#NACI (Canada's advisory board of vaccine scientists) has summarized the latest science: they recommend mRNA over AstraZeneca as the 2nd dose of #COVID19 vaccine. Here's why... 1/n canada.ca/en/public-heal…
1) It seems to be more EFFECTIVE. AZ-mRNA and mRNA-mRNA appear to give a more effective immune response against variants of concern (and the delta variant is spreading in Canada), based on small studies + big real world experience. 2/n
2) It appears to be SAFE. We mix and match a lot of vaccines, safely, and the aforementioned studies + experience show the safety of AZ-mRNA too. 3/n
3) It reduces the RISK OF VITT to zero. We believe the risk of VITT is <1 in 655,000 with 2nd dose AZ. It is zero with mRNA vaccines. 4/n
Remember that Health Canada approves vaccines for use & monitors safety, NACI gives advice, and your province makes the ultimate decision on who gets what. No province has indicated it will forbid 2nd dose AZ. It is still your choice to get it if you wish. Or get mRNA. 5/n
If you just got your 2nd dose AZ, you may be worried! But remember, you were probably comfortable with AZ the first time around. You know what to look for with regards to VITT. You will be fine. You made the GOOD choice to get TWO doses, which means you're fully vaccinated. 6/n
This has been a rollercoaster ride. We are nearing the end. Get your 2nd shot. Help your loved ones, your community to get their 2nd shot (or their 1st). We'll smother the embers of this virus through vaccination and public health measures. I promise. 7/7
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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
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
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
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...
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…
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…
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.)