coronavirus/20…
CASES:
57k cases 7 day average, +7% from prior week
CDC compared to closest 7 day average was July 23, 2020: 63k
Peak of 7 day average 250k cases on January 11, 2021
Currently down -77% from the peak on cases.
TESTS:
1080K tests 7 day average, -10% from prior week July 23, 2020
week 7 day test average was 858K. Test positivity rate was 4.7%; July 23, 2020 positivity rate was 7.3%
Peak of 7 day average was 2.0 million in tests on January 18, 2021
Cases and test positivity: Currently down -46% from the peak on tests. Currently 57k cases vs. 63K July 23
Read 18 tweets
Monica Gandhi MD, MPH Profile picture
27 Mar
Why so excited about IgA? Wanted to explain immunoglobulins (antibodies) a bit to explain why the real-world data is showing us that the #covid19 vaccines block transmission. There are 5 different types of immunoglobulins in human body: IgA, IgM, IgG, IgD, IgE. You hear a lot Image
about "antibodies" and neutralizing antibodies after #covid19 infection & #covid19 vax, which refers to IgG immunoglobulins. But function of IgA antibodies is to protect us at the surfaces that face the world, the "mucosa": nose, mouth, gut, genitals, etc
nature.com/articles/nm1213
Obviously, 1st line of defense against respiratory pathogen like SARS-CoV-2 is where you encounter it (nose/mouth) so IgA responses there after vaccination would help you fight the virus the minute you are exposed and, importantly, limit viral replication so you can't pass it on
Read 13 tweets
Monica Gandhi MD, MPH Profile picture
25 Mar
Excellent biostatistician @dvgbiostat can help us understand how LOW your risk of getting #covid19 is after vaccination:
-Without vaccination, would expect among 1000 people to see 26 infections
-With full vax among 1000 people, would see 0.5 (or a 50/50 chance of seeing 0 or 1)
Using data from the two healthcare worker studies in NEJM 3/23 DURING surge much exposure (HCW). Also few cases could be asymptomatic and noninfectious. As community prevalence goes down with mass vax, risk vanishingly low.
nejm.org/doi/full/10.10…
nejm.org/doi/full/10.10…
Since papers didn't tell us whether the very low number who got COVID (4/8121) after vax had low viral loads in their nose (or asymptomatic as had asymptomatic screening in one study), likely vaccination controlled symptoms, spread too.
Read 6 tweets
Monica Gandhi MD, MPH Profile picture
25 Mar
Important to look at dropping hospitalizations in U.S. among older groups getting vaccinated when judging power of the vaccines (as opposed to younger groups not yet vaccinated). So, when you look at crude cases not yet dropping in many places, look at age-based hospitalizations
From CDC source, Look at drop in last 7-day hospital admissions from 2/24/21 to today- rate drop more dramatic in older ages
>65 yrs: Down -44% (17,019 to 9491)
50-63 yr: Down -23% (15,987 to 12207)
18-49 yrs: Down -16% from 2/24/21 (9058 to 7065)
covid.cdc.gov/covid-data-tra…
Greater drop in hospitalizations among older due to >65 being vaccinated first (although 2 doses in majority of >65 not yet reached). In terms of New Jersey, one of the slowest states to vaccinate long-term care facilities which explains lower drop there
Read 5 tweets
Monica Gandhi MD, MPH Profile picture
24 Mar
Bad News Bias: "The U.S. media is offering a different picture of Covid-19 from science journals or the international media, a study finds." Incredibly incisive continued reporting by @DLeonhardt of NYT. Media in this country biased towards bad news.
nytimes.com/2021/03/24/bri…
It is not your imagination. See figure on share of COVID-19 coverage that is negative. Article writes "If we’re constantly telling a negative story, we are not giving our audience the most accurate portrait of reality. We are shading it". This portrait of reality is not
what we are reading in the science journals, where reality is so much more positive. Media is focusing on few places where cases rising, not majority where they are falling for instance. Or not focused enough on who is still in hospital- unvaccinated. Grateful to @DLeonhardt
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
23 Mar
True, cases going up in Michigan, uptick in hospitalizations but deaths remaining low so far, 3 facts:
-Smaller proportion of new cases from >=60 yrs old
-Hospitalizations per case lower than rate before vaccines started
-Deaths staying low
bridgemi.com/michigan-healt…
See this report. So, like in UK and Israel when B117 more transmissible, vaccinations will bring this down but would go as fast as possible there, keep restrictions until get to higher rate, will come down. Severity of illness/ case lower already with vax: wwmt.com/news/local/as-…
And twitter friend reminded me prior surges in Michigan were more mild so likely not a lot of natural immunity. Unlike CA which has 30% natural immunity after latest surge + vaccines on top of it= quick quell
sfchronicle.com/health/article…
Read 4 tweets

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