Thread by @SherOnHealth

A pandemic is not a time for moral grandstanding and PR spin but we've gotten a double dose of each when faced in Canada with the choice of vaccinating with AstraZeneca to prevent #COVID19 1/16

Public Health and public figures pushed AstraZeneca at a time when vaccines were scarce and variants and cases were surging, telling Canadians it was their duty to take AZ first if that was the 1st vaccine available. 2/16

But messaging shouldn’t trump math when fighting an enemy whose spread threatened to overwhelm the capacity of our hospitals to treat all acutely ill patients. 3/16

The messaging was based on a faulty premise: That by taking on the risk of AstraZeneca, Canadians were willing to sacrifice themselves as individuals for the broader, public good. 4/16

The messaging was also based on bad math: Public Health lowballed the risk of AstraZeneca and was slow to adapt risk assessment to emerging data from other countries. 5/16

When the math is corrected, this is clear: For some, the risk of critical illness is greater from AstraZeneca than from COVID19. For them, getting AZ increases personal risk AND places a greater burden on our hospitals since they are more likely to end up in an ICU. 6/16

It’s never been a question of choosing between individual risk and public good -> when the math is right, the goals are complimentary. 7/16

Other countries get it.
In the UK, birthplace of AstraZeneca, public health excluded those under age 30, and then later, those under age 40. 8/16

But in Canada, some who pushed the patriotic narrative seem focused on making sure those who heeded that advice don’t feel bad. They again are focused on the message at the expense of the math and science that protects us. 9/16

Some of those ‘message over math’ folks warn that if we say some vaccines are worth the wait for some people, we undermine confidence in vaccines and grow resistance to getting vaccinated. The opposite is true… 10/16

When messaging trumps science, we undermine public confidence in public health, we seed doubt and we increase hesitancy. It was false messaging that dug this hole and more of the same will dig us deeper. 11/16

Is it likely the case that AstraZeneca now is better than an mRNA later for some people but not others? That’s what many mathematical models shows. 12/16

As for those who took AstraZeneca not only to protect themselves but because they believed the public messaging that doing so protected the broader community too, they should be praised – they had reason to believe they were serving the public good. 13/16

But those who shaped the messaging should take time to reconsider. Don’t dumb down public health messaging. Canadians are smart enough to understand nuances and this pandemic has taught many about the nature of science and evidence. 14/16

Shape your messaging with the same principles that underlie good science: Be honest, transparent and adapt to changing evidence and circumstances. 15/16

Remember too that Canadians are patients and deserve to know enough about options so that their choices are based upon informed consent. 16/16