The vaccine rollout is spreading - and so is the delta variant. Lots of folks are concerned about the risk of myocarditis in young people who receive mRNA. My advice: make sure your sources include true experts - in this case, doctors who look after heart disease in kids. 1/n
My experience with #VITT left me shaken, as misinformation about blood #clots was amplified (often by other MDs). Science & medicine are a big tent. BUT within those tents are people with specialized training and experience - and their words should carry weight! 2/n
Definitely look at studies, watch the CDC's ACIP live streams, consider the words of doctors, nurses, PH, epidemiologists, scientists of all stripes. But pay close attention to the words of FPs, pediatricians & pediatric cardiologists. I'm happy to speak *around* this issue. 3/n
In particular, interpreting some of the studies and the stats (which I'm qualified to do - I have a graduate degree in health research methodology on top of my MD, and #scicomm is part of my job). But my knowledge of kid's hearts? Next to nothing. 6 lectures in med school. 4/n
Failure to consider the views of other people with more expertise and experience (and that includes patients with the specific condition) is a big red flag. Humility matters. Dunning-Kruger Effect is real. As a parent, I will vaccinate my kids as soon as I can... 5/n
Based on the expertise of pediatricians, immunologists, vaccine scientists, pediatric cardiologists, and our family doctor. When it comes to my kids' health, I want credible, compassionate, evidence-based opinions. 6/6 cnn.com/2021/06/13/hea…
+1: Oversight not to mention the phenomenal surgeons, nurses, allied health professionals, parents, and translational researchers who have a lot to say about heart health in kids. Nothing but ❤️❤️❤️ to them. Looking forward to hearing all of your trusted voices.

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More from @MPaiMD

11 Jun
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
Read 11 tweets
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

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