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Vinay Prasad, MD MPH 🎙️📷 Profile picture
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12 Sep, 6 tweets, 2 min read
The NYTimes coverage of covid and children has sensationalized the risk, & lacked numerical perspective.

As such the coverage torpedoed 1 year of in person school, and now is leading anxious parents to push for off-label vaccine &. going to extremes....
thread
I believe that people should ALWAYS enroll in randomized controlled trials, but one should do so from a neutral emotional state with knowledge of potential risks and benefits.

Pushing for off-label use is not good.
This is a direct result of NYtimes & others fearmongering 👇
This part puzzles me. Even without a covid vaccine, isn't it totally safe for a kid to go camping -- aka OUTSIDE?-- with their family? Were they holding off on going outside?
Yes, the rate is higher than it has been, but the rate is still.. very very low compared to risks we take all the time in life

Why won't the time put the risks in perspective?
These are UK data:
A bigger risk to kids than sars-cov-2 are adults who lack the ability to weigh those risks against prolonged school closure.

Here is one solution:
We can just increase the sample size of these trials... more slots & more power for rare AEs

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More from @VPrasadMDMPH

Vinay Prasad, MD MPH 🎙️📷 Profile picture
16 Sep
Asymptomatic testing of highly vaccinated young populations (e.g college) serves no purpose.
1. No one will follow similar restrictions off campus (aka pointless)
2. These kids are going to get SarsCOV 2 eventually (endemic)
3. It will disrupt their life
4. Policies...
In response make no sense
Masking outdoors
5. Most of the regions doing this are not the regions suffering from delta wave. In fact the place suffering from delta wave won't do it, and the places with high vaccination will do it.
6 mostly signaling
7. College kids protested Vietnam b/c they understood how pointless it was; They have not yet protested this b/c they have been deceived into thinking it helps. Sad times.
Read 4 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
15 Sep
This NEJM booster paper DOES NOT justify mass population boosting

4 issues
1. People who get boosters and those who do not are TOTALLY different people. Look at table 1.
This is confounding by indication/ diff. people/ diff behavior Image
2. The effect size for severe disease is RR 20!
Too good to be true.
An RCT will be fast to exclude a benefit of this size (its just resid. confounding) Image
3. The benefit on any disease is smaller than on severe disease, which makes less sense from an Ab point of view (should be opposite), and more from the type of people getting booster point of view. Image
Read 6 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
14 Sep
The goal of schools and kids is
1. Keep the kids in person as much as possible
2. Use the least amount of disruptions/ restrictions to achieve this so that
3. They can have as normal a childhood as poss.

So:
No to interventions that dont work: making them mask outside 🧵
Yes to cluster RCTs to test if indoor masking works and if so at what ages

Yes to experimenting with less quarantine

No to keep kids apart outside at recess

No to forcing them to gobble meals in 14 mins
No to deep cleaning and other hygiene theater exposing them to chemicals for no purpose

Every onerous restriction you place on them you must be testing to prove it works.

No more indefinite pass on generating evidence
Read 4 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
13 Sep
Want to show 3 comparisons btw today's Lancet article by the now resigned/ retired FDA officials from Vaccine products & what I've been saying about boosters.

Lancet thelancet.com/pb-assets/Lanc…

My piece medpagetoday.com/opinion/vinay-…
1/4
2/4 We both start by pointing out the many problems with vaccine efficacy studies; How we are comparing apples to oranges due to time varying confounding...
3/4 Both essays discuss the need for a global 1st dose strategy
Read 4 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
12 Sep
I agree with many points in both nested threads by @walidgellad and @AngryCardio

I have seen some argue that these study authors should lose medical licenses, and other ridiculous proposals.

The hardest things to grapple with IMO are: despite all limitations.... 1/5
2/5 the final estimate 1/6800 is consistent with several other reports -- Norway, Ontario, Israel and the FDA's own statement.

Myocarditis is clearly real, clearly causal, and clearly worse with Dose 2 -- just as the earth revolves around the sun
3/5 A sensible person will start to think about ways to preserve the bulk of covid benefit while minimizing this ham. 1 dose, etc. are ways to think about that; We have been on this for months now.
medpagetoday.com/opinion/second…
Read 5 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
12 Sep
What we will likely regret re US pandemic:
[THREAD]
1. Entire USA shut down hard in early March (for many places this was excessive, 4 others came too late, NYC).

Use of restrictions at wrong time depletes the populations energy & cannot be sustained....
....eventually, places like SD, the south, etc would fatigue, grow irritated, loosen restrictions and appetite to reinstitute would be gone

2. Whether or not lockdowns work & for what duration will be probed in 10k empirical papers, some will be good
medpagetoday.com/opinion/vinay-…
Likely lockdowns have modest, non durable effects under very specific circumstances, and deploying them in blanket ways instead of targeting resources to the communities with spread was a gargantuan error
Read 21 tweets

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