A ranar 11/19/21 FDA ta Amurka ta ba da izini ga duk wani Ba'amurke da ya girmi shekaru 18 da suka sami allurai biyu na Pfizer ko Moderna. Peter Marks ya ce wannan matakin zai "kawar da rudani game da wanda zai iya karɓar maganin ƙara."
Abin ban mamaki, yana haifar da rudani. Amurka a yanzu ta zama mai fice a duniya, kamar yadda zan yi dalla-dalla a kasa. Shawarar da FDA ta yanke, musamman na Moderna, ya saba wa sauran manyan hukumomin kiwon lafiya kuma yana haifar da shakku sosai game da hukuncin hukumar, da kuma ko ya kasance ba tare da bata lokaci ba.
Mafi muni, aikin yana gabatar da tambayoyi na asali na fa'ida da cutarwa. Yi la'akari da wani ba'amurke ɗan shekara 22 mai lafiya wanda ya riga ya ɗauki allurai biyu na Moderna. FDA yanzu tana ba wa wannan mutumin izinin karɓar 50 ug booster harbi na Moderna. Shin hakan yana cikin maslaha? Duk al'umma?
A taƙaice: FDA ba za ta iya sanin cewa amfanin irin wannan mutumin ya fi haɗarin haɗari ba. FDA ba ta ma san fa'idodin wannan mutumin ba kuma yawancin al'umma sun fi haɗarin haɗari. FDA tana yin wasa mai haɗari tare da tsinkayen rigakafi.
Me yasa na faɗi haka? A yanzu, a bayyane yake cewa Moderna yana da ƙimar myocarditis mafi girma fiye da Pfizer. Ganin kasancewar mafi amintaccen madadin, ƙasashen ƙwazo sun rage saurin amfani da Moderna. A partial list:"
Satumba 29, Lardin Ontario, Ca, yana ba da shawarar Pfizer akan Moderna ga mutane 18 zuwa 24
Oktoba 6, Sweden da Denmark sun dakatar da Moderna ga duk wanda ke ƙasa da 30. (A Denmark a ƙarƙashin 18 na iya buƙatar Moderna)
Oktoba 6, Norway ta ba da shawarar a fi son amfani da Pfizer a cikin maza masu ƙasa da 30
Oktoba 7, Finland ta shiga Sweden da Denmark kuma ta dakatar da Moderna don mazan da aka haifa kafin 1991
Nuwamba 9, France yana ba da shawara akan Moderna a duk wanda ke ƙasa da 30
Nuwamba 10, Jamus tana ba da shawarar Pfizer ga duk wanda ke ƙasa da 30 ko mata masu ciki
A cikin ƙaramin ƙarami, don damuwa iri ɗaya, sauran ƙasashe: Denmark, Norway, Taiwan, Afirka ta Kudu duk suna ba da shawarar kashi 1 na rigakafin mRNA (a yanzu)
Duk da haka, a nan Amurka ga mutum mai lafiya mai shekaru 18-30, yanzu muna ba da izinin karɓar kashi na uku na Moderna. Bari mu yi la'akari da inganci da aminci.
inganci
Ya zuwa yanzu, da Sakin latsa Pfizer game da sakamakon mai haɓaka RCT nuna raguwar ƙwayoyin cuta/ kamuwa da cuta. Babu wanda aka kwantar da shi a cikin kowane rukuni-don haka ba mu da masu haɓaka bayanai suna rage asibiti. Babu wanda ya mutu a cikin kowane rukuni-don haka kuma babu bayanai. Mutane biyu ne kawai ke da iskar oxygen ya zauna ƙasa da 93% a cikin hannun kulawa. Ana buƙatar girman samfurin da ya fi girma don gano bambancin haɗarin lamba don ƙarshen ƙarshen, idan akwai. Duk abin da za a iya faɗi tabbas, a yanzu, masu haɓaka suna rage alamun cutar ta covid19. Babu isasshen bayani don sanin yadda wannan raguwar haɗarin ke hulɗa tare da shekarun mai karɓa.
Amma, da aka ba wannan ƙwayar cuta ce mai kama da cuta, a ƙarshe tana samun sars-cov-2 kuma wasu alamu masu laushi mai yiwuwa babu makawa a rayuwar ku. Dole ne mashaya don masu haɓakawa su kasance suna nuna cewa mutum ba zai iya yin rashin lafiya sosai daga kwayar cutar ba, ba wai kawai an rage alamun cutar ba, kuma ba a nuna (har yanzu) ba.
Safety
Ba mu san adadin myocarditis ba bayan kashi uku na Pfizer. Bayanan farko na Isra'ila sun nuna cewa bai kai kashi biyu ba, amma ba sifili ba ne. Ba mu san adadin myocarditis daga kashi biyu na Moderna ba. Tabbas zai fi sifili girma, kuma da alama zai fi Pfizer girma, amma har yanzu ba a san wannan ba.
Net amfani
Don ƙayyade fa'idar net, dole ne mutum ya daidaita inganci da aminci. Shin masu haɓakawa suna rage yawan asibiti a cikin wanda ke ƙasa da 30, ƙasa da 40? Ba mu da wani tunani, kuma aiki ne mai tsayi yin hakan. Adadin asibiti a cikin koshin lafiya, mutanen da ba masu kiba da aka yi wa alurar riga kafi ba a cikin wannan rukunin shekarun sun yi ƙasa sosai, kuma musamman ƙananan tare da jerin kashi 2 na Moderna, har ma da fuskar delta.
Don haka, duk wani myocarditis wanda ya fi sifili wanda ke haifar da asibiti zai iya ɓata duk wata fa'ida daga haɓakawa. Ko da ƙaramin kashi uku na myocarditis na iya haifar da haɓaka cutarwa, musamman ga matasa, maza masu lafiya. Idan wani yanki na myocarditis yana da matsaloli na dogon lokaci, zai zama babbar matsala.
A taƙaice, FDA ba ta da cikakkun bayanai don sanin tabbas cewa haɓakawa-musamman Moderna kashi na uku ga wanda ya riga ya sami allurai biyu-kuma musamman a tsakanin samari masu lafiya suna ba da fa'idar kiwon lafiya. Yana yiwuwa ya zama mai cutarwa. Wannan kawai bai wadatar da hukumar ba.
Sars-cov2 ya yadu a cikin yawan jama'a
Kodayake kowa yana tunanin haɓakawa ya zama dole don canza yanayin cutar, wannan ikirari yana da hasashe sosai kuma ba ta goyan bayan kwararan hujjoji. Idan aka yi la'akari da yanayin da'awar-kamar yadda rashin tabbas yake-dole ne a yanke shawarar rigakafin a matakin lafiyar mutum ba bisa tunanin buri na yaduwar yawan jama'a ba. Mu kawai ba mu san abin da haɓakawa zai iya yi ko ba zai iya yi ba, da kuma mafi fa'ida.
Mafi kyawun mutumin da ke tunanin wannan batu akan twitter shine Walid Gellad.
Anan Walid yana nuna cewa babu wanda ya san haɗarin aminci tare da Moderna:
Shin recs masu haɓakawa na yanzu suna da ruɗani?
Tunanin cewa muna buƙatar samun manufofi iri ɗaya don Pfizer & Moderna saboda duk wani abu da ya rage yana da rudani shine babban wauta da za a faɗi. Kasashe a duniya suna gina manufofi daban-daban na waɗannan samfuran 2 waɗanda aka ba da bayanin fa'idar haɗarin haɗari daban-daban (kamar yadda ya kamata!), Kuma 'yan ƙasar Sweden, Norway, Denmark, Burtaniya, Afirka ta Kudu, da Taiwan duk ba sa tsalle daga gine-ginen da ke cike da ruɗani da sarkar tunani.
Na biyu, an riga an sami rikitarwa a cikin wannan sarari. J&J yana da ƙa'idodi / jagora daban-daban. Akwai allurai daban-daban ta shekaru (5-11 vs 12 da sama) don Pfizer. Pfizer da Moderna suna da allurai daban-daban da kansu (30 vs. 100 x 2 sannan 50).
Ina ganin gaskiya rashin gaskiya ne a ce muna buƙatar girman 1 ya dace da duk shawarwarin ƙarfafawa saboda in ba haka ba yana da "rikitarwa." A ƙarshe, ba su da wata shaida ta kai tsaye cewa ruɗani ya wanzu. Batun magana ce kawai.
Menene gaske yake faruwa?
Ka ba ni damar fayyace abin da nake ganin da gaske ke faruwa a nan. Na farko, ku tuna manyan jami'an FDA guda biyu - Marion Gruber da Phil Krause - sun yi murabus kuma da sun bar hukumar ta yanzu ta rahotannin labarai na gaba. Na gaba tuna….
A tuna, kafafen yada labarai da dama sun ce dalilin murabus din nasu shine matsin lamba daga fadar White House don amincewa da masu kara karfi bisa rashin isassun bayanai. Wanda a yanzu yana faruwa a zahiri a gaban idanunmu, kuma ma'aunin fa'ida na haɗarin haɗari shine mafi muni ga samari, kuma mafi muni ga Moderna, kuma ba mu san ainihin menene ba.
Ba za mu iya mantawa da cewa akwai bambanci tsakanin la'akarin likita da na siyasa ba. La'akarin likita shine menene ma'auni na fa'idodin ƙarfafawa da cutarwa. Asibiti nawa kuke hanawa ta hanyar haɓaka vs. nawa kuke haifarwa ta hanyar haɓakawa (myocarditis)? Kuma wannan ya bambanta da shekaru ko jinsi?
La'akarin siyasa shine adadin lokuta na COVID19 da ke yin labarai. Arzikin siyasar wannan gwamnati da tattalin arzikin Amurka suna da alaƙa da shari'o'i / fargabar Covid-19. Siyasa ba ta damu ba (kamar yadda) game da myocarditis.
Don haka, mafi munin mutumin da kuke son jagorantar waɗannan yanke shawara shine Fadar White House, kuma mafi kyawun mutum shine waɗannan mutane biyu waɗanda kawai suka daina.
Batu na ƙarshe: Masana twitter munafukai ne ko ɓarna a nan. Dubi abin da Walid ya lura game da wani babban kwararre.
A ranar 23 ga Satumba, Ashish Jha yana goyan bayan jagorar ƙarfafa tsoho (mafi ƙanƙanta, amma ba cikakke ba):
Kuma a ranar 18 ga Nuwamba, Ashish ya ce dokokin da ya goyi bayan sun fi rudani fiye da yadda ya kamata.
A ƙarshe, dubi abin da Walid ya yi ya nuna ci gaba da yawo na maganganun da ba daidai ba daga asusu ɗaya:
Final tunani
Yayin da nake tunani a kan wannan yanayin, ina tsammanin akwai manyan matsaloli guda biyu. Ɗaya, ikon yin sharhi game da wannan batu yana da ƙiyayya, tare da yawancin zarge-zargen ƙarya na "anti-vax" ga duk wanda ya ba da shawarar ƙimar fa'idar haɗarin haɗari. Na biyu, mutanen da ke ci gaba da yin tsokaci suna tafka kurakurai tare da tantancewa da cin gajiyar kabilanci. Maganar gaskiya ita ce jama'ar Amurka suna ɗaukar babbar caca mara kyau wanda Turai ta ƙi, kuma kaɗan za su ce akasin haka.
An sake bugawa daga marubucin blog
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Vinay Prasad MD MPH masanin ilmin jini-oncologist ne kuma Mataimakin Farfesa a Sashen Cutar cututtuka da Biostatistics a Jami'ar California San Francisco. Yana gudanar da dakin gwaje-gwaje na VKPrasad a UCSF, wanda ke nazarin magungunan ciwon daji, manufofin kiwon lafiya, gwajin asibiti da mafi kyawun yanke shawara. Shi marubucin sama da labaran ilimi 300, da kuma littattafan Ƙarshen Juyawar Likitanci (2015), da Malignant (2020).
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