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Vinay Prasad, MD MPH 🎙️📷 Profile picture
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Feb 20 • 5 tweets • 2 min read
Wow, the New York times has finally admitted 50% of the truth about kids & masks; conceding downsides & good outcomes in kids

One more year and they will admit that there is no evidence to show that masking kids slows viral spread.

Halfway there!
nytimes.com/article/mask-m… Image
I reviewed the evidence in July
medpagetoday.com/opinion/vinay-…
Sept
theatlantic.com/ideas/archive/…
And Jan
tabletmag.com/sections/scien…
Each time the truth is more popular!

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More from @VPrasadMDMPH

Vinay Prasad, MD MPH 🎙️📷 Profile picture
Feb 21
Delighted to share visiting scholar's @Timothee_MD latest paper

We analyze a FDA failure: The rapid approval of "totally novel" Melflufen based on surrogate 👇

Followed by withdrawal b/c of increased deaths <8 mo later!

What is going on at FDA?
authors.elsevier.com/sd/article/S19… Image
First, of all there are many many treatment options, many many ongoing trials, and countless combinations already available to treat myeloma

Yes, we need new drugs, but we can wait for RCTs to show they extend survival, we don't need to use broken surrogates like response
Second, melflufen is like me-too melphalan, a drug used for decades.

The drug was approved based on uncontrolled response rate of 23.5%, but what if you just gave pts a different, older alkylator? Image
Read 9 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
Feb 17
Dazzling, daring, stunning piece by JH Russell and @DmpPatterson in @tabletmag tellin the true story of masking during COVID 👇

"The overselling of policies began in the early days of the pandemic with the problematic #masks4all movement...."
must read
🧵
tabletmag.com/sections/scien…
First, they are spot on. Many don't see it, but Trump is so influential, He sets the sides!

When he was for schools, Liberals lost their mind and worked to keep them closed; AAP did a bizarre flip flop & sided with unions to keep them closed.

And the same for masks 👇
Absolutely right again 👇

Inexperienced & naive twitter pundits kept saying the pandemic would vanish if we all worse a mask or n95 for 14, 21 days, a claim....

"neither true nor possible"
Read 20 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
Feb 11
Wow! 👇
secondary endpoint
potential for infinite looks at data
yet still, scant events (50?) of dubious clinical value (some asx?)
Plus other issues, including durability discussed in video

But postponing/ flip flopping is going to poison vax confidence

White house should not have pressured FDA on boosters
Gruber and Kraus should still be there
Politics cannot dictate vaccine approval
This is a total fiasco
This administration is doing serious, serious damage to vaccine confidence
The backlash will hurt a lot of people
States will get rid of good programs to encourage routine childhood immunization
Vaccines become even more political
This administration does not have a plan here
They should have awknowledged natural immunity
and tried for just 1 dose in people with no prior NI
Read 5 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
Feb 3
Lots of talk of wearing masks.
The policy question is: what happens when you advise people to:
Wear cloth masks
Wear surgical
Wear n95s

You have to combine mask properties with real world compliance

Ans:
No benefit
11% benefit in setting w no immunity & high bias rct
No trial
The 11% benefit should have an* because there is a serious risk of concealment being revealed in the study due to imbalance and study population by arm
If you pair this imbalance with the idea that people will be slightly less likely to report symptoms if they were enrolled on the margin. You have a big problem
Read 6 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
Feb 2
Some people are reporting that the failed Pfizer trial kids 6mo -4yo will show a reduction in symptomatic infections even though the antibody titers failed

Here is why even that data will be problematic 🧵
The first question will be how many of these infections occurred when Omicron was the dominant strain.

Any infection from the prior strain will not be that interesting or pertinent.
The next question will be: how symptomatic were the kids.

The second dose of their vaccine was perfectly timed so that the transient immunity would occur during the Omicron Wave. This also coincided with widespread asymptomatic testing for the holidays
Read 10 tweets
Vinay Prasad, MD MPH 🎙️📷 Profile picture
Feb 2
This administration's COVID-19 policy is best summarized by n95 for kids, while nursing home patients are unboosted

We do controversial things on the lowest risk that will make no difference, but poison public sentiment

And we don't do simple things that would save lives

🧵
Here are some controversies:
White House pushes boosters so FDA officials resign
We push boosters down to 12 years old without all appropriate advisory committees
We use Pfizer data so Moderna can be given booster at 5 months
We mandate millions of 20-year-olds get boosted in college or for certain employers even though they are at negligible risk after vaccine, and there is no evidence, booster will further lower their risk of severe outcomes
Read 20 tweets

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