
Infectious diseases doc in #theSoo @saultareahosp @thenosm
Sault Ste. Marie, Ontario
Joined December 2010
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Lucas Castellani retweeted
There have been a number of questions raised about my statement that GRADE should be abandoned as a basis for drafting clinical guidelines. It's a simple issue that can seem complex. And people have some preconceived ideas that I want to clarify in this string.
1/16
Lucas Castellani retweeted
I've been hearing a lot about this common concern: "Are kids getting too many vaccines?"
It's a fair question. I'm a parent too. And as an infectious diseases physician who directs an antibiotic stewardship program, a big part of my job is stopping unnecessary medications. I'm a minimalist by nature - both personally and professionally.
But here's what most people don't realize:
A shocking fact in vaccine science: Kids today are exposed to FEWER antigens from vaccines than children in 1900 - when there was literally ONE vaccine (smallpox).
In 1986, kids received about 10 shots protecting against 7 diseases. Those vaccines exposed them to over 3,000 antigens - the pieces of viruses or bacteria (like proteins or sugars) that teach the immune system to recognize and respond to real infections.
Today's schedule includes more injections - about 50 by age 18 - but the total number of antigens is just ~150. That's a 95% reduction in antigen exposure, thanks to modern acellular and conjugate vaccine designs.
The data over 18 years (Offit et al., Pediatrics 2002):
🔹1900: 1 vaccine (smallpox) = ~200 antigens
🔹1986: ~10 vaccines = 3,000+ antigens + 3mg aluminum
🔹2025: ~50 vaccines = ~150 antigens + 5-6mg aluminum
As for aluminum adjuvant - a compound added to help trigger a stronger immune response - children today receive about 5–6 mg total over the full vaccine schedule, up from ~3 mg in 1986. That's a modest increase over 18 years. For perspective, infants ingest ~7–10 mg of aluminum just in their first six months from breast milk or formula.
So yes, there are more shots. But the actual antigen exposure is dramatically lower than it was in 1986 - or even 1900. Modern vaccines stripped out thousands of extra proteins while adding protection against Hib meningitis, pneumococcal sepsis, chickenpox complications, liver cancer, HPV cancers, and more.
TL;DR: Modern vaccines do far more with less. That's progress. Let's not go backwards.
@BradSpellberg @mtosterholm @ReporterGoodman @HelenBranswell @thekibosch @ENirenberg @AliSMV7 @atrupar @alejodiaz81 @zacroBID @ThePharmFox @DhandAbhay
Lucas Castellani retweeted
The meeting concluded with the much-anticipated presentation of the prestigious Dr. William Hutchinson Award. This award recognizes distinguished contributions to health care in Sault Ste. Marie and Algoma. The 2023 recipient was Dr. Ehsan Mohammadi.
sah.on.ca/about/awards-recog…
Lucas Castellani retweeted
Floor swabs at LTC homes early predictor of COVID outbreaks, study finds #COVID19 #LTC ow.ly/MCF650NjfKZ
Lucas Castellani retweeted
Wastewater testing has proved to be a valuable tool for forecasting Covid-19 outbreaks. Fralick et al. now report that polymerase chain reaction (PCR) swabbing of surfaces may provide a similar benefit for predicting outbreaks in long-term care homes. eviden.cc/3S3wrgy
Lucas Castellani retweeted
Today is #WorldAIDSDay and the start of Indigenous AIDS Awareness Week, #IAAW, a time to reflect on what we have achieved and what we still must achieve with the response to HIV. End Inequalities. End AIDS. End Pandemics.
#WAD #WAD2022
Lucas Castellani retweeted
🚨New pre-print from CUBE team🚨 For this study we wanted to understand how COVID-19 in the environment surrounding a hospitalized patient changes over space and time 🧵1/6 @ReesKassen @NishaOttawa @IDdocSSM @dnagenotek @BurellaMadison @dguttman @LAHug_ medrxiv.org/content/10.1101/…
Lucas Castellani retweeted
In the lead up to #WorldAIDSDay (December 1)
➡️ Remember, honor and celebrate those who we have lost due to HIV/AIDS
➡️ #EndStigma
➡️ Spread the message #UEqualsU (and all HIV prevention strategies)
#WorldAIDSday2022
#IDtwitter #HIVtwitter
Lucas Castellani retweeted
India reported highest no of measles cases this year! The disease on the upswing in many Indian states! Despite a vaccine w/ 95% efficacy & long lasting protection, we need to vaccinate 95% of target population to prevent an outbreak! @naveenthacker
timesofindia.indiatimes.com/…
Lucas Castellani retweeted
Here at @DukeHealth we know that antimicrobial stewardship is a team sport. We couldn’t do what we do without our team members and the support of our administrators!
Join us as we share why we’re thankful for the opportunity to #BeAntibioticsAware:
Lucas Castellani retweeted
🚨Calling all med students, residents, and staff docs🚨Want to learn more about working and locuming in Northern Ontario? Tune in to the upcoming Find your True North Conference. Free to join! @thenosm @SaultMed @snewbery1 i'll be there! event.fourwaves.com/findingy…
Lucas Castellani retweeted
1/14
🤔Why does it take weeks for the radiographic evidence of pneumonia to clear?
Patients often feel better DAYS after starting treatment.
And yet the chest x-ray takes WEEKS to return to normal.
Why the delay?
Lucas Castellani retweeted
On Aug 23rd our CUBE team (cube-ontario.github.io/) will be discussing our work @PublicHealthON. Link below for anyone who wants to join! eventbrite.ca/e/pho-rounds-c…
Lucas Castellani retweeted
🚨Results from our CUBE study are out!🚨 medrxiv.org/content/10.1101/…. Over the past 10 months we have been swabbing the floors of LTCs for SARS-CoV2. It is like wastewater surveillance, but with greater spatial resolution. After all, why swab feces when you can swab floors?! 🧵 1/7
Lucas Castellani retweeted
Thank you @peggylam_ and @CBCNews for helping to raise awareness about specialized #LongCovid clinics and needed funding for them to support people suffering with the #postCOVIDcondition.
@LongCovidGroup @LongCovidGroup
cbc.ca/listen/live-radio/1-6…
Story starts @3min 45sec
Lucas Castellani retweeted
It is a crisis in Northern Ontario with the urgent need for over 326 physicians right now. @thenosm expansion will be one long term solution but we need help now with ER rooms closing for lack of MDs. @snewbery1 @NOSMMDworkforce @SueLeBeau1 @AlykhanAbdulla
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Lucas Castellani retweeted
Maybe it is just me, but i feel like almost everyone on GIM gets DVT prophylaxis, primarily out of routine (and order-sets). @sholzberg and i pose the question of whether this is the ideal approach @NEJMEvidence evidence.nejm.org/stoken/def…
Lucas Castellani retweeted
Signs you are locuming in the sault. You get brought in treats while on-call!! So yes, you should come do an elective in the @SaultAreaHosp @SaultMed
Thank you to Dr Tozer!!
Lucas Castellani retweeted
BREAKING: Federal public health officials now aware of reports of severe acute hepatitis of "unknown origin" in young children in Canada, @CBCNews has learned.
Cases being investigated to determine any links to unexplained outbreaks in U.K., U.S.:
cbc.ca/news/health/liver-dis…
Lucas Castellani retweeted
🆕💥💥Cluster Randomized Trial Antimicrobial prophylaxis discontinuation within 24h after wound closure was noninferior to longer duration in preventing postoperative health care–associated infections, including SSI, After Clean Orthopedic Surgery jamanetwork.com/journals/jam…






















