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Vincent Rajkumar Profile picture
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16 Jul, 4 tweets, 2 min read
Well it sure looks like we sure gave a lot of money to Janssen and Moderna.

Astra Zeneca, one of the most affordable vaccines for the world, got the least in public funding from anyone. @NEJM nejm.org/doi/full/10.10…
The article is important. #VaccineEquity nejm.org/doi/full/10.10…
The irony is that vaccines developed with the most amount of public support are the most expensive and least available for poorer countries in the world. Oxford Astra Zeneca having received very little is the one that a lot of the world depends on.
*the second sure was a typo. But in retrospect may be ok.

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More from @VincentRK

Vincent Rajkumar Profile picture
15 Jul
Great discussion of vaccine hesitancy, boosters, vaccine efficacy in immunosuppressed, hugs, & group homes for people with disabilities @inthebubblepod with @ASlavitt and @davidaxelrod

I thought it may be political, but very little politics. And yes the Maryland story is true.
One of topics was when @davidaxelrod referred to his immunosuppressed sister in law. A lot of immunosuppressed patients with cancer are in her situation.

It is good she got tested for antibodies. But currently immunosuppressed patients lack guidance from CDC or FDA to do that.
Do you think the CDC could give guidance to immunosuppressed patients to at least ask their doctors, and give guidance to doctors that checking for neutralizing antibodies is a good idea?
Read 4 tweets
Vincent Rajkumar Profile picture
15 Jul
Why are people not getting vaccinated against COVID?

Some live in countries that don't have vaccines.

Some live in countries which have vaccines but have trouble accessing vaccines.

Some live in countries which have vaccines and have ready access but are vaccine hesitant.
1) Some live in countries that don't have vaccines.

This is the responsibility of countries which have plenty of vaccines to solve. For the right reason, but also in self interest if you don't want your wonderful vaccination rates to be disrupted by a vaccine resistant variant.
2) Some live in countries which have vaccines but have trouble accessing vaccines.

There are people who due to their jobs or poverty have trouble accessing vaccines. This is something that local city & state level governments must resolve. Make it free and easy to get vaccines.
Read 4 tweets
Vincent Rajkumar Profile picture
14 Jul
People keep stating that COVID vaccines lead to more variants. Wrong.

Thread
1) First of all, a vaccinated person is 80-90% less likely to get infected than an unvaccinated person.
2) Say they do get infected, vaccinated people are more likely the type who will wear a mask and be careful if they even get mild symptoms.
3) Similarly, even if infected, studies show vaccinated people have low viral dose, and are much less likely to pass on COVID to someone else compared to unvaccinated people. @gavi @MonicaGandhi9 @Dr_Ellie gavi.org/vaccineswork/m…
Read 6 tweets
Vincent Rajkumar Profile picture
14 Jul
A friend just got a prescription of the diabetes medicine, Ozempic® (semaglutide) injection. 3 syringes: $2200. Fully insured, so out of pocket only $150.

Here the problem:
1/ High price means new medicines like this are only for well off people with good insurance

Thread
2/ And secondly, don't think for a minute that the insurance company is paying the remaining $2050. Due to rebates they may pay $1000 or less.

So the only people who pay the full list price will be unsuspecting uninsured paying cash, who think the list price is the real price.
3/ The exact same thing happens with insulin. One vial of analog insulin costs >$300. Insured people will probably get it with a copay of <$30. The insurance company has to pay only $100 or less due to rebates.

Only people paying $300 are vulnerable diabetics without insurance.
Read 7 tweets
Vincent Rajkumar Profile picture
14 Jul
COVID rising sharply in Spain,Netherlands, UK due to the delta variant. Note all have better vaccination rates than USA. Thanks to vaccination, deaths remain low, so far.

Still worrisome. Lives will be lost, & they will be almost all among unvaccinated. A preventable tragedy.
The loss of life and the morbidity due to hospitalizations among the unvaccinated may not be captured by graphs. The protection in the vaccinated will keep death rates look better than we saw relative to cases last year.

But make no mistake that many families will be crushed.
It is wrong to remain unvaccinated if we are eligible and have access to vaccines.

The vast majority of the world does not have access to life saving vaccines because we are holding them here for you. #GetVaccinated
Read 6 tweets
Vincent Rajkumar Profile picture
14 Jul
What does cure mean in cancer? When can we call a cancer curable?

My thoughts in this article apply to all cancers. ascopost.com/issues/july-10…

@ASCOPost @ASCO #MedTwitter #Myeloma
For those interested in more please read @DeVitaDoctor book "The Death of Cancer".

He cured advanced Hodgkin lymphoma. He first defines when he would use the word cure: you give finite duration of therapy, stop all therapy, and 5 years later the cancer doesn't comes back.
In myeloma treatment is continuous from the beginning.

What happens if you just do that they did in Hodgkin lymphoma. Finite therapy (induction plus transplant) and stop? Even in exceptional responders relapses occur steadily over time. nature.com/articles/s4140…
Read 4 tweets

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