The amazing @DrSamiraJeimy and I collaborated on a post because we are both tired of seeing the term ‘immunity debt’ being thrown around.
We also get into why we are seeing a record number of pediatric hospitalizations, so stick with us.
🧵(1/8)
So what is this ‘immunity debt’ concept?
Claims that lack of exposure to infections weakened children's immune systems, causing them to have severe infections.
There is no evidence that this is real.
(2/8)
In the absence of infections, the immune system does not lie dormant & weaken. We are constantly exposed to & co-exist with, trillions of viruses, bacteria & fungi.
Lack of infections does not weaken the immune system. But some infections, like measles and COVID-19, can. (3/8)
Pediatric hospitals are filled with sick children. What is going on?
While numbers of RSV & influenza are not higher than last yr at this time, MORE children are hospitalized than last yr. So higher proportion of children are coming to hospital with severe illness. (4/8)
Why is this occurring?
With removal of public health measures such as masking, many viruses are spreading widely. Given we have had a break from these, most of the population is susceptible & exposed again at the same time. But doesn’t explain the higher % of sick kids. (5/8)
One hypothesis: We know many viral infections, such as Covid and measles, can impact immunity downstream, even after mild infections.
Omicron spread widely among kids, & they may not have immune reserves to fend off subsequent viruses & infections as efficiently as before. (6/8)
To add, there is a massive healthcare staffing crisis. Healthcare workers are sick themselves, leaving healthcare due to being burnt out & underpaid. Without staff, hospital beds are in short supply.
Also, there is an ongoing shortage of fever reducing meds for children. (7/8)
Many are using this crisis to claim that public health measures have somehow impacted our immunity - THIS IS NOT A THING.
The public health measures we took in the last few years only helped reduce the burden of illness and did not in fact cause this crisis. (8/8)
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Bivalent Booster Dose:
Confused about what you should do?
Let's work through this together (1/7)
Health Canada 🇨🇦 has now approved two bivalent boosters:
Moderna BA. 1 for 18+
Pfizer BA. 4/5 for 12+
(2/7)
Adults: Age >60, Immunocompromised or risk factors for severe illness
3+ months out of either an infection or last booster: get a bivalent booster now.
You can get either the Moderna BA. 1 OR Pfizer BA. 4/5 booster. The type of bivalent is less important (see last slide). (3/7)
New data: Reinfection was found to substantially increase the risk of death, hospitalization, and adverse health outcomes, making strategies preventing reinfection critical.
Summary 🧵 1/9
A recent study using the national health care databases of the US Department of Veterans Affairs compared people with first infection, reinfection or no infection.
Estimate risks and 6-month burdens of all-cause mortality, hospitalization and other adverse health outcomes. 2/9
1- Reinfection resulted in additional risks of death, hospitalization and adverse health outcomes, including:
pulmonary, cardiovascular, coagulation and hematologic, diabetes, fatigue, gastrointestinal, kidney, mental health, musculoskeletal, and neurologic disorders. 3/9
Lots of new data on Long Covid especially on vaccines and Omicron, so @LizMarnik and I once again teamed up to update our previous thread with recent studies.
Double-vaccinated have ~50% lower risk after BA.1 vs Delta. But, even in triple-vaccinated, long Covid more common after Omicron BA.2 infections (9.3%) versus Omicron BA.1 infections (7.8%). 2/9
Next up: Lancet systematic review and meta-analysis.
Incidence of any long Covid symptoms was 56.9%, with most common symptoms being:
fatigue, muscle and joint pain, neurological, respiratory, mobility impairment and cardiac issues. 3/9
We (@LizMarnik and I) have been asked many times to share Long Covid data, especially as it pertains to mild infections and neurological, cardiac effects. So we rounded up some recent data. 🧵 1/9
Recent study assessed data from the US Department of Veterans Affairs.
Risk and 1-year burden of cardiovascular disease in survivors of acute Covid-19 are substantial. 2/9 nature.com/articles/s4159…
A recent study looked at the neurological impacts of Covid-19 infection in those aged 51-81. They found reduction in grey matter thickness, smell-related markers of tissue damage, reduced brain size & cognitive decline even in non-hospitalized. 3/9 nature.com/articles/s4158…