If @nytimes report is correct that diagnosis in vaccine recipient is transverse myelitis (TM), then level of concern goes up https://tinyurl.com/yygkas9s Why? First, biologic plausibility: an immunologically-mediated attack is what we worry about re: vaccine side effects (1/4; Thread) https://twitter.com/Bob_Wachter/status/1303497045257457666
Second, transverse myelitis is fairly unusual, with estimated 24 cases/million in U.S. (if you include transverse myelitis that turn out to be initial presentation of multiple sclerosis, and not just isolated transverse myelitis, which is even rarer) https://tinyurl.com/y4dugqg7 (2/4)
Via back-of-envelope math, over 2 months, among 15,000 people (approximate # that have been vaccinated; ~half of 30K in the trial; the other half get placebo), the baseline expectation is that 0.06 pt would get TM in absence of vaccine. So concern re: cause & effect is real (3/4)
We'll need to wait for more info (Is TM truly the diagnosis? Did patient have other risk factors for TM? Any hint of other immunologic side effects in other vaccine recipients?). But, based on the above, the concerns have merit and a full investigation seems prudent (4/4).(End)