Thread by @heysciencesam

I know there are a lot of people who recently got the AstraZeneca vaccine who feel ... snubbed ... after last week's communications.

This thread is for you. I hope it re-affirms your smart decision to get protected from COVID asap & empowers you to know the signs of VITT.

Vaccines prevent disease. So any potential risk from a vaccine must ALWAYS be discussed in the context of risks from the disease it prevents.

Risks from an infectious disease like COVID vary w/ time, age, location, & personal risk profile.

That's why it changes & is confusing.

For places in Canada in the midst of a third wave, especially for those who don't work from home, the up to 94% protection against hospitalization from COVID that one dose of AstraZeneca offers was (and is) valuable.

https://twitter.com/heysciencesam/status/1382913729264779264?s=20

Late last week, from leadership at NACI:

"Quach said people who took AstraZeneca did not get a 'second-best shot.'

"The recommendation is not a retrospective one." "
ctvnews.ca/health/coronav…

#GenXZeneca, and everyone else who took the AstraZeneca/COVISHIELD in Canada as soon as you could:

You made the best decision for yourself & your community with all the available evidence. Thank you, and PLEASE don't feel bad about that.

Now I want you to be aware, not scared, about the rare but serious risk of VITT (clots with low platelets) following adenoviral vaccines (AstraZeneca/COVISHIELD and Janssen/J&J) because early diagnosis & treatment yield the best outcomes.

VITT can occur within 4-28 days following vaccination with AstraZeneca/COVISHIELD or Janssen/J&J.

For AstraZeneca/COVISHIELD, @COVIDSciOntario recently reported their latest global analysis suggests VITT occurs after 1 in every 26,000 doses to 1 in 127,000 doses.

The @COVIDSciOntario table does NOT think VITT is more common in people with a history of clots, on birth control or other hormones, with autoimmune disease, platelet disorders, or who are pregnant.

This is because VITT is not your average type of clot.
bit.ly/VITT-May7

However NACI said those who are pregnant should get an mRNA vaccine since, in the rare chance a pregnant person does get VITT, it'd be more complicated to treat.

That makes a lot of sense, and our fave clotting expert @MPaidMD agrees 👇🏼

https://twitter.com/MPaiMD/status/1391571506153541632?s=20

The experts @COVIDSciOntario do caution that those with a history of heparin-induced thrombocytopenia (HIT), cerebral sinus vein thrombosis (CSVT) with low platelets, and potentially women and younger people may be at a slightly increased risk of VITT.

bit.ly/VITT-May7

If you're anything like me your medical anxiety may be causing you to be HYPER aware of every sensation in your body right now 🥴

So I made this handy chart based on info from @COVIDSciOntario & expert input from @MPaiMD @ASPphysician to help you know what's normal & what isn't.

You know your body. If something feels wrong, talk to your doc.

If something feels REALLY wrong, go to the nearest emergency department & use this thread + bit.ly/VITT-May7 to self-advocate.

Medical gaslighting is a thing & part of why so many of us have medical anxiety.

I've been a ball of anxiety lately. If you feel that way too, you're not alone.

I know it's not always easy to get support (especially when many places in Canada don't have proper #PaidSickDaysNow).

The graphic below & this link may help get you started: canada.ca/en/public-heal…

But again, VITT is rare and symptoms occur within 4-28 days after vaccination with AstraZeneca/COVISHIELD or Janssen/J&J.

Trust yourself, and note the red flags to watch out for 👇🏼

There are no simple solutions in a global crisis.

AstraZeneca/COVISHIELD is key for reducing the COVID crisis around the world. It's helped in the UK, it has helped here in Canada, and I hope it helps our friends in India.

Same with the one-and-done Janssen/J&J vaccine.

It's a HUGE privilege to have any choice on vaccines, even bigger to be able to wait to exercise that choice.

But whatever your situation, when deciding on when to take a vaccine or "which one" to take, please don't forget to factor your risks of COVID into the decision.

For those about to get the AstraZeneca vaccine in Canada, @SabiVM laid it out clearly in the thread below:

https://twitter.com/SabiVM/status/1389405974897774594?s=20

Based on more recent VITT numbers, @ASPphysician re-calculated some of the NACI risk/benefit analyses to help people in different parts of the country understand their personal risk analysis (though remember vaccines also protect your communities):

https://twitter.com/ASPphysician/status/1391076253680156677?s=20

For your second dose, which is very important because it gives the more robust protection you need against variants of concern, I think those who got 1st dose of AstraZeneca will have the option of choosing between an mRNA vaccine for dose 2, pending results from UK study (soon).

Please read the latest summary on VITT from world experts @COVIDSciOntario: bit.ly/VITT-May7

And I highly recommend scrolling through clotting expert @MPaiMD's newsfeed for more updates & interpretations.

Some of the key take-aways from this thread in video form via a conversation I had with the wonderful @KWardTV:

https://twitter.com/KWardTV/status/1391900482344521730?s=20