Craig Spencer MD MPH Profile picture
Dec 27, 2021 10 tweets 2 min read Read on X
I’ve seen a lot of Covid in the ER recently.

With so many people getting infected recently, some folks may wonder what’s the point of getting vaccinated at all?

And is there really any value to a booster dose if I’ve had two Pfizer/Moderna or a shot of J&J?

My observations: 🧵
Every patient I’ve seen with Covid that’s had a 3rd ‘booster’ dose has had mild symptoms.

By mild I mean mostly sore throat. Lots of sore throat. Also some fatigue, maybe some muscle pain.

No difficulty breathing. No shortness of breath.

All a little uncomfortable, but fine.
Most patients I’ve seen that had 2 doses of Pfizer/Moderna still had ‘mild’ symptoms, but more than those who had received a third dose.

More fatigued. More fever. More coughing. A little more miserable overall.

But no shortness of breath. No difficulty breathing.

Mostly fine.
Most patients I’ve seen that had one dose of J&J and had Covid were worse overall. Felt horrible. Fever for a few days (or more).

Weak, tired. Some shortness of breath and cough.

But not one needing hospitalization. Not one needing oxygen.

Not great. But not life-threatening.
And almost every single patient that I’ve taken care of that needed to be admitted for Covid has been unvaccinated.

Every one with profound shortness of breath. Every one whose oxygen dropped when they walked. Every one needing oxygen to breath regularly.
The point is you’re gonna hear about a LOT of people getting Covid in the coming days and weeks.

Those that have been vaccinated and got a booster dose will mostly fare well with minimal symptoms.

Those getting two doses might have a few more symptoms, but should still do well.
Those who got a single J&J similarly may have more symptoms, but have more protection than the unvaccinated (if you got a single dose of J&J, please get another vaccine dose—preferably Pfizer or Moderna—ASAP!)

But as I’ve witnessed in the ER, the greatest burden still falls on…
The unvaccinated. Those who haven’t gotten a single dose of vaccine.

They’re the most likely to need oxygen. They’re the most likely to have complications. They’re the most likely to get admitted. And the most likely to stay in the hospital for days or longer with severe Covid.
These are all just observations from my recent shifts in the ER.

But the same has been borne out by local and national data showing that the unvaccinated make up a very disproportionate share of those with severe disease, needing hospitalization, and dying from Covid.
So no matter your political affiliation, or thoughts on masks, or where you live in this country, as an ER doctor you’d trust with your life if you rolled into my emergency room at 3am, I promise you that you’d rather face the oncoming Omicron wave vaccinated.

Please be safe. ❤️

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More from @Craig_A_Spencer

Jun 10
I was seeing patients in the ER when I got a text from a friend

"How bad is this thing about RFK Jr removing ALL 17 experts from a CDC vaccine advisory committee?"

Theres been a lot of hot takes on here already

But heres why this makes me worry, from a clinical perspective 🧵
For background, if you haven't heard yet:

There are 17 members of an advisory committee on immunization practices at the CDC. It's called ACIP.

It's made up of brilliant volunteers who review reams of data and make recommendations on vaccines.

They all got booted today.

hhs.gov/press-room/hhs…
There was almost unanimous rebuke from clinical organizations that should give us all pause.

These are the doctors that take of every American — from obstetricians to pediatricians to family practitioners—that ALL came out today to denounce RFK's move today.
Read 13 tweets
May 30
There were disturbing developments this week that will undoubtedly affect your health.

But most people didn't notice, because they weren't so splashy, or may not seem like a big deal.

But I want to talk to you about each of them, why they matter, and why we should be worried:
Earlier this week, RFK Jr stood alongside the FDA and NIH directors and announced a change in COVID vaccine recommendations...

On X. And only X.

No reports, no science, no reflection on the discussion or decision-making process behind this.

This is very concerning...
Over and over, RFK Jr promised 'radical transparency'.

But the process here is just radical.

His official announcement—by tweet—is that Covid vaccines are no longer recommended for kids and pregnant women.

There were scant details. And he doesn't discuss the data, at all.
Read 15 tweets
Apr 7
Today we learned the sad news another kid died from measles in Texas.

We also learned what RFK Jr. will and will not say

And we got a clearer glimpse of the playbook being used to discredit the proven measures to tackle measles outbreaks

Let me tell you why I'm worried 🧵 Image
Let's start with what we know

The death announced today was in an 8 year old girl

The hospital reports she died of 'measles pulmonary failure'

They also report she was unvaccinated

And had no other health conditions

An absolute tragedy. And completely preventable. Image
Her death was the third measles death in the past few months

And the second in a child

There have been more pediatric deaths from measles in the past 2 months as there have been in the previous 2 decades

This isn't just a coincidence

Read 28 tweets
Mar 26
The U.S. has actively dismantled the global disease-detection programs we all—including Americans—rely on to stay safe

Today this administration’s short-sighted global health agenda got even even worse

It’s ending its support for vaccine programs around the world

Why?? 🧵 Image
With unnecessary haste, the Trump administration is pulling funding from GAVI.

GAVI is a massive force in global health.

Since starting in 2000, it has saved millions of lives around the world through vaccination

Gift link to @nytimes story by @snolen
nytimes.com/2025/03/26/hea…
It is focused on getting vaccines to people around the world who need them

For routine immunization…

And also for really important but less common diseases like Ebola

To date, they’ve vaccinated over a billion kids!!!

They are irreplaceable. Losing GAVI would be disastrous.
Read 17 tweets
Mar 12
I just watched the whole RFK Jr—Hannity interview where they discuss measles.

I don't know what to say.

I'm really just speechless.

Listening to health leadership bungle basic facts at best—and tell outright lies about long-settled science at worst—is just SO disappointing.
No, the measles vaccine does NOT wane by 4.5% every year!

He's confusing the measles vaccine for the mumps vaccine, which does wane.

No, Vitamin A is NOT a cure-all, even if it CAN help.

The vaccine is BY FAR the safest way to stay safe.
He keeps saying natural immunity gives you better protection long-term...

But he never says that a measles infection can cause 'immune amnesia', suppressing your immune system immediately and for years after.
Read 5 tweets
Mar 3
The World Health Organization just released an update on the cluster of deaths in the Democratic Republic of Congo.

There's a lot in here, and I'll break it down below.

But the biggest takeaway?

We are SO lucky to have WHO doing this work...

who.int/emergencies/di…
This cluster was first detected in early February in the northwestern part of DR Congo.

So far 55 deaths have been reported.

The deaths were quick—many reported in 24 hrs after symptom onset.

Ebola and Marburg testing was negative Image
Most deaths are in young people, especially males.

50% of those tested for malaria were positive...so it might explain SOME of this, but not ALL of this.

From the report: "working hypotheses include chemical poisoning or a rapid onset bacterial meningitis cluster" Image
Read 7 tweets

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