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Kashif Pirzada, MD Profile picture
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21 Jun, 11 tweets, 4 min read
A lot of concern about mixing the two mRNA vaccines. Due to the vagaries of global supply, most people who got Pfizer will be offered Moderna in the coming weeks. I'll show you why this is a great thing, and why its important to get your second shot as quickly as possible
A research group sequenced both vaccines from discarded vials, and found that the important spike protein encoding sections were almost exact matches to each other. Some minor differences in the 5' and 3' untranslated areas, used by cells for formatting

github.com/NAalytics/Asse…
If you look at the sequence between the start and stop codons (which tells cells where to start and stop encoding), its off by just one base pair at the end! Both match the spike protein sequence identified early on in the pandemic.
Both vaccines always showed very similar efficacy to each other in trials, and this is being borne out by real world field data as well. These vaccines are supremely effective against all variants of Covid; we are very lucky to have these available to us
The Delta variant is spreading quickly though, is much more contagious than the original, and two doses are needed to fight this variant's vaccine resistance. A delay to wait for your preferred vaccine may leave you unprotected.
It's been 20 years since I did some bench research in a genetics lab as a student, so if any molecular geneticists want to chime, please do!
CureVac is another mRNA vaccine that was being developed in Germany which failed to demonstrate as strong efficacy, but that’s due to some design issues that Pfizer/Moderna were able to avoid:
We need to remember just how unequal vaccine distribution is worldwide. We need to boost initiatives like CoVax. There’s self interest in this too, the rest of the world will keep generating new and more resistant variants until everyone is vaccinated
Great thread on other countries doing mix and match programs with their vaccines:

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More from @KashPrime

Kashif Pirzada, MD Profile picture
14 Jun
With the Delta variant, we'll likely need ~90% vaccinated to get to herd immunity.
It's possible we'll get close to this, 89% of Canadians want to get vaccinated. This is out of the question in most of Europe and the US, where vaccine skepticism is much higher. Vaccine checks on arrival for travelers will be needed
Certain provinces will probably never get to herd immunity:
Read 6 tweets
Kashif Pirzada, MD Profile picture
8 Jun
It’s been a hard day for members of my family and broader community, seeing 3 generations of a whole family wiped out... who look very much like us, and did everything right. They were highly educated, loved this country, worked hard, the Canadian dream in every respect...
My family has been here 51 years, my father came in 1970 (after a harrowing stopover in Moscow, a story for another day) to join his siblings building a life here. He came to a young country full of promise, but blighted by attacks against South Asians.
ftp.issuu.com/uw_imprint/doc…
He and representatives of the community met with the editorial board of a tabloid newspaper in the 70s to get them to stop pushing race-baiting stories targeting the South Asian community. The response: 'We will print whatever sells newspapers.' Thankfully things are better now
Read 16 tweets
Kashif Pirzada, MD Profile picture
2 Jun
We've created this guide on how to protect yourself from an airborne virus using HEPA filters in offices and schools. A simple solution that needs to be used especially in the fall/winter when opening windows and doors will be less practical:
docs.google.com/document/d/17t…
CO2 monitors are an important component to this, and can roughly tell you how much of the air is fresh in a given room. Higher than 700 is risky, and the higher the number, the more you get 'rebreathed' air from another person possibly containing infectious virus.
The goal is to get to 6 ACH (air changes an hour), which is the minimum in most hospital settings. We describe how to calculate this, and what types of filters you should be buying.
Read 7 tweets
Kashif Pirzada, MD Profile picture
6 May
Data from @GovCanHealth which was obtained by @kellygrant1 at @globeandmail with some astonishing stats on effectiveness of the vaccines, even after a single dose. The calculations behind these numbers are here:
This matches roughly with similar stats published by Ontario Public Health. You can download it here: publichealthontario.ca/-/media/docume…
Also discussed here:
Much discussion about the new study from Qatar showing the second dose is more effective, but our situations are not comparable. They stuck to the 3w schedule, so could not study how immunity evolves after more time.
cp24.com/news/early-eff…
Read 7 tweets
Kashif Pirzada, MD Profile picture
6 May
Feeling great today on my ER shift:
- hardly any new critically ill COVID cases
- almost every patient I’ve seen is vaccinated with at least one shot

And the good news keeps coming:
It looks like vaccines will work for all of the variants of concern:
By Sept-Oct almost every child will have access to them as well:
Read 7 tweets
Kashif Pirzada, MD Profile picture
27 Apr
Nova Scotia is giving everyone a masterclass on how to crush an outbreak. With a test positive rate of just 1% they are
- closing schools, non-essential businesses
- limiting essential retail to 25% capacity
- rapid testing 2% of the population daily - a huge undertaking
They long ago limited entry into the province, non resident visitors are being turned back at the border and airport. A far cry from the tepid restrictions at the national border.
cbc.ca/news/canada/no…
Their premier even posts his itinerary everyday! You can just tell every minute is being spent making things safer for his people. A very sharp contrast to the rest of the country.
Read 7 tweets

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