Adam Toledo

It seems trite to talk about the pandemic this morning. I have a post ready to go for evangelicals. But that will wait until tomorrow. For today, we are holding space on this page for mourning and honoring Adam Toledo, Daunte Wright, George Floyd, Breonna Taylor, Ahmaud Arbery, Philando Castile, Tamir Rice, and many others before them.

We hold space for lamenting, mourning, and tears for those men, women, and 13 year old boy. “True peace is not the absence of tension, but the presence of justice.”- MLK Jr.

We hold space for that tension and mourning here. And, be a part of the justice.

Friends on this site who are mourning more than I can understand, I’m so sorry. You’re seen and heard here.

-Emily

***If this post makes you frustrated, for the love of everything don’t post a comment. You’re missing the point and the problem. Listen, lament, and listen some more.

Texans: You are not close to herd immunity


Although vaccinations in the state have ramped up, we are only at 21%. 21% of the Texas population is fully vaccinated. That puts Texas in the BOTTOM 15 states being fully vaccinated.


Among adults 65+, 56% have been fully vaccinated. That’s a great win! But, that is not herd immunity.

✅ Herd immunity is when enough of the population (total, not just the adults older than 65+) is vaccinated to confer protection on those that aren’t vaccinated. We KNOW that is at least 80% for COVID-19. We have a long way to go – even among the 65+ age group.

✅ Why am I not including those who have been infected with COVID-19? Because vaccine-immunity is better than natural-immunity. I’ll link to all of that data here: https://www.facebook.com/friendlyneighborepidemiologist/posts/268469204775736

Also, the ethical, safest, and most long-term way to achieve herd immunity is through vaccines. Natural immunity will wane quicker than vaccine immunity. The let-it-rip approach to natural infections is wrong with the risk of death and long-haulers.

✅ Are we close to herd immunity? Nope, not close.
Our vaccination rates are lower than Michigan which I wrote about last week: Is Michigan a canary in the coal mine for what’s to come in Texas? https://www.facebook.com/friendlyneighborepidemiologist/posts/279478787008111

✅ We are now seeing cases rise again. Cases are increasing in over HALF of Texas counties over the past 14 days. Hospitalizations are also increasing. The B.1.1.7 variant is increasing in the state and among hospitalized patients (many of who are young). So, vaccinating ALL the population matters greatly with the B.1.1.7 variant which seems to be more severe among younger adults. I wrote about that here: https://www.facebook.com/friendlyneighborepidemiologist/posts/279478787008111

✅ Texans, get your shots and hang in there. Wear your masks and protect those around you. We are not close to herd immunity. We all WANT to be. But, don’t let that feeling make you put your guard down. Let the data dictate our actions.

-FNE

✅SOURCES:
Vaccine data: https://www.nytimes.com/interactive/2020/us/covid-19-vaccine-doses.html

https://tabexternal.dshs.texas.gov/t/THD/views/COVID-19VaccineinTexasDashboard/Summary?:origin=card_share_link&:embed=y&:isGuestRedirectFromVizportal=y

Texas county-specific COVID cases data: https://www.nytimes.com/interactive/2021/us/texas-covid-cases.html

Texas B.1.1.7 variant info: https://www.news-medical.net/news/20210329/New-study-reports-increased-spread-of-B117-variant-in-Houston-Texas.aspx

J&J pause update

Yesterday the ACIP (Advisor Committee on Immunization Practices) met to discuss the J&J data regarding the potential risk of CVST clots. As a reminder, ACIP is made up of experts that are external to CDC, FDA, and J&J – these experts come from really diverse fields of immunology, epidemiology, clinical expertise (MD, etc), policy, and infectious diseases.


✅ Here are my main takeaways:

◾ 1. The 6 cases of rare clots they were looking into (and that I talked about in my previous post here: J&J Vaccine Pause (emily-smith.net) are different than other clots you might already know of (like PE or DVT). These are CVST with low platelets. Why does this matter? The treatment regimens for these specific types of clots are different than other clots. So accurate diagnoses will lead to better treatment.

◾ 2. This pause will help gather more data to inform doctors of what they should be looking out for in case someone presents with CVST symptoms. Again, accurate diagnosis will lead to the best treatment.

◾ 3. A causal link has not been established. But, the pause will let the ACIP committee gather more data over the next few weeks to see if the CVST clots occur in others who received a vaccine. This will give a “wash out” period of a few weeks since these clots occurred with 3 weeks after vaccination.

◾ 4. If you want more details about yesterday’s meeting, YLE did a great cliff notes version here: JJ: Emergency ACIP meeting cliff notes – Your Local Epidemiologist (substack.com)

✅ I want to end this post with speaking to you women who recently received J&J and are nervous. I also got J&J so I understand the mind-games that happen. We KNOW the risk is REALLY LOW – but, your mind may still make you nervous. Y’all, I get that. I hope this can help ease your anxieties with the following points:

◾ Remember these are very, very rare. And, all occurrences have been within 3 weeks of vaccination (most were within 2 weeks). My trusted MD friends that it is extremely unlikely occurrences will occur after that time.

◾ Symptoms to monitor for include a severe headache, belly/gut pain, shortness of breath, or leg pain/swelling. Contact your healthcare provider if you develop those.

◾ Try to remember to breathe. =) I’m not downplaying these occurrences – if you have had a clot of any kind you know those can be scary. Breathing, talking to someone, getting outside, doing what you need to do to overcome those mind-games are a good idea.

◾ For those of you who already struggle with anxiety or depression, this news does not help – even knowing how very rare they are. =) I saw many of you talking about that in the comments in my previous J&J post, and I wish I could just give you a hug. So, do what you have to do to take care of yourself this week.

◾ I’m linking to this post from our gal-pal friends over Dear Pandemic. They wrote a great post about this issue too titled “I got the J&J shot and I’m freaking out…what do I do?”: I got the J&J shot and now I’m freaking out… what should I do? — Dear Pandemic


Take care, friends.
-FNE

SOURCES:

My original J&J post: J&J Vaccine Pause (emily-smith.net)

YLE’s post on the J&J ACIP meeting: JJ: Emergency ACIP meeting cliff notes – Your Local Epidemiologist (substack.com)

Dear Pandemic’s post on “I got the J&J shot and now I’m freaking out…what do I do?”: I got the J&J shot and now I’m freaking out… what should I do? — Dear Pandemic

Giving Back: Loving Our Neighbors

Many of you have asked how you can support or give back for my work and efforts over this past year. For the past months, we have been working on a project on ways for you to do just that. 🥳

✅ Today we are launching the project, titled “Loving Our Global Neighbors”, with my main global partners in Somaliland. Your support will help fund:

– Needed PPE in the country (they are out of gloves and making their own cloth masks. We can do better, friends.)

– Ensuring children and families get the healthcare they need – Funding for my students to conduct research and support that work

– If we raise enough funds, my moonshot dream is to build a NEW maternity ward in the hospital. We can do this! 👏👏👏

For more details, I made a video outlining this work and why it is so important in the midst of COVID-19 in the world.

✅ And, a REALLY great part of this? We have a fantastic donor who will MATCH your gift, dollar for dollar, in what you give. Jackson family, thank you for this generous gift! Will you join me in loving our neighbors? Thank you, FNE community, for walking with me through this past year and as we continue to move forward in 2021. I’ve said it before and I’ll say it again – this FNE community is the best and I’m so thankful for you all. This project, more than anything else, will support me in ways that are most important to me. Thank you for considering, friends!

Here’s the link to give:

https://baylor.scalefunder.com/gday/giving-day/32677/department/39051

– Friendly Neighbor Epidemiologist

***Giving Note: We are launching this through my university, Baylor, so the site giving link will take you to the Baylor University Giving Day. All proceeds that are raised will go towards my project. Thank you, Baylor, for the support!

I’m bursting with joy on this post!

Over this past year, many of you have asked how you can help, give back, or support me. Although I’ve enjoyed the offers of coffee and cookies (y’all know I lurv those by now, along with tacos), I have a better way. =)

I’ve been working on a project near-and-dear to my heart for a while and T.O.M.O.R.R.O.W. I get to share it with you all, my friends, in the FNE community. I’ll give you a hint…it has to do with my personal hero and main colleague you see in the picture. We’ve talked about her before, Dr. Edna, and you can tell we are thrilled. We both got off our last conversation talking about how blessed we are and simply thankful.

So, if you want to give back or support, stay tuned tomorrow! =)

-FNE

***If you missed the posts about Dr. Edna, here you go:

✅ Happy International Women’s Day: https://www.facebook.com/friendlyneighborepidemiologist/posts/258407089115281

✅ To the Drs (women in STEM): https://www.facebook.com/friendlyneighborepidemiologist/posts/210097443946246

J&J Vaccine Pause

Today, out of an abundance of caution, J&J vaccines were paused in the US. On a personal note, I received the J&J vaccine.=) Let me help you sift through these headlines and hopefully calm some fears you might have.

✅ 7 million doses of the J&J vaccines have been administered. Of those, 6 people developed a rare blood clot. Key things to keep in mind:

1. All six recipients were women between the ages of 18 and 48.

2. All clots occurred between days 6 to 13.

3. This is comparable to what was observed with the clots seen after AstraZeneca vaccines in the UK. Those were 4 out of 1 million people, all women between the same ages, and occurred between days 6 to 28 after the vaccine. The J&J and AstraZeneca vaccines are both the same adenovirus type (instead of the mRNA vaccine types) – so, that’s why I’m comparing them.

4. These specific types of clots (CVST) are very, very rare and the pause is part of due diligence with vaccine trials and roll-out. (Without getting too technical, the combination of CVST plus low platelets are what is being investigated.) The background rate of these specific types of clots are 2 to 14 per million. Identifying these events and pausing after 6 people shows that the public health vaccine surveillance system in the US is working. Picking out these 6 events out of the 7 million doses that have already been administered should signal to us that our systems are working.

5. I do not want to downplay these events. But, they do need to be put into context of the overall risk.

– Blood clots associated with COVID-19 are MUCH higher (see the graphic). 6 out of a million with the vaccine versus 165,000 with COVID-19. The risk is much higher if you actually get COVID.

-The risk of clots with birth control pills or smoking are also much higher (see the graphic).

6. Tomorrow the CDC and FDA will jointly examine possible links in a meeting with the outside advisory committee.

I know many of you have questions about what you should do if you already received the J&J vaccine. Should you monitor for symptoms? Are the clots only within the first 2 weeks? Should you get another one if you’re between those ages and a woman? I do expect those recommendations to come tomorrow after the meeting. I’ll keep you updated.

Remember correlation does not equal causation. I hope this post helps squash some of your fears. Many of you are already at an anxious point in the pandemic and I bet these headlines do not help. Stay encouraged, friends. Remember the big picture and the system is working.

-FNE

***Note: The graphic shows the risk for AstraZeneca. These are comparable to the J&J vaccines, but the graphic has not been updated. Also, there are different types of blood clots (which range from rare to common and from non-severe to severe) and the graphic shows all types clumped together. So, it’s not completely apples to apples, but it does help us compare risks.

SOURCE: https://www.nytimes.com/2021/04/13/us/politics/johnson-johnson-vaccine-blood-clots-fda-cdc.html?fbclid=IwAR24_6l0G2rr5rG5BfroGAfG-RYFchH8BhkSgjYo1o90bl6-YweVSotn5Xw