Share this page!

Vincent Rajkumar Profile picture
Twitter logo
13 Apr, 8 tweets, 4 min read
Breaking: FDA asks states to pause J & J vaccine due to blood clots in 6 women age 18 to 48.

J & J vaccine is an adenoviral vector vaccine, as is the Astra Zeneca vaccine

These unusual clots have NOT been seen with mRNA (Pfizer, Moderna) vaccines.
cnbc.com/2021/04/13/us-…
I don't have the details of the 6 cases of thrombosis that prompted the recommendation. But it looks like the concern is the unusual combination of serious blood clots with low platelets in young people that prompted it. Not regular blood clots. @nytimes google.com/amp/s/www.nyti…
The good news is that the US will maintain and reach vaccine related goals even without the J &J vaccine. @ASlavitt is quoted in this story @CNN.

google.com/amp/s/amp.cnn.…
Approximately 7 million doses of J & J vaccine have been given in the US. 6 cases of blood clots are being investigated.

IMPORTANT: The public should note that these clots have NOT been seen with Pfizer and Moderna vaccines after ~180 million doses. The vaccines are safe.
It's a real scientific puzzle why unusual blood clots have been seen with Astra Zeneca, an adenoviral vector vaccine; and now J&J another adenoviral vector vaccine.

Here is a good write up on how these vaccines work. @carlzimmer @13pt nytimes.com/interactive/20…
Link to my thread on the blood clots seen with Astra Zeneca vaccine. Emphasizing that we don't know details of whether the 6 blood clots reported with J&J vaccine resemble the clinical picture seen with the Astra Zeneca vaccine. We should know more soon.
In light of what happened with the Astra Zeneca vaccine, considering the US has enough doses of Pfizer and Moderna, the FDA recommendation to pause the J&J vaccine is the right one.
Details on the type of clots seen with J&J vaccine.

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Vincent Rajkumar

Vincent Rajkumar Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @VincentRK

Vincent Rajkumar Profile picture
15 Apr
Did COVID cause remission of an advanced cancer?

61 year old man was diagnosed with Hodgkin Lymphoma. He then developed COVID. Only got supportive care. No steroids or immunotherapy. 4 months later, cancer had mostly resolved (left image vs right) 🪢

onlinelibrary.wiley.com/doi/full/10.11… Image
There are 3 possible explanations:

1) Hodgkin Lymphoma is unique among cancers in that what you see as big lumps of tumor are not cancer cells: Bulk of tumor mass is just normal reactive lymphocytes with small amounts of cancer (Reed Sternberg) cells mixed in. (Owl like cells) ImageImage
So after COVID the reactive cells may disappear due to the severe viral infection, making it look like the cancer has gone into remission. But maybe only the normal reactive cells have disappeared. Time will tell if the true Hodgkin cancer cells are still there and will come back
Read 7 tweets
Vincent Rajkumar Profile picture
14 Apr
Low platelets: common
Blood clots in legs/arms: common

Blood clots in veins draining the brain: very rare
Blood clots in veins draining the brain plus very low platelets: extremely rare

Early on, Astra Zeneca: puzzle
Now: J& J. Hence the pause.

Pfizer/Moderna: No such clots
The risk is very small.
6 cases after 7 million doses of J&J vaccine. But just need few days to verify numerator, and assess risk/benefit.

Risk from COVID likely far outweighs risk from Astra Zeneca or J&J vaccine greatly in almost all people >age 30.
We have 2 other safe vaccines, Pfizer and Moderna in the US: After 180 million doses given no concern for such blood clots related to the vaccines.

Vaccine administration sites are adjusting. We have enough vaccines for everyone.

Things will be clearer in a week.
Read 4 tweets
Vincent Rajkumar Profile picture
11 Apr
Astra Zeneca vaccine & blood clots. Summary.

Rare form of blood clots plus low platelets. ~60% involve veins of brain. Almost all after 1st dose.

Risk (UK MHRA): 1 in 250,000 people
Risk (EU EMA): 1 in 100,000 people

Risk of dying: 20-25% of people with these clots have died
Approximately half of the deaths in the UK (11 of 19) were under age 50.

The benefits of the Astra Zeneca vaccine according to regulators appear to outweigh risks in all except those less than age 30. bmj.com/content/373/bm…
While blood clots occur at a certain rate in population what is unusual about these clots is the association with low platelets. Platelets help make blood clots & when platelets are low we are at risk of bleeding not clotting.

Low platelets in context of blood clots is unusual.
Read 13 tweets
Vincent Rajkumar Profile picture
10 Apr
If we have more COVID vaccines than people, but cannot get to herd immunity due to vaccine hesitancy then we have messed up the messaging.

The message should be clear and should come from every leader in the country.
How effective are the vaccines?
Forget who did what wrong on the messaging. Just focus on the messages going forward.

Don't get stuck in debates of whether vaccines prevent transmission. They do reduce transmission dramatically. (It's will also be a largely moot question once 80% have been vaccinated).
Read 4 tweets
Vincent Rajkumar Profile picture
8 Apr
Mortality rate of symptomatic COVID when healthcare system was overwhelmed early on (as in Italy, Spain, Belgium, & parts of the US) was incredibly high. As we flattened the curve & learnt to treat, the rate reduced to 2-3%.

cf. Australia didn't get overwhelmed. @OurWorldInData
It is indeed remarkable how across the world the mortality rate of confirmed, presumably symptomatic, COVID has coalesced to around 2-3%.
Although with improvements in treatment, mortality rates of symptomatic COVID may be lower that what we saw early last year in places that got overwhelmed, no country should be in a situation where the healthcare system is overwhelmed. That leads to much higher loss of life.
Read 5 tweets
Vincent Rajkumar Profile picture
7 Apr
570,000 Americans have died due to COVID.

Even if we assume every single American has already had COVID, the lowest possible infection fatality rate (IFR) is 0.17%.

The true IFR is likely ~0.5%.
This is similar to what I had estimated a year ago.

In symptomatic people with confirmed COVID, the mortality rate is ~2%.
IFR can vary: by population characteristics, time period, availability of treatments, health system capabilities, etc.

But the death rate in the US, 1700 deaths per million, shows how devastating COVID can be in a rich country with supposedly the best healthcare resources of any
Read 5 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!

Like this author's thread?

Get emails when @VincentRK has new unrolls!

Check out other threads from @VincentRK!

Read all threads by @VincentRK