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Vincent Rajkumar Profile picture
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21 Jul, 4 tweets, 1 min read
We shouldn't make patients feel guilty that they are breaking the law to protect their health. Yet that's what we are doing

1) Medicare Modernization Act asks government to look the other way & use enforcement discretion to not prosecute patients importing drugs for personal use
2) Now similarly I'm seeing a lot of tweets where patients are made to feel they have to lie in order to get a COVID vaccine booster that their own doctors think they need because for example they are immunosuppressed and don't seem to have had an immune response.
The Medicare Modernization Act even went to the extent of saying that it should be made clear what is OK and what is not, so patients know whether they will run into trouble if they for example bought insulin from Canada.
It's always better to have clear laws and guidance on what's ok and what's not.

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More from @VincentRK

Vincent Rajkumar Profile picture
22 Jul
The drop in cases and deaths occurred following start of vaccinations as been reversed in the UK by the delta variant.

Hospitalizations are on the rise in many states the US, and it appears almost all are unvaccinated. Deaths will like rise here as well. Please get vaccinated. ImageImage
Each day brings news reports like this.

Maryland marylandmatters.org/2021/06/28/unv…
Texas texastribune.org/2021/07/21/cor…
Read 8 tweets
Vincent Rajkumar Profile picture
21 Jul
For months I have been advocating for CDC and FDA to issue guidance on second doses for the millions of people who got the single dose J&J vaccine.

Now we have more data. I urge them to act. The delta variant doesn't respect one dose. nytimes.com/2021/07/20/hea…
One dose of Pfizer and Astra Zeneca didn't cut it. There was nothing special about J&J that would have allowed it to be uniquely effective. We knew this months ago.

One dose is not enough. One dose is not = fully vaccinated.
Short term protection which is what was studied in the randomized trials was good. So was it after one dose of Astra Zeneca.

But immunology 101 is that a second exposure to same antigen allows more class switching and more effective and durable response.
Read 5 tweets
Vincent Rajkumar Profile picture
18 Jul
COVID vaccines work & keep severe disease & deaths down. But if England lifts restrictions tomorrow, amidst a serious rise in cases in the UK, it is inviting loss of life.

Why not wait till this spike goes down? Why do it now when you have barely 50% of people fully vaccinated? ImageImage
Deaths are going up, but not in the same magnitude as prior waves coz high % of elderly have been vaccinated.

You can see the rise in deaths better in log scale.

Does the decision mean willingness to accept 50 deaths a day? That is seriously not good. Image
Make some arbitrary decision and stick to it despite overwhelming evidence that the decision is a huge mistake is something we have seen over and over in this pandemic in many (but not all) countries.
Read 5 tweets
Vincent Rajkumar Profile picture
16 Jul
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.
Read 4 tweets
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

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