Céline Gounder, MD, ScM, FIDSA 🇺🇦 Profile picture
Medicine / Infectious Disease / Epidemiology / @KFF @CBSNews @NYUGrossman @BellevueHosp doc / Threads @drcelinegounder / BSky @drcelinegounder

Oct 21, 2021, 9 tweets

1/ Some interesting slides from today's @CDCgov ACIP meeting:
cdc.gov/vaccines/acip/…

Waning immunity?
Or the Delta factor (more infectious, somewhat more immune-evading)?

Some of both.
But in 65+, it's the Delta factor.

2/ Also, those 65+ have a weaker immune response up front.

I'd expect to see the same among immunocompromised persons.

Immunosenescence is a form of immunocompromise.

3/ Why is there ⬇️VE vs hospitalization over time among those among 18-44 yo with 1+ non-immunocompromising chronic conditions?

Confounding by behavior?

If real, this would justify different eligibility criteria by race based on "weathering" argument:
washingtonpost.com/opinions/black…

4/ This (and Israeli data) might justify lowering age of booster eligibility:

5/ Important point:

6/ Almost 11M (~3%) of Americans have already gotten additional doses of COVID vaccine.

7/ I don't think this will surprise anyone:

8/ Exposure & healthcare access certainly do vary by SES, race/ethnicity, and other demographics.

We do not know if "weathering" leads to more severe breakthrough infections by race/ethnicity.

On that, see earlier in this thread:

9/ Many of us have thought that J&J was a two-dose vaccine for some time now:
nytimes.com/2021/08/09/opi…

That more vulnerable populations have gotten more J&J makes giving a 2nd dose to J&J recipients more pressing from an equity perspective.

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