I'm a physician & woman who's in the under 50 age group. I'd chosen to receive the Johnson & Johnson vaccine. If I knew then what I know now about the risk of a rare but serious blood clotting disorder, I would have chosen another vaccine. 🧵@postopinions washingtonpost.com/opinions/2021/…
The blood clotting disorder associated with J&J, thrombosis with thrombocytopenia syndrome (TTS), is not a run-of-the-mill blood clot. Of the 15 women who had TTS, 3 died. 7 remain hospitalized, 4 in intensive care. Most were previously healthy women, median age of 37. /2
15 cases out of 8 million doses seems like a very low risk. The risk for women in the 18-49 group is higher--1 in 80,000.
This is still low, and benefits of preventing severe illness from #covid19 still far outweigh risks if the J&J is the only vaccine available. /3
But it's not. And that's the key. There are two other very safe & effective vaccines (from Pfizer & Moderna) that do not pose any risk of TTS.
Why didn't the CDC & FDA issue a warning that advises women under 50 to receive one of these two other available vaccines instead? /4
Some younger women will still opt to receive the J&J. It's one-dose, and those scared of needles or can't easily return for a second may prefer it.
That's their choice. But the default position should be to direct women under 50 to other vaccines that don't carry this risk. /5
Informed decision-making involves knowing risks, benefits, & alternatives--and having these alternatives offered to a group identified to be highest risk.
After all the emphasis federal health officials put on prioritizing safety, it’s what we should expect from them. /END
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As a doctor and volunteer in the J&J clinical trial who received the vaccine <2 weeks ago, here's my take on the recommendation for the FDA & CDC pause for the Johnson & Johnson #covid19#vaccine: 🧵
(1) This is exactly the right move. All possibly concerning safety signals should be immediately & transparently investigated.
This shows that regulatory entities are doing their job. Even something very rare (6 cases out of 7 million) will be immediately looked into.
(2) The events flagged (blood clots with low platelets) are extremely rare. Causation hasn't been established. The reason this really needs to be alerted now is for doctors who may see patients with this rare condition, to know what to look for and how to treat them.
Obesity is a major risk factor for diabetes, heart disease, certain cancers & worse outcomes from #covid19. With stress & food insecurity, 42% self-reported gaining weight since the pandemic, with an average addition of 29 pounds. 10% gained 50+ pounds. /2 apa.org/news/press/rel…
The experts I spoke to proposed numerous solutions, including seeing food as medicine so doctors can prescribe healthy produce for patients; changing policies around ultra-processed foods & sugary sodas; and recognizing that systemic racism is built into our food system. /3
Asking for vaccination status is a kind of health screen to identify those at low risk for infecting others, not unlike symptom questionnaires or #covid19 tests.
If these aren’t seen as constraints on individual liberties, showing vaccine status shouldn't be, either. /2
In addition, individuals are increasingly asking one another whether they’ve gotten their shots. Vaccination enables activities that otherwise couldn’t occur safely.
I think it’s time for us to extend the newfound normalcy from social settings to business operations. /3
I know this is a difficult needle to thread. What I want to see is nuance & risk estimates instead of taking an absolutist approach. Healthcare providers must help people exercise good judgment while considering each person’s individual values, or else we lose their trust.
Also, people need to be given incentives to get vaccinated As reopening occurs & people return back to normal, we are losing the opportunity to tie reopening to vaccination. At some point soon, everything will be fully reopened anyway, and there will be no carrot left to offer.
The #covid19 vaccine is extremely protective against severe disease. There's growing evidence that it may reduce the likelihood of people being carriers.
People should resume essential activities but were being put off--like cancer screenings & dental screenings. (2/5)
It's probably fine to resume some non-essential activities, like going to the gym & out to eat. People should still abide by masking & distancing in case they can infect others. I'd still avoid crowded bars--& be extra cautious if others in your home are unvaccinated. (3/5)