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Monica Gandhi MD, MPH Profile picture
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16 Apr, 4 tweets, 2 min read
Okay, you know what is interesting? I wrote this piece at the end of January (published early Feb) and it still is going on despite even more data out there on effectiveness & variants; we are not messaging vaccine optimism to decrease vaccine hesitancy
leaps.org/want-to-motiva…
1) On 1st point, variants, I hope we have convinced people that our vaccines will still work against variants. I have written threads since January but I hope the simple fact that the man that wrote the textbook on Virology is not worried is enough:
threadreaderapp.com/thread/1373506…
1) And the 2nd point, message the end of masks, distancing. Ease more restrictions as vaccines take hold and decouple cases from severe illness. If we want a good metric, please see WaPo- ease mandates based on # of hospitalizations/100K + vax rate
washingtonpost.com/outlook/2021/0…
On 3rd point (that vaccine efficacy was so good in the clinical trials), the real-world studies are even better! Pfizer data April 1: 44,000 people across world (inc. S. Africa), 100% protection against severe disease; CDC data 1st responders March 29-see

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More from @MonicaGandhi9

Monica Gandhi MD, MPH Profile picture
18 Apr
I really admire especially my local paper's dogged determination to help open schools given the impacts of school closures on child mental & physical health. However, would argue with @drlucymcbride that we need a @factsnotfear approach to our reporting
sfchronicle.com/opinion/editor…
if we really want parents/teachers/students to feel safe about school openings. Examples of #factsnotfear reports are 1) explain to public what the vax effectiveness data is showing us in real-world: vax incredibly effective under stress of surges, differential mask wearing etc. Image
Very difficult to get or give #covid19 after vaccine. So, also explain to public all the accumulating data that vaccines massively reduce transmission. Cover the multiple papers which show this & discuss how IgA (mucosal antibody) generated by vax protect from nasal infection Image
Read 11 tweets
Monica Gandhi MD, MPH Profile picture
17 Apr
Researchers have put together paper from publicly-available databases in US (waiting to hear back from journal) confirming what these two Lancet-based articles showed us last week, that B117 not more virulent in US. CDC today
thelancet.com/journals/lanin…
& thelancet.com/journals/lanpu…
added denominators to estimation of variants to come up with a %. Not making case that the variants are more virulent based on hospitalization data (from 4 week sampling period ending 3/27/21). See data below: 1st number for each state: COVID cases per 100k as of yesterday's
Okay, here is data. 1st number hospitalizations/100K now; 2nd number hospitalizations/100K at peak; 3rd number % B117 in state now that CDC has added denominators. See how % B117 not corresponding to virulence now that we know percentages? (and some states surging; some not)
Read 7 tweets
Monica Gandhi MD, MPH Profile picture
16 Apr
Pfizer CEO said boosters may be needed. Unlikely
1) T cell immunity from vax (and Abs) work against variants; 2) T cells last long time- 34 y & counting after measles vax; 3) 1st SARS recovered have T cells 17 yr later; 4) Covid Vax generate memory B cells (lymph node biopsy)
So, to back up each claim (I have longer thread on this)
1) T cell immunity from vax works against variants: I hope you have been persuaded
2) T cells last 34 years and counting after measles vaccine:
ncbi.nlm.nih.gov/pmc/articles/P…
3) First SARS pandemic was coronavirus like this one (called SARS-CoV) and it also called severe disease. Lasted 9 months late 2002-2003. Survivors of similar virus SARS have strong T cell immunity 17 years later and counting
nature.com/articles/s4158…
Read 7 tweets
Monica Gandhi MD, MPH Profile picture
15 Apr
A profoundly important article in my opinion from @davidzweig in my opinion from @NYMag about why children should not be remote learning in the fall. Key points: 1) NJ Governor saying it will not be option unless "world goes sideways"; 2) Remote learning nymag.com/intelligencer/…
harms well documented; 3) "Study after study has shown that schools tend to have lower case rates than the surrounding community"; 4) Dr. "Vincent Racaniello, a professor of microbiology and immunology at Columbia University and author of Principles of Virology, the leading
textbook on the subject, recently concluded, after addressing the mechanisms at work, “I am not worried at all that this virus is going to out-evolve vaccines.'"; 5) Are children at risk? "To put the mortality risk in perspective, the CDC estimates that around 600 children
Read 5 tweets
Monica Gandhi MD, MPH Profile picture
14 Apr
COVID-19 policy blog today cautiously optimistic about turning point near with states who had increased cases/hospitalizations. "In Michigan, testing positivity rates and reproduction numbers are stabilizing or ...falling in many counties"
policylab.chop.edu/blog/covid-19-…
"Our models now forecast declines in reproduction numbers and case incidence over the next four weeks". And importantly for SCHOOLS: "Infections with the B.1.1.7 variant strain grew most quickly for children at the height of the United Kingdom’s winter surge. That, and ..
"rising infections now in youth, has led some to warn the public.. to consider closing schools again in this current resurgence. But our interpretation is far different, and we would advise schools that are doing well to stay the course"..."There is no evidence that the severity
Read 7 tweets
Monica Gandhi MD, MPH Profile picture
13 Apr
Rare side effect after J&J vaccine. 6 cases of blood clot called cerebral venous sinus thrombosis (CVST) among women between the ages of 18-48, with symptoms between 6-13 days after vaccination. Out of 6.8 million doses given (0.00009%). U.S. pausing statnews.com/2021/04/13/u-s…
222 cases of CVST out of 34 million people with AztraZeneca vaccine reported as well (0.00006%), most cases in women under 55 years. Of note, both J&J vaccine and AZ vaccine are adenovirus vaccines with DNA coding for spike protein inside them.
sciencemag.org/news/2021/04/h…
Both extremely rare (0.0000006-0.000009) so please first keep that in mind. Postulated mechanism here - syndrome called vaccination immune thrombotic thrombocytopenia (VITT). All patients with low platelets (thrombocytopenia) & unusual clots (thrombosis).
nejm.org/doi/full/10.10…
Read 9 tweets

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