Thread by @ASPphysician

It's possible that the best decision for the population and the best decision for individuals are different.

In a young otherwise healthy person where other vaccines are available soon and they can mitigate their risk, the risk of illness/death from AZ > risk of death from COVID

Would a parent give their 12yo kid AZ if it were shown to be safe and efficacious in studies but still carried the VIPIT risk? I seriously doubt it. Then how about a 15yo? 20 yo? 21?

At some age benefit > risk. NACI decided that that inflection point is 55y. I agree with them.

However, to the general public, the value of getting as many people as possible vaccinated is huge.

The argument of being in a 3rd wave isn't being lost on me, but most of these vaccines during the 3rd wave will/should not go in young people.

Communicating all of this is hard.

We have known about VIPIT—the clotting and low platelet disorder—for roughly 2 weeks.

We've had enough vaccine to immunize most of our at risk adults for months and are still failing.

We've known about COVID for about 15 months.

1. Keep your eye on the ball—it ain't AZ.
2. Control the damn virus using non-pharmacologic interventions not ICU beds.
2. Get vaccine into arms that will save the most lives.
3. Have humility about who should be adopting what risks and acknowledge uncertainty.
4. Communicate.