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

• • •

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

Keep Current with Leana Wen, M.D.

Leana Wen, M.D. 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 @DrLeanaWen

13 Apr
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: 🧵

nytimes.com/2021/04/13/us/…
(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.
Read 5 tweets
12 Apr
My latest @PostOpinions column is about the need for urgent attention to an epidemic that is responsible for 300,000 deaths every year: obesity.

As @Dmozaffarian told me, "the slow pandemic of #obesity has intertwined with the fast pandemic of #covid19".🧵washingtonpost.com/opinions/2021/…
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
Read 6 tweets
7 Apr
There's lots of discussion on the pros/cons of "vaccine passports".

We need to stop using this term. It's inaccurate, inflammatory & divisive.

Instead, let's describe how proof of #covid19 #vaccination can return us to normalcy @postopinions (thread):

washingtonpost.com/opinions/we-ne…
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
Read 9 tweets
11 Mar
It's been one year since the World Health Organization officially declared #covid19 to be a #pandemic.

What have we learned? Where do we go from here?

A thread. /1
5 key lessons:
1) Importance of a national, coordinated response. Piecemeal approaches to PPE, testing & vaccination do not work.

2) Without data, we are flying blind. A year ago, every detected case was a canary in a coal mine. Same issue with lack of genomic surveillance. /2
3) Hospitals are the last line of defense, not the first. The community, through preventive measures, are the frontlines.

4) Public health depends on public trust. Mixed messaging erodes trust & leads to politicizing of basic measures like masks./3
Read 9 tweets
9 Mar
Today's CDC guidelines on what fully vaccinated people can do are too timid, too limited & fail to tie reopening guidance with vaccination status.

As a result, we are missing a critical opportunity to incentivize Americans to be vaccinated. @PostOpinions washingtonpost.com/opinions/cdc-r…
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.
Read 4 tweets
16 Feb
This is the #1 question I get asked: What can newly vaccinated do? Is it safe to see grandkids?

Though there are still unknowns, we need to give a better answer than "follow all precautions".

My dos/don't in this week's @PostOpinions column: washingtonpost.com/opinions/2021/… (1/5)
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)
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!