A word on #AstraZeneca (making the decision about your 2nd shot, and when the 🤬 you can get your 2nd shot)... 1/x
The frustration of Ontarians who got AZ for dose #1, and now feel hung out to dry since their 2nd dose hasn't been accelerated, is palpable. Think the insistence on a 12 week gap isn't science based? You're right. It sucks, and it's scary (esp if you're in a hotspot!) 2/x
I have yet to meet a scientist or health care professional who thinks that a 12 week gap between AZ and mRNA is carved in stone. And NACI - the TRUE vaccine experts - have already said 4-12 weeks is fine. Their recommendations should hold a lot of weight. 3/x
If you received AZ, know that many of these knowledgeable experts are advocating for narrowing the window between shots, ESPECIALLY in hotspots, where we know that getting 2 doses in fast is most important. We need a nimble vaccine strategy in the face of the delta variant. 4/x
So hang tight. People are working hard to encourage the government to make the right decision ASAP, and help get us to a better place, faster. While you wait for dose 2, continue to follow PH guidance re: masks, distance. Avoid the indoors. Enjoy the outdoors safely. 5/x
Use your time to reflect on how this pandemic has been handled. Frustrated about decisions that weren't science based, that made inequity worse, that harmed the people that any humane society should protect and prioritize? Bookmark that. There's an election next year. 6/x
Maybe call @fordnation at 416-325-1941 and add your voice to the chorus that's demanding a vaccine rollout (and a pandemic recovery) that protects ALL Ontarians. #GenXZeneca is the last generation that grew up phoning, not emailing or texting. Let's use our telephonic skills. 7/x
And if you're on the fence about what vaccine to pick, check out this decision aid! Another team effort from docs, scientists, pharmacists, and patient partners. We'll walk you through the AZ vs mRNA decision so you can decide what's right for you. uwaterloo.ca/pharmacy/sites… 8/x
Big ❤️ to @AndreaChittle, @SabiVM, @heysciencesam, @NoahIvers, @DrSamiraJeimy, @PharmacistMama, @tara_kiran, @hwitteman, @DrKateJMiller & our super efficient UWaterloo contingent, @kgrindrod and @adrianwpoon. You guys are my pandemic silver lining. 9/x
Have a good weekend, Ontario. Stay safe. Get vaccinated. Better days ahead. 10/10
Okay, just one more. It's a privilege to be in the same orbit as Dr @Tania_WattsUofT, one of this country's foremost immunologists. People like to hand wave about "science," but Dr. Watts' thoughts on this issue are the SCIENCE (+ expertise + experience).

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More from @MPaiMD

22 May
Lots of AZ questions swirling. I can’t answer them all (1. Don’t actually have all the answers; 2. Need a Twitter break for my 🧠 health!) But @JHMustapha’s tweet resonated: yes, info on AZ and VITT changing DAILY. If this makes you anxious, you may elect not take AZ again. 1/n
To give informed consent to AZ you must appreciate seriousness of these clots (they’re serious), risk of waiting for a different vaccine (moot, as mRNA supply ⬆️), and risk of getting VITT w 2nd dose. UK data is evolving so risk of 1:1mill has ⬇️ to 1:600thou and may ⬇️ more. 2/n
That’s not because scientists are jerks or governments are duplicitous or anything else shady! It’s bc as we do things over and over (eg. Give more shots), we will estimate a risk closer to the truth. I can’t guess what the “true” incidence of VITT w 2nd dose is. 3/n
Read 12 tweets
10 May
Okay one more thread before bed! Lots of Qs asking "what IS VITT?" Before I get to that, if you'd like an AWESOME metaphor about vaccine choice, please read my buddy @DrKateJMiller's, then read on for some FACTS about VITT clots caused by AZ and J&J...
@COVIDSciOntario has published an evidence based brief on VITT (which includes a lay summary). All science, no spin. (Seriously, no spin.) @heysciencesam has helped us break the VITT facts down into tasty evidence bites. covid19-sciencetable.ca/sciencebrief/v…
These are the facts. 4-28 day window for symptoms to start (typical immune reaction... just like autoimmune HIT for the #hemetwitter nerds). Those incidence figures are referenced in the brief. covid19-sciencetable.ca/sciencebrief/v…
Read 10 tweets
10 May
LONG week on call @HamHealthSci. Lots of calls about #VITT post AZ vaccine. I'm transparent w my patients - I believe empowerment leads to earlier detection, better outcomes, less stress. So I'm grateful to @heysciencesam for creating tools to help me be transparent with YOU! 🧵
If you've had AZ 4-28 days ago, be on the lookout for the following symptoms. If you have them, seek medical attention! (Sam, thx for making the doctor in this graphic look JUST LIKE ME 😜 #GenXZeneca #WomenInMedicine)
How do migraine sufferers know if this is a VITT headache? VITT headache often worse, more persistent, or has diff features than your usual headache. It might go with visual changes. When in doubt: seek care. We're educating clinicians about VITT here: covid19-sciencetable.ca/sciencebrief/v…
Read 10 tweets
7 May
⭐️ @COVIDSciOntario’s UPDATED guide to Vaccine-Induced Immune Thrombotic Thrombocytopenia #VITT Following Adenovirus Vector COVID-19 Vaccination! covid19-sciencetable.ca/sciencebrief/v… Image
If you’re NOT a healthcare professional, we have a lay summary for you here: covid19-sciencetable.ca/sciencebrief/v…
And targeted guides for outpatient and ED/inpatient settings are coming soon! (We’ve been working so hard on this our keyboards have caught 🔥. Need a quick breather.)
Read 6 tweets
3 May
There have been a lot of… thoughts about NACI’s statement on “preferred vaccines” today. Many feel angry/bewildered/tricked/confused/all of the above. I get it. I still stand by this thread. As my friend @ASPphysician has said, not much has changed. Let me elaborate... 1/n
FIRST, I must emphasize the clotting issue. Clots associated with the adenovirus vector COVID-19 vaccines (“VITT”) are SERIOUS. If you have weird symptoms that start 4-28 days post shot, seek medical care. A doc can order a complete blood count to see if you could have VITT. 2/n
In the next day or two @COVIDSciOntario will be posting an updated symptom list. For now, our existing version will do. I’ll post it as soon as it’s ready. Please don’t second guess symptoms post-vaccine. Early detection matters. 3/n
Read 22 tweets
23 Apr
So you read today’s NACI advice - AZ ok if you’re 30+! Unless you can wait for mRNA 💉! And then you read the MANY hot takes from experts, non-experts, and para-experts. And you are SCARED. Let’s work through it. (The required reading is below). 1/n ema.europa.eu/en/documents/c…
Disclaimer: I’m a blood clot doctor. I am not a public health expert. Or an ID doc. But you wouldn’t believe how much I talk to people about weighing their risk of clots. (So much.) I can help you make good choices for you (and be less petrified if you just got AZ yesterday.) 2/n
Here’s the real UP TO DATE (as of now) risk of getting VITT (the bad AZ clots). If you’re under 50 it’s between 1/50K and 1/100K. Wish I could be more precise. But when the science is moving fast and the event is rare, you can’t make better predictions than that. 3/n
Read 23 tweets

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