The pain of a father who lost his son following vaccination.

There is no doubt a trend to deny such deaths for “lack of proof”

Rare. But these are the hidden casualties.

Article shared by a Japanese doctor.

Unfortunately, talking about the downside of vaccination is taboo. ImageImageImage
Talking of the adverse outcomes following vaccination is not the same as “anti vaxx”

In fact, denying downsides by hiding behind the heavy curtains of “proof” is unscientific.

Most medical interventions have downsides. And not everyone has the same risk tolerance.

2/
Ridiculing those who are reluctant to vaccinate is a trend in the west.

Can’t agree with that.

There are people who are afraid to fly, despite knowing that flights are safer than driving. No one ridicules them. At least I don’t.

3/
If someone close to us had a bad outcome after chemotherapy, it is natural for us to feel that it is dangerous. The same holds for all interventions.

If someone is afraid to vaccinate, it is important to talk with them with respect and interest, without looking down at them.

4/
If after hearing the facts they won’t change their mind, it is unfair and plain wrong to call them “loonies” or other such derogatory terms.

A few others deliberately plot against all public health measures, often with a motive to sell unproven “remedies” to make a profit.

5/
That is the section that must be called out as unscientific.

Knowingly or otherwise, they generate big profits for magic remedy (snake oil) sellers. Such sellers exist in every country. They often cite abstract sources to back up their own claim of ‘conspiracies’.

6/
I have noticed that doctors are often “afraid” to acknowledge that vaccination can rarely cause serious complications.

I don’t understand why; because the ethics of a doctor is to explain ALL aspects of disease and treatment to patients and to society, and help them decide.

7/
If doctors start being “one-sided”, to deny that treatments have downsides, ridicule those who ask questions, fail to communicate openly, then in the long run that will erode public trust.

Bottom line:

Vaccination is one of the proven tools to control the pandemic.

8/
But vaccination alone is not going to control it.

Depending on vaccination alone is like sitting on a chair with one leg, ignoring the other 3 legs.

1. Improving room ventilation
2. Avoiding indoor gatherings
3. Wearing masks appropriate for the setting

9/
In any society, there will be a few individuals who have a different risk perception as mentioned above.

But with sincere efforts, vaccine hesitancy can be kept low.

In Kerala, vaccine acceptance is over 97%.

That’s from honest, transparent, respectful communication.

10/10

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More from @RajeevJayadevan

25 Nov
Apples 🍎 to oranges 🍊 comparison alert

Ref. A recent small retrospective study on Covaxin showed “50% effectiveness”. See link for paper & comment

I saw @GargiRawat was unfairly criticised for reporting

See thread; it takes time to understand👇

1/16

thelancet.com/journals/lanin…
1. The original efficacy study on Covaxin was a randomised controlled trial involving over 25,798 people.

This showed 77.8% efficacy against symptomatic disease, 93.4% against severe disease, 63.6% for asymptomatic and 65.2% at delta variant. Had tweeted in detail earlier.

2/
A randomised study starts with 2 groups of people. One gets vaccine, the other gets placebo. They are observed “prospectively” that is looking forward-during a study period. Disease outcomes are measured & compared between the groups. The % difference is reported as efficacy.

3/
Read 20 tweets
25 Nov
From our weekly COVID-19 meetings that had been going on ever since the pandemic started, we issued several advisories to policy makers, media, doctors and the general public.

From this week:

🚩Ignoring early symptoms (e.g. fever) can lead to severe outcomes.

Thread 👇

1/5
COVID-19 has established treatments available such as

1. dexamethasone (saved more lives than all other drugs in COVID-19; but ONLY when used in the right patient, at the right time, in the right dose)

and

2. monoclonal antibodies (only for select indications)

2/
If the diagnosis is delayed, these medications cannot be given, we call it “the window of therapeutic opportunity”

Which means the drugs don’t produce the desired effect once that window has passed

Which means our delay is allowing preventable complications to set in

3/
Read 5 tweets
25 Nov
Myocarditis with mRNA vaccine.

“Patients invariably had chest pain” is a misleading statement.

It is more like “In all REPORTED cases of myocarditis, chest pain was present”

Note myocarditis need not cause chest pain, hence not all patients will seek medical attention.

1/ Image
The diagnostic criteria of “myocarditis” are given below.

However, patients are more likely to notice chest pain than other symptoms. Hence these people get diagnosed, (and reported).

Chest pain is more likely in those who ALSO have PERICARDITIS.

2/

ahajournals.org/doi/pdf/10.116… ImageImage
Myocarditis can occur with other symptoms like palpitations, shortness of breath or may not cause overt symptoms.

Myocarditis might only cause ECG or ECHO cardiogram abnormalities or isolated elevation in cardiac enzymes like Troponin.

This means we could be missing cases.

3/ Image
Read 9 tweets
15 Nov
No decline in real world effectiveness of vaccine against death & hospitalisation. Graphs are drawn from Minnesota data.

I have used a ratio of event rates among unvaccinated : vaccinated population. The graphs show death & hospitalisation rates.

1/5

health.state.mn.us/diseases/coron…
The ratios are based on vaccination % prevailing 30 days prior to each data point, so that it reflects the true effect of vaccination.

It must also be kept in mind that the vaccinated segment by default are older, more likely to fall sick and have serious outcomes.

2/
This implies that the ratios are an underestimate of the true protection offered by vaccines.

In other words, we are not comparing groups of equal health status when we do a ratio of the unvaccinated and vaccinated.

The true protection will be larger.

3/
Read 5 tweets
15 Nov
Two doses of vaccine generate long-lived and stable Memory T cells.

The longevity of immune response to SARS-CoV2 virus depends on the presence and stability of memory cells of the B & T genre.

This is a landmark paper from Rome by Guerrera et al.

1/

science.org/doi/10.1126/sc…
The presence of long lived memory B cells had previously been established in several papers, see my tweets. This paper focuses on memory T cells in response to 2 doses of mRNA vaccine.

I will discuss some basic immunology first, to help understand the context of this paper.

2/
Following the innate response, the adaptive immulogical response to a virus infection is basically two pronged.

The two arms are T cells and B cells.

B cells make antibodies which work like security guards OUTSIDE our gate, preventing the thief from entering the premises.

3/
Read 14 tweets
14 Nov
The most powerful graph that I have seen of the pandemic.

This calls for a rethink of vaccination strategy.

Note the sharp demarcation around age 40-45.

Vaccination of this 40+ segment needs priority.

Below that age, it could even be made optional. Here’s why👇

(Thread)
Although vaccines were launched with a hope of stopping transmission and further waves, we have seen that high % vaccination coverage does not stop subsequent waves. This is because they are ineffective in providing mucosal immunity; virus is silently spreading in communities.
2/
At the same time, we have found that vaccines are not 100% benign products as is often suggested by certain academics.

They have failed to acknowledge the small but significant number of serious and fatal outcomes is that occurred - particularly among younger individuals.

3/
Read 31 tweets

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