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I have lots of thoughts on the pausing of the J&J vaccine.
The biggest is that I’m glad that we do good science and post-vaccine monitoring. The 2nd is that even if real, this association is very small. More below: https://apnews.com/article/politics-immunizations-coronavirus-pandemic-2dde2aacf486bab59844ef907a28cbce
The biggest is that I’m glad that we do good science and post-vaccine monitoring. The 2nd is that even if real, this association is very small. More below: https://apnews.com/article/politics-immunizations-coronavirus-pandemic-2dde2aacf486bab59844ef907a28cbce
1. Reporting 6 cases of cerebral venous sinus thrombosis plus low platelets- the same complication observed w/ AstraZeneca - among 7 million doses administered.
**If real, it would never have been picked up by clinical trials. The rate is TINY. No trial involves millions of ppl.
**If real, it would never have been picked up by clinical trials. The rate is TINY. No trial involves millions of ppl.
2. What makes it plausible?
the same complication has been reported as a very rare SE of AZ
these 2 vaccines have the same “vector” (adenovirus) https://www.gavi.org/vaccineswork/what-blood-clotting-disorder-astrazeneca-vaccine-has-been-linked
the same complication has been reported as a very rare SE of AZ these 2 vaccines have the same “vector” (adenovirus) https://www.gavi.org/vaccineswork/what-blood-clotting-disorder-astrazeneca-vaccine-has-been-linked
3. Even if real, let’s put it in context: if you catch #COVID19 you have an approximate 20% chance of getting a blood clot, according to a recent systematic review. (The real rate may be a little lower.)
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30383-7/fulltext
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30383-7/fulltext
4. Let’s compare: Which is higher?
5. Science and medicine, like life, is full of weighing risks vs benefits.
Right now, the risk of catching #covid19 & getting a bad complication is much higher than this very rare adverse effect.
BUT - for some groups (women? Young women?) that assumption may not be true.
Right now, the risk of catching #covid19 & getting a bad complication is much higher than this very rare adverse effect.
BUT - for some groups (women? Young women?) that assumption may not be true.
6. What is INDUBITABLY true right now is that #covid19 cases are rising in the US and across the world, and the J&J vaccine is very very good at preventing disease / excellent at preventing severe disease and death.
7. What is also true is that it is difficult for most of us to accurately judge risk of Omission (risk of avoiding vaccines) versus risk of commission (risk of getting vaccines).
We over estimate the latter, to our own - and our community’s - peril.
We over estimate the latter, to our own - and our community’s - peril.
8. There's also this: https://twitter.com/MaxKennerly/status/1381949175756099591?s=20
9. Looking forward to more data on WHO is at risk (if anyone), and WHAT the next steps should be. The guidance will evolve.
If anything, though, this should reassure folks that the science is transparent. Nothing is being hidden. We are all on the same team.
If anything, though, this should reassure folks that the science is transparent. Nothing is being hidden. We are all on the same team.
