tjwebbmd.com

08/10/2021

So many people have sent me this video of Dr. Dan Stock at the Mt. Vernon school board meeting that I felt a sense of urgency to offer a minute-by-minute analysis as quickly as possible. I'm a little over halfway through, and my attention is called back to clinical responsibilities. I'll try to finish the rest as soon as possible, but wanted to go ahead and share what I have (so please forgive the typos)...

We have now given 352 million COVID-19 vaccine doses in the US alone and over 4 billion doses worldwide, and there is well over there is still no evidence that the COVID-19 vaccines cause antibody-…

08/05/2021

I haven't had any time to write about COVID-19 misinformation recently. But I've seen this being spread around Facebook recently and I think we need to better understand what this means.

𝐓𝐡𝐞 𝐁𝐚𝐫𝐧𝐬𝐭𝐚𝐛𝐥𝐞 𝐨𝐮𝐭𝐛𝐫𝐞𝐚𝐤 𝐢𝐬 𝐚 𝐠𝐫𝐞𝐚𝐭 𝐞𝐱𝐚𝐦𝐩𝐥𝐞 𝐨𝐟 𝐡𝐨𝐰 𝙚𝙛𝙛𝙚𝙘𝙩𝙞𝙫𝙚 𝐭𝐡𝐞 𝐯𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐚𝐫𝐞; 𝐭𝐡𝐞𝐲 𝐬𝐡𝐨𝐰 𝐮𝐬 𝐰𝐡𝐚𝐭 𝐚𝐧 𝐨𝐮𝐭𝐛𝐫𝐞𝐚𝐤 𝐨𝐟 𝐭𝐡𝐞 𝐝𝐞𝐥𝐭𝐚 𝐯𝐚𝐫𝐢𝐚𝐧𝐭 𝐨𝐟 𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐰𝐨𝐮𝐥𝐝 𝐛𝐞 𝐥𝐢𝐤𝐞 𝐢𝐧 𝐚 𝐡𝐞𝐚𝐯𝐢𝐥𝐲 𝐯𝐚𝐜𝐜𝐢𝐧𝐚𝐭𝐞𝐝 𝐩𝐨𝐩𝐮𝐥𝐚𝐭𝐢𝐨𝐧.

Barnstable is a county of 213,000 people in the 2nd most densely populated state in the country. It just suffered an outbreak triggered by a super-spreader event. This resulted in only about 500 cases of COVID-19 (in residents; we don't have data, including vaccination data, on the other half who were from out-of-state), 5 hospitalizations, and 0 deaths. About 79% of the population is fully vaccinated there; saying 74% of those who got COVID-19 during this outbreak were vaccinated is a bit like saying "the people who lived there are the ones who got it there"; unvaccinated Texas and Floridians couldn't have gotten COVID-19 from the outbreak in Barnstable County Massachusetts; they were in Texas and Florida.

All of the evidence we have from the other 3,005 counties (and 64 Parishes) in the US strongly suggests that if Barnstable had had this outbreak with, say, a 36% vaccination rate like we have here, this would 𝙣𝙤𝙩 be a mere 500 person outbreak with 5 hospitalizations and 𝐳𝐞𝐫𝐨 deaths. Less densely populated counties without super-spreader events are seeing worse numbers than these every day, and their hospitals and ICU's are filling up as patients continue to die.

We are a smaller county with half the population density, excellent local leadership, and no recent super-spreader events; yet we have 853 active cases, 161 new cases from just yesterday (I diagnosed some of those personally), and over a 100 hospitalizations. Most of those cases- and almost all of those hospitalizations- are unvaccinated patients. Our numbers just leave Barnstable county standing- it's because we have such a low vaccination rate.

Vaccines don't put a forcefield around us that keep us from coming in contact with the virus; they prime our immune system to fight the virus when we do come into contact with it by teaching us how to build effective antibodies and a targeted immune response. No vaccine can keep every person from becoming symptomatic when they are exposed to COVID-19. But they reduce infections and thus transmission, and most importantly they greatly reduce the risk of severe illness and death; that has been their purpose since they were invented in the late 1700's, and that was the purpose of vaccination's predecessor, inoculation, which we inherited (one could argue, stole) from African, Indian, and Asian traditional healing practices.

Right now, hospitals all over the country are drowning in almost entirely unvaccinated COVID-19 cases that are absolutely overwhelming our medical infrastructure, and many of those patients are dying tragically. They didn't have to. None of the patients who got COVID-19 in the Cape Cod outbreak did. The Barnstable outbreak is indeed a warning about just how contagious the Delta variant really is. It also shows us how much better off we would right now as a nation if all of our counties- and parishes- had vaccinated at the rate of Massachusetts.

05/20/2021

It's been a while since I've written on any COVID-19 or vaccine misinformation, but this one hits close to home. This physician trained at the same program I did.

A Brief Apology It’s been a difficult pandemic. And while our COVID-19 cases and the severity of illness we faced as a community was undoubtedly worse over the Winter, the hardest time period…

03/03/2021

I don't have time to write about Texas, the state where I live and practice medicine, deciding today to stop requiring masks and to "100% reopen." If you want more info I suggest you start with my friend Dr. Emily Smith, the Friendly Neighbor Epidemiologist: https://www.facebook.com/friendlyneighborepidemiologist/posts/254900069465983

But I did take the time to fix the official announcement from the Governor's Office. You're welcome, Governor's Office.

02/11/2021

As a Physician, one of the most difficult dichotomies to hold in tension is the contrast between the heroic sacrifices you have seen your colleagues make on behalf of their patients every single day, and the very real harm and humiliation so many people have experienced at the hands of doctors.

It means that even if you’ve spent every day of your professional life listening with empathy, maintaining high standards of truth and kindness, and fighting for equitable care for your patients, the trust of a patient still isn’t something you are 𝙚𝙣𝙩𝙞𝙩𝙡𝙚𝙙 to.

Trust has been broken by other doctors, by systems we have been complicit in or too complacent with, and unless we are flawless (I’m certainly not), even by ourselves.

We have to 𝐫𝐞𝐛𝐮𝐢𝐥𝐝 trust. With every single patient, every single time.

02/09/2021

𝐖𝐢𝐥𝐥 𝐲𝐨𝐮 𝐬𝐡𝐚𝐫𝐞 𝐰𝐢𝐭𝐡 𝐦𝐞 𝐭𝐡𝐞 𝐞𝐩𝐢𝐬𝐨𝐝𝐞 𝐨𝐫 𝐬𝐞𝐫𝐢𝐞𝐬 𝐨𝐟 𝐞𝐯𝐞𝐧𝐭𝐬 𝐭𝐡𝐚𝐭 𝐦𝐚𝐝𝐞 𝐲𝐨𝐮 𝐬𝐭𝐨𝐩 𝐭𝐫𝐮𝐬𝐭𝐢𝐧𝐠 𝐝𝐨𝐜𝐭𝐨𝐫𝐬?

𝐚𝐧𝐝/𝐨𝐫

𝐖𝐢𝐥𝐥 𝐲𝐨𝐮 𝐬𝐡𝐚𝐫𝐞 𝐭𝐡𝐞 𝐞𝐯𝐞𝐧𝐭 𝐭𝐡𝐚𝐭 𝐫𝐞𝐬𝐭𝐨𝐫𝐞𝐝 𝐲𝐨𝐮𝐫 𝐟𝐚𝐢𝐭𝐡 𝐢𝐧 𝐝𝐨𝐜𝐭𝐨𝐫𝐬 𝐚𝐧𝐝 𝐦𝐨𝐝𝐞𝐫𝐧 𝐦𝐞𝐝𝐢𝐜𝐢𝐧𝐞?

𝐍𝐨𝐭𝐞: I'm committed to not defend, explain away, or argue the other side of any story or incident shared here (unless specifically asked to by the commenter), and I'll ask others to do likewise.

02/06/2021

A recent survey found that only 25% of Black Americans were planning to get the COVID-19 vaccine. As a primary care physician, I've been talking about the vaccines with my patients for over a month now and helping them navigate all of the myths and misinformation so they can make the most informed choice possible.

For my Black patients, those discussions have a specific historical context that has to be acknowledged and addressed; this long history of medical research abuse against Black Americans.

In this article, and with no small amount of trepidation, I take a look at that history, discuss the ongoing healthcare disparities that have placed an increased burden from COVID-19 on Black communities and the need for equal access to the new vaccines, and most importantly, share a list of resources from Black physicians, scientists, and public health experts.

Black Americans face a double-edged sword. Longstanding healthcare inequities and neglect of Black healthcare needs places Black communities in a position of heightened vulnerability to the COVID-1…

01/30/2021

A video of Dr. Simone Gold speaking about the COVID-19 vaccines at a church in Florida is going viral right now and needs to be addressed.

I typically don't like to post incomplete blog entries, but this vaccine misinformation video is about an hour long and I've got a long afternoon in front of me.

I'm breaking it down minute-by-minute and will update the website after each timestamp. Feel free to follow along or check back later.

*The following post is currently in-progress.* If you are looking for an analysis/debunking of a particular section of the video that is not yet posted, please check back later.

01/19/2021

I just read that Dr. Simone Gold of "America's Frontline Doctors" was arrested for her involvement in the storming of the US Capitol, during which she also gave a speech against the COVID-19 vaccines and calling COVID-19 a "non-lethal virus." Dr. Gold doesn't know me from Adam, but at this point she feels like an old antagonist to me; I've been arguing against her COVID-19 misinformation for what feels like ages.

Dr. Gold is a physician and a lawyer and ought to have known better on both counts; first, she should have realized the illegality of her actions, and with a degree in law does not have the excuse, which I actually find rather sympathetic, that she was duped by the election misinformation into thinking she was performing a noble, patriotic, and ultimately legally permissible act on behalf of her country.

But even more compelling to me is that she should have known better months and months ago when she began spreading COVID-19 misinformation and lies, placing political goals and rhetoric above her Oath to first do no harm, to honor the hard won scientific gains of those physicians in whose footsteps she walks, to apply all measures for the benefit of the sick, to prevent disease whenever she can (because prevention is always preferable to a 'cure', which in this case she has only claimed to have in hydroxychloroquine), and even to remember that she is a member of a society and has an obligation to her fellow human beings.

I do not wish ill on her, and honestly hope (and expect) that her illegal actions will be met with clemency. But I sincerely hope that this incident may do what being demonstrably wrong on every point of scientific contention throughout this pandemic, and the deaths of 400,000 of her countrymen, have not done; I hope it will teach her the seriousness of her own actions and the power of her own words, for either good or ill. God alone knows how many people her viral misinformation videos have hurt.

If you need a reminder of who Dr. Simone Gold is, I've addressed her misinformation letters and videos in a few prior posts. I was also sent another lecture of hers, this time against the COVID-19 vaccines, which I hope to address soon.
https://tjwebbmd.com/.../americas-frontline-doctors-i...

https://tjwebbmd.com/.../covid-19-as-a-mass-casualty...

No Dr. Immanuel, it is not unethical to refrain from using a medication in a clinical scenario where it has no proven efficacy. This is the philosophy that led to the opioid epidemic and every day …

01/07/2021

𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐐𝐮𝐞𝐬𝐭𝐢𝐨𝐧𝐬 & 𝐀𝐧𝐬𝐰𝐞𝐫𝐬

𝐈𝐟 𝐈 𝐠𝐞𝐭 𝐭𝐡𝐞 𝐯𝐚𝐜𝐜𝐢𝐧𝐞, 𝐜𝐚𝐧 𝐈 𝐬𝐭𝐢𝐥𝐥 𝐭𝐫𝐚𝐧𝐬𝐦𝐢𝐭/𝐬𝐩𝐫𝐞𝐚𝐝 𝐭𝐡𝐞 𝐯𝐢𝐫𝐮𝐬?

This is a question I’ve heard frequently, especially from those who themselves work in healthcare or have vulnerable friends and loved ones. It is a question driven by compassion. In this blog we have been trying to address the fears and concerns that arise not only from conspiracy theories and misinformation, but also from the very small but real risks associated with the vaccines; yet I know that many people would brave whatever degree of risk to themselves (again, It’s very small) if it meant protecting their family and community. If they could be guaranteed that their choice to get vaccinated meant they could safely visit an unwell grandparent or have coffee face to face with a friend without any risk of spreading the virus, it would be a no brainer 𝙚𝙫𝙚𝙣 𝙞𝙛 there was a considerable risk it might cause significant side effects like Bell’s Palsy (there isn’t: https://tinyurl.com/y3pkuxh5).

And I wish I could give that complete reassurance today, but while I 𝑐𝑎𝑛 say that the chances are very good this vaccine will not only protect you but also protect those around you, we still need much more data to be able to quantify the degree of that protection.

The point of the vaccines is to provide your systemic adaptive immune system, the part that acts powerfully and rapidly against specific disease, with the information it needs to produce the antibodies you need to keep you from getting very sick. A common misconception is that after you get say the flu shot, you can’t get the flu. It’s not true. The flu shot doesn’t give you a magical forcefield around your body that blocks flu virus, it just helps you fight it much, much more quickly and efficiently when you do get it; often to the point that you never even know you are infected, or at least only have very minor symptoms (Image 1). 𝙑𝙖𝙘𝙘𝙞𝙣𝙚𝙨 𝙙𝙧𝙖𝙨𝙩𝙞𝙘𝙖𝙡𝙡𝙮 𝙧𝙚𝙙𝙪𝙘𝙚 𝙩𝙝𝙚 𝙘𝙝𝙖𝙣𝙘𝙚𝙨 𝙤𝙛 𝙮𝙤𝙪 𝙗𝙚𝙘𝙤𝙢𝙞𝙣𝙜 𝙚𝙭𝙩𝙧𝙚𝙢𝙚𝙡𝙮 𝙞𝙡𝙡 𝙛𝙧𝙤𝙢 𝙙𝙚𝙖𝙙𝙡𝙮 𝙙𝙞𝙨𝙚𝙖𝙨𝙚 𝙡𝙞𝙠𝙚 𝙞𝙣𝙛𝙡𝙪𝙚𝙣𝙯𝙖, 𝙢𝙚𝙖𝙨𝙡𝙚𝙨, 𝙤𝙧 𝘾𝙊𝙑𝙄𝘿-19; 𝙩𝙝𝙖𝙩’𝙨 𝙩𝙝𝙚𝙞𝙧 𝙟𝙤𝙗.

This main function of vaccines is what underpins the epidemiology strategy of giving the COVID-19 vaccine to healthcare workers and the most vulnerable first. The medically vulnerable, because they are the most likely to require high levels of care, to suffer long-term problems from infection, or to die from COVID-19; and healthcare workers because as the pandemic worsens it becomes more and more important to preserve our medical workforce, and vaccinated folks are less likely to need sick time (much less become seriously ill and require hospitalization themselves) for COVID-19. The other reasons for vaccinating healthcare workers go back to courage, trust, and solidarity with our patients in the face of any new treatment (https://tinyurl.com/y7xlc4ko). We are prioritizing vaccinating the vulnerable instead of say pathologic extroverts because the effectiveness of the vaccines at preventing significant illness 𝙞𝙨 𝙠𝙣𝙤𝙬𝙣 (90-95%), but their effectiveness at preventing transmission is still unknown (image 2).

So how do we find out so that Dustin can get his vaccine? Well, the big question mark is 𝙄𝙜𝘼 𝙖𝙣𝙩𝙞𝙗𝙤𝙙𝙞𝙚𝙨 (Image 3). Most of the research on antibody production from COVID-19 vaccination focuses on IgM and IgG because they predominate in the blood and represent, respectively, our short-term and long-term antibody protection against systemic (whole body) illness. But IgA is the main antibody in the mucous membranes; your mouth and throat, nasal passages, lung surfaces, and digestive track (it’s also the antibody responsible for passive immunity transmitted through breastmilk), and we know that the IgA response to infection is a big, big part of what neutralizes the virus and decreases transmission in those first 10 days of symptoms. If the vaccines “only” cause a significant IgG and IgM response during that post-vaccine exposure to the COVID-19 virus, it will prevent severe infection; and may still prevent enough viral replication to stop transmission. But if it produces a strong IgA response too (or a strong enough mucosal IgG response), it will almost definitely neutralize any live virus in the upper airway as well, making transmission as unlikely as severe illness. In other words, the degree of IgA response is a strong predictor of whether the vaccine protects those around you as well as it protects you.

Because of this, researchers are already studying the degree of production of mucosal IgA against COVID-19 in vaccine recipients, with some promising results, and at least one intranasal vaccine (which produce a very strong IgA response) is under development. And while the best information we could get would be to see exactly how well someone develops IgA and neutralizes the virus by studying them when they are exposed to COVID-19 after vaccination, it’s sort of hard to catch people in that window. In the end we will probably have to settle for epidemiology data instead; carefully watching to see if clusters of infection occur around exposed, asymptomatic 𝙫𝙖𝙘𝙘𝙞𝙣𝙖𝙩𝙚𝙙 people at the same rate that they do around 𝙪𝙣𝙫𝙖𝙘𝙘𝙞𝙣𝙖𝙩𝙚𝙙 people. That will take time, but if and when it becomes apparent that vaccinated people really aren’t spreading the virus to those around them at all, that will be the point I’ll stop wearing my mask, practicing social distancing, and washing my hands (fine, fine; I’ll keep on washing my hands: https://youtu.be/VK2vpOh5wws).

I realize this was a really long-winded way of saying “I have no idea,” but I want to conclude with a few reasons you should get the vaccine even if your main concern is not spreading the virus to others. 𝐅𝐢𝐫𝐬𝐭, there is already a lot of good data that supports the idea that these vaccines will provide mucosal immunity (and thus decrease transmission), both from studies of the COVID-19 vaccines themselves (Image 4) and from our much more robust knowledge of vaccines in general; it’s hard to say anything with much confidence yet because we’ve had these vaccines for such a short time, but I’m pretty optimist they will. We’ve followed these principles for years; we recommend everyone around a newborn be vaccinated against Pertussis (whooping cough) because the newborn can’t be, and we know that vaccine-derived herd immunity works even for viruses that are primarily spread through respiratory particles. 𝐒𝐞𝐜𝐨𝐧𝐝, there is no conceivable mechanism by which they would increase transmission. The vaccines 𝙘𝙖𝙣𝙣𝙤𝙩 make you produce live virus (at all) so they can’t make you contagious, and if you are exposed to COVID-19 later on your body will still respond with a mucosal immune response whether it is augmented by your vaccine or not (and it probably will be); the vaccine won’t stop that. And 𝐭𝐡𝐢𝐫𝐝, by preventing a severe systemic illness, the vaccine will decrease the amount of time you are shedding virus and prevent transmission in some of the most high-risk settings; aerosol producing procedures like nebulizer treatments or intubation in the hospital. And by preventing symptoms like coughing and sneezing the vaccine will make you less contagious when exposed to the virus, as long as you are still following other transmission control measures like wearing a mask and quarantining after exposure.

So no, unfortunately being vaccinated against COVID-19 does not give us carte blanche to schedule giant indoor parties, throw away our masks, and treat the pandemic as if it were over; but they are a huge step in that direction, and in addition to protecting ourselves they do have a fair, if yet unproven, chance of protecting those around us too. And besides, if you don’t get vaccinated, how are you going to get your government tracking microchip?

Bad joke, sorry.

𝐍𝐞𝐱𝐭: "𝐀𝐫𝐞 𝐭𝐡𝐞 𝐯𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐞𝐭𝐡𝐢𝐜𝐚𝐥 (𝐚𝐛𝐨𝐫𝐭𝐢𝐨𝐧, 𝐡𝐮𝐦𝐚𝐧 𝐜𝐞𝐥𝐥𝐬 𝐥𝐢𝐧𝐞𝐬, 𝐚𝐧𝐝 𝐦𝐞𝐝𝐢𝐜𝐚𝐥 𝐫𝐞𝐬𝐞𝐚𝐫𝐜𝐡)?"

𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐐𝐮𝐞𝐬𝐭𝐢𝐨𝐧𝐬 & 𝐀𝐧𝐬𝐰𝐞𝐫𝐬:

𝐅𝐮𝐥𝐥 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐐&𝐀 𝐎𝐧 𝐓𝐉𝐖𝐞𝐛𝐛𝐌𝐃.𝐜𝐨𝐦 (updated regularly): https://tjwebbmd.com/.../covid-19-vaccine-questions-and...

𝟭. 𝐇𝐨𝐰 𝐝𝐨 𝐭𝐡𝐞𝐬𝐞 𝐯𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐰𝐨𝐫𝐤? https://tinyurl.com/ycetonku
𝟮. 𝐖𝐢𝐥𝐥 𝐭𝐡𝐞 𝐯𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐡𝐚𝐯𝐞 𝐚𝐧𝐲 𝐥𝐚𝐬𝐭𝐢𝐧𝐠 𝐞𝐟𝐟𝐞𝐜𝐭 𝐨𝐧 𝐦𝐲 𝐛𝐨𝐝𝐲? (𝑨: 𝒀𝒆𝒔!) & 𝐖𝐢𝐥𝐥 𝐭𝐡𝐞𝐲 𝐜𝐚𝐮𝐬𝐞 𝐢𝐧𝐟𝐞𝐫𝐭𝐢𝐥𝐢𝐭𝐲? (𝑨: 𝑵𝒐!) https://tinyurl.com/yabolsbf
𝟑. 𝐀𝐫𝐞𝐧'𝐭 𝐭𝐡𝐞 𝐯𝐚𝐜𝐜𝐢𝐧𝐞 𝐢𝐧𝐠𝐫𝐞𝐝𝐢𝐞𝐧𝐭𝐬 𝐭𝐨𝐱𝐢𝐜? (𝐴: 𝑁𝑜) https://tinyurl.com/y6a2rex9

𝐎𝐭𝐡𝐞𝐫 𝐕𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐏𝐨𝐬𝐭𝐬:

𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐌𝐢𝐬𝐢𝐧𝐟𝐨𝐫𝐦𝐚𝐭𝐢𝐨𝐧 𝐕𝐢𝐝𝐞𝐨 𝐃𝐞𝐛𝐮𝐧𝐤𝐢𝐧𝐠 https://tjwebbmd.com/2020/11/21/covid-19-vaccine-misinformation-minute-by-minute-analysis

𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐚𝐧𝐝 𝐁𝐞𝐥𝐥’𝐬 𝐏𝐚𝐥𝐬𝐲: 𝐈 𝐰𝐢𝐬𝐡 𝐬𝐡𝐞 𝐰𝐚𝐬 𝐦𝐲 𝐩𝐚𝐭𝐢𝐞𝐧𝐭. https://tjwebbmd.com/2020/12/31/covid-19-and-bells-palsy-i-wish-she-was-my-patient

𝐍𝐨 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐒𝐞𝐥𝐟𝐢𝐞 𝐘𝐞𝐭 or "𝘞𝘩𝘺 𝘐 𝘢𝘮 𝘶𝘯𝘤𝘰𝘮𝘧𝘰𝘳𝘵𝘢𝘣𝘭𝘦 𝘨𝘦𝘵𝘵𝘪𝘯𝘨 𝘷𝘢𝘤𝘤𝘪𝘯𝘢𝘵𝘦𝘥" https://tinyurl.com/y7xlc4ko

"𝐀 𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐰𝐢𝐭𝐡 𝟗𝟓% 𝐄𝐟𝐟𝐞𝐜𝐭𝐢𝐯𝐞𝐧𝐞𝐬𝐬... 𝐓𝐞𝐥𝐥 𝐌𝐞 𝐀𝐧𝐨𝐭𝐡𝐞𝐫 𝐁𝐞𝐝𝐭𝐢𝐦𝐞 𝐒𝐭𝐨𝐫𝐲." https://tinyurl.com/y7ylla8k

𝐅𝐫𝐢𝐞𝐧𝐝𝐥𝐲 𝐍𝐞𝐢𝐠𝐡𝐛𝐨𝐫 𝐄𝐩𝐢𝐝𝐞𝐦𝐢𝐨𝐥𝐨𝐠𝐢𝐬𝐭 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐒𝐞𝐫𝐢𝐞𝐬
𝐒𝐭𝐚𝐫𝐭 𝐇𝐞𝐫𝐞: Herd immunity and vaccines: Vaccines 101 – https://tinyurl.com/y27txvro

12/31/2020

𝐖𝐞 𝐧𝐞𝐞𝐝 𝐭𝐨 𝐜𝐡𝐚𝐧𝐠𝐞 𝐭𝐡𝐞 𝐜𝐨𝐧𝐯𝐞𝐫𝐬𝐚𝐭𝐢𝐨𝐧 𝐚𝐫𝐨𝐮𝐧𝐝 𝐭𝐡𝐢𝐬 𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐯𝐚𝐜𝐜𝐢𝐧𝐞 𝐁𝐞𝐥𝐥'𝐬 𝐏𝐚𝐥𝐬𝐲 𝐯𝐢𝐝𝐞𝐨.

Yesterday two patients, both African American, asked me about the COVID-19 vaccines, and about this viral video specifically. After a long, heartfelt conversation, both are again considering getting vaccinated.

This is exactly why I got my vaccine last week.

𝐖𝐞 𝐜𝐚𝐧𝐧𝐨𝐭 𝐭𝐚𝐥𝐤 𝐚𝐛𝐨𝐮𝐭 𝐭𝐡𝐢𝐬 𝐯𝐢𝐝𝐞𝐨 𝐰𝐢𝐭𝐡𝐨𝐮𝐭 𝐭𝐚𝐥𝐤𝐢𝐧𝐠 𝐚𝐛𝐨𝐮𝐭 𝐡𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞 𝐣𝐮𝐬𝐭𝐢𝐜𝐞 𝐚𝐧𝐝 𝐀𝐦𝐞𝐫𝐢𝐜𝐚𝐧 𝐦𝐞𝐝𝐢𝐜𝐢𝐧𝐞'𝐬 𝐟𝐚𝐢𝐥𝐮𝐫𝐞 𝐭𝐨 𝐜𝐚𝐫𝐞 𝐟𝐨𝐫 𝐏𝐞𝐨𝐩𝐥𝐞 𝐨𝐟 𝐂𝐨𝐥𝐨𝐫.

Contents:
-Having a Healthy Incredulity About Internet Videos
-Bell’s Palsy: Medical Facts
-Bell’s Palsy: Why I Wish She Were My Patient
-Healthcare as War on Black Bodies: Vaccine Skepticism as a Consequence of Systemic Racism in Medicine

These vaccines are the best hope we have of ending the pandemic. I believe in them. They are safe, and your chances of developing a significant reaction- including Bell’s Palsy- is incredibly…

12/30/2020

𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐐𝐮𝐞𝐬𝐭𝐢𝐨𝐧𝐬 & 𝐀𝐧𝐬𝐰𝐞𝐫𝐬

𝐀𝐫𝐞𝐧'𝐭 𝐭𝐡𝐞 𝐯𝐚𝐜𝐜𝐢𝐧𝐞 𝐢𝐧𝐠𝐫𝐞𝐝𝐢𝐞𝐧𝐭𝐬 𝐭𝐨𝐱𝐢𝐜?
(𝐴: 𝑁𝑜)

Those whom I interact with regularly who are undecided or hesitant about vaccines are typically patients and parents with sincere, legitimate questions, who deserve the time it takes to hear their concerns, answer their questions completely, and offer reassurance. But unfortunately, 𝙩𝙝𝙚𝙧𝙚 𝙖𝙧𝙚 𝙖𝙡𝙨𝙤 people out there who are promoting anti-vaccine propaganda and deliberately creating false information. One common strategy to increase unease or paranoia about vaccinating our children is to simply list the scientific sounding ingredients and then ask, “𝘥𝘰 𝘺𝘰𝘶 𝘳𝘦𝘢𝘭𝘭𝘺 𝘸𝘢𝘯𝘵 𝘵𝘰 𝘱𝘶𝘵 𝘵𝘩𝘢𝘵 𝘪𝘯𝘵𝘰 𝘵𝘩𝘦𝘪𝘳 𝘣𝘰𝘥𝘪𝘦𝘴?” Usually this approach will ignore benign sounding ingredients like “sucrose” or “gelatin”, and focus in on lengthy or scientific-sounding ingredients like “nicotinamide adenine dinucleotide” or “cetyltrimethylammonium bromide,” which register emotionally as more intimidating, less safe, and less natural. Of course we know that logically a chemical with a long name would not necessarily be any more or less dangerous than one with a short name; “ricin” has a short name, and it’s the 5th most dangerous chemical in the world (that is 𝗷𝘂𝘀𝘁 an example; there is 𝗡𝗢 ricin in your vaccines. 𝘐 𝘥𝘰 𝘯𝘰𝘵 𝘸𝘢𝘯𝘵 𝘵𝘰 𝘴𝘦𝘦 𝘢 𝘣𝘶𝘯𝘤𝘩 𝘰𝘧 𝘮𝘦𝘮𝘦𝘴 𝘯𝘦𝘹𝘵 𝘸𝘦𝘦𝘬 𝘤𝘭𝘢𝘪𝘮𝘪𝘯𝘨 𝘵𝘩𝘦𝘺 𝘱𝘶𝘵 𝘳𝘪𝘤𝘪𝘯 𝘪𝘯 𝘷𝘢𝘤𝘤𝘪𝘯𝘦𝘴). But fear mongering is not always logical.

They might also home in on a naturally occurring and well known chemical that most people think about in conjunction with another of its uses, counting on that association alone to create fear. A good example is 𝗳𝗼𝗿𝗺𝗮𝗹𝗱𝗲𝗵𝘆𝗱𝗲, which most of us think of in the context of embalming, but is also used in applications from color photography to deodorants; and of course, as an anti-bacterial and anti-fungal in certain vaccines. Some vaccines contain about .005 to .01 mg per dose; a 2 month old baby produces up to 200 times more than that every single day as a part of their normal metabolism (for adults, it’s more like 3,000 times more). Yet because our culture so strongly associates formaldehyde with death, merely invoking it’s name is enough to create unease.

Most of the ingredients in vaccines are there to keep the attenuated or killed virus pieces from decaying long before they are injected. Others are there to prevent the growth of bacteria or fungi in the vaccine vials themselves. Still others are used to stimulate the body’s immune cells around the injection site to make them more likely to produce an adequate response that leads to long-term immunity. 𝗔𝗹𝗹 chemicals we encounter in our lives are toxic under certain circumstances or in high enough doses (image 3); 𝙣𝙤𝙣𝙚 of the ingredients in vaccines are toxic at the doses or in the manner given. I think people often forget that the scientists who design the vaccines, and the doctors and nurses that counsel patients about them and inject them, are human beings who also vaccinate ourselves and our children; we want vaccines to be safe for 𝙨𝙚𝙡𝙛𝙞𝙨𝙝 reasons, too, not just altruistic ones.

That all applies to traditional vaccines; the new mRNA vaccines are made differently, and so they don’t need a lot of the same additional chemicals to ensure they work. In fact, what’s shocking about them is just how few ingredients they actually have. In addition to the messenger RNA molecules themselves, the Pfizer vaccine has just 4 synthetic fats (lipid nanoparticles) meant to deliver the mRNA into the cells that will build the COVID-19 spike protein, 4 salts to make sure the vaccine is at the same acidity and osmolality as the tissue it is being injected into so it can get absorbed (and hurt less), and 1 sugar, sucrose, to protect the vaccine during cold storage.

Salt, fat, sugar. And that’s it.

Some of the substances can still cause a reaction; the leading theory right now is that the few anaphylactic reactions to the Pfizer vaccine were likely due to polyethylene glycol, a common chemical we give in huge doses for constipation, but which can cause an extremely rare, but serious, allergic reaction. This chemical is used to create the lipid nanoparticles through some Tony Stark level methods I can’t hope to understand. The lipid nanoparticles (very small fat molecules that can protect the mRNA) themselves are indeed new technology; which in science terms means about 30 years old (Image 4). Over that time period their safety has been studied extensively and found to be safe, non-toxic, and biocompatible/biodegradable. And because the world is crazy, 𝙣𝙤, 𝙩𝙝𝙚𝙮 𝙖𝙧𝙚 𝙣𝙤𝙩 𝙩𝙞𝙣𝙮 𝙧𝙤𝙗𝙤𝙩𝙨 (Image 5)(but how cool would that be?!).

I can’t claim to be familiar with every anti-vaccine meme and article out there, but I haven’t seen as much about ‘toxic ingredients’ with the COVID-19 vaccine, and I think that’s because even compared to the safe ingredients of traditional vaccines the ingredients of the COVID-19 mRNA vaccines, marvels of modern science, still manage to 𝙨𝙤𝙪𝙣𝙙 very unimpressive, and thus feel less intimidating.

𝐍𝐞𝐱𝐭: "𝐈𝐟 𝐈 𝐠𝐞𝐭 𝐭𝐡𝐞 𝐯𝐚𝐜𝐜𝐢𝐧𝐞, 𝐜𝐚𝐧 𝐈 𝐬𝐭𝐢𝐥𝐥 𝐭𝐫𝐚𝐧𝐬𝐦𝐢𝐭 𝐭𝐡𝐞 𝐯𝐢𝐫𝐮𝐬?"

𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐐𝐮𝐞𝐬𝐭𝐢𝐨𝐧𝐬 & 𝐀𝐧𝐬𝐰𝐞𝐫𝐬:
𝐅𝐮𝐥𝐥 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐐&𝐀 𝐎𝐧 𝐓𝐉𝐖𝐞𝐛𝐛𝐌𝐃.𝐜𝐨𝐦 (updated regularly): https://tjwebbmd.com/2020/12/24/covid-19-vaccine-questions-and-answers

𝟭. 𝐇𝐨𝐰 𝐝𝐨 𝐭𝐡𝐞𝐬𝐞 𝐯𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐰𝐨𝐫𝐤? https://tinyurl.com/ycetonku
𝟮. 𝐖𝐢𝐥𝐥 𝐭𝐡𝐞 𝐯𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐡𝐚𝐯𝐞 𝐚𝐧𝐲 𝐥𝐚𝐬𝐭𝐢𝐧𝐠 𝐞𝐟𝐟𝐞𝐜𝐭 𝐨𝐧 𝐦𝐲 𝐛𝐨𝐝𝐲? (𝑨: 𝒀𝒆𝒔!) & 𝐖𝐢𝐥𝐥 𝐭𝐡𝐞𝐲 𝐜𝐚𝐮𝐬𝐞 𝐢𝐧𝐟𝐞𝐫𝐭𝐢𝐥𝐢𝐭𝐲? (𝑨: 𝑵𝒐!) https://tinyurl.com/yabolsbf

𝐎𝐭𝐡𝐞𝐫 𝐕𝐚𝐜𝐜𝐢𝐧𝐞𝐬 𝐏𝐨𝐬𝐭𝐬:
𝐍𝐨 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐒𝐞𝐥𝐟𝐢𝐞 𝐘𝐞𝐭 or "𝘞𝘩𝘺 𝘐 𝘢𝘮 𝘶𝘯𝘤𝘰𝘮𝘧𝘰𝘳𝘵𝘢𝘣𝘭𝘦 𝘨𝘦𝘵𝘵𝘪𝘯𝘨 𝘷𝘢𝘤𝘤𝘪𝘯𝘢𝘵𝘦𝘥" https://tinyurl.com/y7xlc4ko

"𝐀 𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐰𝐢𝐭𝐡 𝟗𝟓% 𝐄𝐟𝐟𝐞𝐜𝐭𝐢𝐯𝐞𝐧𝐞𝐬𝐬... 𝐓𝐞𝐥𝐥 𝐌𝐞 𝐀𝐧𝐨𝐭𝐡𝐞𝐫 𝐁𝐞𝐝𝐭𝐢𝐦𝐞 𝐒𝐭𝐨𝐫𝐲." https://tinyurl.com/y7ylla8k

𝐅𝐫𝐢𝐞𝐧𝐝𝐥𝐲 𝐍𝐞𝐢𝐠𝐡𝐛𝐨𝐫 𝐄𝐩𝐢𝐝𝐞𝐦𝐢𝐨𝐥𝐨𝐠𝐢𝐬𝐭 𝐕𝐚𝐜𝐜𝐢𝐧𝐞 𝐒𝐞𝐫𝐢𝐞𝐬
𝐒𝐭𝐚𝐫𝐭 𝐇𝐞𝐫𝐞: Herd immunity and vaccines: Vaccines 101 – https://tinyurl.com/y27txvro