Discover and read the best of Twitter Threads about #JnJers
Most recents (15)
Fauci should be questioning not only FDA and CDC guidance but also Pfizer's claimed 2% rebound rate
One recalls @Bob_Wachter's spouse also did not find the rebound mild and indeed progressed to PASC
Seems only sensible to hypothesize that the rebound rate is higher in those who are more susceptible to disease progression, who have weaker immunity. These are the same people Paxlovid will help the most but it seems we can't rely on Paxlovid alone; we need better vaccines.
Essentially type 2 statistical errors are errors. And relying on those errors to hold back useful interventions led to deadly lack-of-recommendations by public health agencies
As @DLeonhardt reports
nytimes.com/2022/02/07/bri…
As @DLeonhardt reports
nytimes.com/2022/02/07/bri…
@DLeonhardt Good to see inaction on boosters for J&J cited as one of the examples. Seems the CDC would like to ignore #JnJers so it's good to be reminded that they have been treated badly.
Also good to mention again the FDA officials opposed to boosters (who still insist they are correct!)
Also good to mention again the FDA officials opposed to boosters (who still insist they are correct!)
Only thing I'd add: anti-intervention messages get traction citing "lack of solid data" precisely because newspapers, including (especially?) the @nytimes, publishes articles featuring them. Often these are news articles citing "experts" with a track record of being wrong.
Since my analysis concluding 3 shots are required for the broad response needed against Omicron, and that #JnJers will need 2 shots of RNA, others like former Surgeon General @JeromeAdamsMD have reached the same conclusion
16M Americans are stuck in pre-Omicron limbo. We just need to admit J&J was like one shot of RNA, so they were behind 2xRNA-vaxxed and should be allowed to catch up. (And a 2nd J&J is not as good due to immunized clearance of the adenovirus vector)
Most #JnJers understand past mistakes of CDC and FDA on this and other topics have already degraded their credibility. This is why people are turning to writing articles to point out the problem. Credibility on this topic can only go up by addressing it
usatoday.com/story/news/hea…
usatoday.com/story/news/hea…
Reordered the COVID19 meta-thread by date.
2020.03: Introducing the #coronadeck, explaining what we knew about SARSCoV2 based on its 80% identity to SARSCoV1. Discussed evidence for masks. This was back when CDC and WHO were saying they were ineffective.
2020.03: Introducing the #coronadeck, explaining what we knew about SARSCoV2 based on its 80% identity to SARSCoV1. Discussed evidence for masks. This was back when CDC and WHO were saying they were ineffective.
2020.04: On why SARSCoV2 disease should have been called simply SARS2 or vSARS or even simply SARS, rather than the meaningless COVID-19.
2020.04: Wherein I appeared on CBC to advocate for mask wearing, because studies show it works to prevent viral infections. On the other side was a doctor following public health talking points, that masks were ineffective.
An important study just posted from @BalazsLab
Findings are good for Pfizerites and Modernans but sobering for #JnJers
#JnJers even after boosting have lower neutralizing antibodies against Delta and Omicron vs 3x Pfizer
I'll discuss implications
🧵
Findings are good for Pfizerites and Modernans but sobering for #JnJers
#JnJers even after boosting have lower neutralizing antibodies against Delta and Omicron vs 3x Pfizer
I'll discuss implications
🧵
Study design is excellent. Relevant vaccine statuses were tested in parallel: {Moderna, Pfizer, J&J} x {distant vax, recent vax, infection+vax, boosted vax}. Assay was pseudovirus neutralization. Color-coded images explain everything. 
Also there's a very informative diagram of what was actually done. A picture not just says 1000 words, but is so much easier to understand and prevents confusion about what reagents and procedures were used, so hoping this becomes more common in papers.
I've been getting 2 questions a lot:
1. If I'm J&J and I boost with Moderna/Pfizer, do I need a 2nd dose of Moderna/Pfizer?
2. If I'm J&J and I boosted with Moderna/Pfizer once, when should I boost again?
1. If I'm J&J and I boost with Moderna/Pfizer, do I need a 2nd dose of Moderna/Pfizer?
2. If I'm J&J and I boosted with Moderna/Pfizer once, when should I boost again?
Answers:
1. Congrats, you've chosen wisely to boost your J&J with Moderna or Pfizer. After 1 shot of either, you'll have more antibodies than people after 2x Moderna or 2x Pfizer
2. After you've boosted your J&J with Moderna or Pfizer, you're good for at least 6 months (vs Delta)
1. Congrats, you've chosen wisely to boost your J&J with Moderna or Pfizer. After 1 shot of either, you'll have more antibodies than people after 2x Moderna or 2x Pfizer
2. After you've boosted your J&J with Moderna or Pfizer, you're good for at least 6 months (vs Delta)
Now the evidence. We all remember the NIH-sponsored heterologous boost study that measured antibody levels in people who got each of the 3 vaccines in the US, boosted by a single dose of any of the 3 vaccine types (9 combinations).
pubmed.ncbi.nlm.nih.gov/34671773/
pubmed.ncbi.nlm.nih.gov/34671773/
Another study just posted comparing Abs & T cells in #JnJers after J&J, Moderna100, or Pfizer boost
Confirms NIH and Singapore studies: Both Abs and T cells are boosted by Moderna100 > Pfizer > J&J
#JnJers should boost accordingly
h/t @ChildrenNeedUs_
medrxiv.org/content/10.110…
Confirms NIH and Singapore studies: Both Abs and T cells are boosted by Moderna100 > Pfizer > J&J
#JnJers should boost accordingly
h/t @ChildrenNeedUs_
medrxiv.org/content/10.110…
Booster happened at 3mo after J&J vaccination.
Fig 2A: Antibody levels after boost go as Moderna100 > Pfizer > J&J
Moderna50 would be in between Moderna100 and Pfizer, most likely
Fig 2A: Antibody levels after boost go as Moderna100 > Pfizer > J&J
Moderna50 would be in between Moderna100 and Pfizer, most likely
Fig 2B: p values were not done for differences in post-boost antibody levels by booster group, but for diffs in fold change within individuals by booster group. Subtle distinction, but the latter is more variable (boxes and whiskers are taller). Anyway all diffs significant.
🎉🎇🙂 Wonderful news! @US_FDA will allow mix & match boosters!
As the linked article below says, booster freedom helps local health officials. And it's also the right thing scientifically, especially for #JnJers
This is the happiest I've ever felt from a FDA decision!
As the linked article below says, booster freedom helps local health officials. And it's also the right thing scientifically, especially for #JnJers
This is the happiest I've ever felt from a FDA decision!
I had some hope FDA might do this, after Dr. Marks' said in Friday's VRBPAC meeting that they'd like to know what info was needed to approve mixed boosters, and some VRBPAC members replied that the "Mix and Match Booster Trial" results were clear enough
nytimes.com/2021/10/16/us/…
nytimes.com/2021/10/16/us/…
I'd learned from repeated lack of action not to hope too much. Gathering info on the benefits of heterologous boosts for #JnJers and seeing it tossed aside for various nonreasons made me feel like Sisyphus rolling a stone
So this news is like Sisyphus finally cresting the hill
So this news is like Sisyphus finally cresting the hill
Finally the study we've all been waiting for on mix&match boosters.
Results: J&J starts at 6-15x lower antibodies than Pfizer/Moderna. It's boosted 56x by Moderna, 5x by another J&J.
Clearly Moderna is the better booster for #JnJers
All as predicted
medrxiv.org/content/10.110…
Results: J&J starts at 6-15x lower antibodies than Pfizer/Moderna. It's boosted 56x by Moderna, 5x by another J&J.
Clearly Moderna is the better booster for #JnJers
All as predicted
medrxiv.org/content/10.110…
Note J&J starting at 6x lower abs than Pfizer and then boosted 5x by a 2nd J&J dose means J&J x2 gets you to where Pfizer "fully immunized" people were to begin with. That pretty much proves what many of us have been saying: J&J should have gone for a 2-dose vax to begin with.
Also a J&J booster is also not as effective in raising antibodies for Pfizer and Moderna recipients as a Moderna booster.
Finally, ENSEMBLE2 results (2-dose J&J vaccine) have arrived. The results?
Good, in a preliminary way
A disappointment, in the inexplicably tiny sample sizes and large uncertainties
Also some questionable real-world analyses
I'll discuss
#JnJers
jnj.com/johnson-johnso…
Good, in a preliminary way
A disappointment, in the inexplicably tiny sample sizes and large uncertainties
Also some questionable real-world analyses
I'll discuss
#JnJers
jnj.com/johnson-johnso…
I'm sure we'll be hearing a lot about the top-line results: Protection of 75% worldwide for ≥moderate COVID-19 and 100 percent for severe COVID-19. Some news are reporting 94% protection for ≥moderate COVID-19 in the US.
These results are seen in the press release below
These results are seen in the press release below
I like to start with the good news first before diving into issues with the data, so that means we can talk about the 75% protection against ≥moderate COVID19 worldwide and what it means.
And there you go
New CDC stuy shows best estimate of J&J efficacy vs Delta hospitalization is 60%
This is worse than 80% for Pfizer and 95% for Moderna
cdc.gov/mmwr/volumes/7…
New CDC stuy shows best estimate of J&J efficacy vs Delta hospitalization is 60%
This is worse than 80% for Pfizer and 95% for Moderna
cdc.gov/mmwr/volumes/7…
And before anyone complains the CIs are overlapping, that's a sophomoric complaint. Remember that's the 95% CI, and 95% is an arbitrary bar. Also there are other data that show J&J's lower effectiveness on hospitalization, such as below (pre-Delta)
Or the finding that J&J is only 71% effective vs hospitalization due to Delta, from South Africa
In our @nytimes opinion piece, Dr. Paul Sax (Brigham and Women's Hospital) and I present why the data support RNA boosters for immunocompromised J&J patients, now possible off-label.
And when boosters kick in for everyone, we hope #JnJers are given good options at the same time.
And when boosters kick in for everyone, we hope #JnJers are given good options at the same time.
@nytimes From available breakthrough numbers, J&J has consistently shown higher rates than the other two vaccines, as I discuss in the thread below.
This week's DC numbers suggest in that population J&J vaccine efficacy against infection is about 50%
This week's DC numbers suggest in that population J&J vaccine efficacy against infection is about 50%
And that's why we think the data we have sitting in databases on J&J VE need to be openly discussed, and why boosters for #JnJers are needed at least at the same time as boosters for everyone else.
The highly anticipated study of J&J booster antibody responses is out. (Note this is not the 2-dose Ph3 clinical trial.) As mentioned in press release a 2nd J&J shot 6mo after the first bumps antibody levels ~9x.
medrxiv.org/content/10.110…
medrxiv.org/content/10.110…
They also tested a half-dose booster; this bumps antibody levels 7x
Also side effects seem milder than after the first dose. These are great results and hopefully J&J boosters can be approved soon.
For those asking when this is going to end:
Once >6 mo kids can get vaxxed, then only those with weaker immunity need boosters on occasion. <6mo old would count on lower prevalence to reduce risk
What we could really use: greek alphabet soup vaccines
nytimes.com/2021/08/18/hea…
Once >6 mo kids can get vaxxed, then only those with weaker immunity need boosters on occasion. <6mo old would count on lower prevalence to reduce risk
What we could really use: greek alphabet soup vaccines
nytimes.com/2021/08/18/hea…
For #JnJers, working on bringing some attention to the issue
Record-number of eye-rolling comments in this article: nytimes.com/2021/08/18/hea…
“Feeling sick like a dog and laid up in bed, but not in the hospital with severe Covid, is not a good enough reason,” Dr. Gounder said.
“Feeling sick like a dog and laid up in bed, but not in the hospital with severe Covid, is not a good enough reason,” Dr. Gounder said.
Will continue with Pfizer vs Moderna at another time... I have papers to write and need to keep the lab running, train students, etc, and don't get paid for the COVID-19 stuff
OK and DC numbers were all-time, so both pre-∆ and ∆. They don't account for RNA vaccines being given when J&J was not yet approved or on hold, but that effect is minor now that the average exposure risk experienced by recipients become more similar over time.
In San Diego, the data are recent, so mostly Delta. The 23 unvaccinated vs 2.3 J&J vaccinated cases per 1000 people would suggest 90% efficacy. This of course would be really great. But could be vaccinated are also more careful, so it's hard to know without a case-control study
