You should not be shopping around for your favorite COVID-19 vaccine barring extraordinary circumstances (i.e. you are medically contraindicated from receiving a particular one): a (not very short) thread.
Tl;dr if you shop around for your favorite vaccine you are effectively biting yourself in the ass and also putting everyone at risk.
I’ve been asked more than once about which vaccine is best to take. My response is: choose your vaccine like you choose your beer. The best one is the one in front of you (or in your arm- though I guess that ruins the beer analogy. Although, who knows what people do with beer?)
Even though I phrased it like this, I am being 100% serious.

Vaccines are interesting because they sit at this important nexus between public health and medicine. Vaccination protects you, but it also protects those around you and vice versa.
It is in your best interest to have the best possible protection- but it’s more complex than picking the one with the biggest number.

Firstly, there is no simple way to compare these vaccines to one another based on their clinical trial data.
I am not being diplomatic here- it’s a fact.…

There are important factors that confound attempts to compare the efficacy of these vaccines.
If you have a “favorite” vaccine you either have preternatural epidemiological and statistical perspicacity, or you are overlooking important factors in your analysis.
They are ALL excellent. They all prevent the outcomes we care about preventing most: severe disease, hospitalization, and death. We are accumulating evidence that they ALL reduce transmission. They are ALL good choices.
Even though it may not look it, you are doing your community (and in fact YOURSELF) a disservice by picking and choosing your favorite vaccine and refusing to get ones that are not that vaccine. Here’s why:
I don’t really like to get all Kantian about things but in this particular case, I think it’s fair to consider what would happen if everyone did this. People show up to their vaccine appointment, find out it’s not the one they wanted, and then cancel.
Then they go schedule a new appointment hoping it’s the right one and who knows how far into the future that is? You know what’s happening in the interim? SARS-CoV-2 is evolving.
But here’s the thing: SARS-CoV-2 in any given person doesn’t evolve much at all (unless they’re immunocompromised-…).…
The accumulation of problematic mutations in SARS-CoV-2 happens when it has uncontrolled transmission in the population and accumulates mutations from being inside everyone. Its evolution across a population is much more important than its evolution within a host.
For now, it looks like our vaccines do a great job against variants still (including B.1.1.7 lineage ones which I find especially concerning). But if we give it enough time, enough hosts, SARS-CoV-2 WILL evolve to escape the protection from our vaccines.…
So, in delaying your vaccine until your favorite comes around, you are impeding progress towards halting transmission of SARS-CoV-2. You are helping to create the environment it needs to evolve immune escape.
Vaccines are critical not just in protecting others but because by removing susceptible individuals from the population by granting them immunity, SARS-CoV-2 has fewer opportunities to evolve.
If you wait long enough, the susceptible host it finds will be you. I implore you: take the first vaccine you can. That is our fastest, best way out of here.

If you are eligible: please hurry and get vaccinated as soon as possible.
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More from @ENirenberg

27 Feb
I am getting a bit frustrated listening to people discuss vaccine mandates so here is my scream into the void.
Firstly, I am not a huge fan of mandates, speaking frankly.

I do appreciate individual liberties and I don't like it when we have to have punitive measures in place to convince people to do the right thing. It is much more my preference to use education-based approaches.
Nonetheless, we may end up in a position where targeted mandates become necessary e.g. before going on an international flight, before making use of an indoor dining facility, as a condition of employment in a medical center, etc.
Read 9 tweets
23 Feb
*Long thread warning*

Because people seem to be confused I thought I could throw in my own explanations about the possible effects of vaccines on transmission. Let's imagine an arbitrary scale of vaccine efficacy for a minute, like this one that I made up:
Let's now consider what the absolute perfect vaccine might do on this scale.

Well ideally, the immune response it induces is so rapid and so robust that it is able to keep you from even getting infected. This is called sterilizing immunity.
Sterilizing immunity does not have anything to do with sterility in the reproductive sense; it refers to being able to maintain a sterile (i.e. not contaminated) environment. This is as good as things can get. Why don't we just make all of our vaccines do this?
Read 24 tweets
22 Feb
If anyone is confused about what sealioning looks like, here's a really excellent example.

Multiple physicians, including pediatricians and infectious disease specialists, have presented evidence showing this assumption is incorrect. But he's "just asking questions."
About half of pediatric flu deaths occur in previously healthy children.…

Here's a summary on the 2019-2020 flu season in kids:…

Feigin and Cherry's Pediatric Infectious Diseases also notes the following:
In other words, flu often doesn't act alone. Co-pathogenesis with bacteria is not all that rare, and the virus itself provokes immunological derangements and can remodel the microenvironment of the respiratory tract to promote disease.…
Read 16 tweets
30 Jan
Let's talk about the US's vaccine adverse event reporting system (VAERS), with emphasis on its misuse by bad actors.

VAERS is a self-explanatory system. I mean that literally: it tells you exactly how to use it (and how not to).

VAERS is a spontaneous (passive) reporting system. Anyone can submit a VAERS report, and certain events for certain vaccines are required to be reported by healthcare providers under the NCVIA law. Herein however lies one of the limitations.…
As an adverse event is anything bad that happens following the receipt of a pharmaceutical, it need not be causally related to the vaccine. If you look hard enough you can find VAERS reports for things that are obviously unrelated. For instance:
Read 17 tweets
20 Dec 20
I have a bigger audience now (still don't get how that happened) than I'm used to so I need to clarify some things about me.

Firstly, I am not a public health expert, nor an expert on COVID-19, pandemics generally, virology, infectious disease, or medicine.
I have a BSc in Biochemistry and I did a lot of coursework in immunology at a fairly high level and some labwork and journal clubs therein too.

It would also be delusionally hubristic of me to claim that I were an expert in either immunology or biochemistry or vaccines.
I know some things and have some experience with them.

I am comfortable enough with these things that I can pick up most papers about them and have at least a basic idea of what's going going on. I might also be able to offer criticism if it's a topic I am very familiar with.
Read 13 tweets
20 Dec 20
Some reminders after a disheartening thread:

- Depression is a real psychiatric condition that in addition to cognitive and emotional hallmarks produces changes at the cellular level within the brain and may include pharmacotherapy as part of a treatment plan.
- Behaving as though there is artistry and meaning in a person's suffering to get them to revel in it and neglect their wellbeing, furthermore as a means of remuneration, is grotesque and depraved. Feigning innocence and ignorance at being confronted with this truth is shameful.
- Antiretroviral therapy saves lives. Good compliance with ART can lead HIV patients to a normal life expectancy and prevent transmission of virus to partners. Convincing people not to take indicated ART robs people of years they could have spent with loved ones.
Read 5 tweets

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