Dr Lennard Lee (Oxford University) Profile picture
Associate Prof Oxford (NDM) & Birmingham University | NHS Oncologist | HMG advisor | @independentsage | #cancervaccines #personalviews

Oct 18, 2022, 13 tweets

1/x 🧵 ***NEW RESEARCH *** from @EdinburghUni. The paper is relevant for the #immunocompromised and #evusheld and #forgotten500k. It really acts as a WAKE UP & ACT call. It a good paper. thelancet.com/journals/lance…

2/x What's the background? The pandemic continues. 👾Some people are at excess risk and can't hug loved ones, see family or enter normal life 😢. We all believe they are the #immunocompromised, but what does the data show? 💻

3/x This data looked at 16 208 600 vaccined individuals across England🏴󠁧󠁢󠁥󠁮󠁧󠁿, Scotland🏴󠁧󠁢󠁳󠁣󠁴󠁿, Ireland 🇮🇪 and Wales 🏴󠁧󠁢󠁷󠁬󠁳󠁿. i.e. EVERYONE. From Dec 8, 2020, and Feb 28, 2022, so it includes the OMICRON ERA, so relevant. Risk was very carefully defined.

4/x What did they find? 👇🫢. For a few significantly higher risk. nearly 6x for the immunocompromised. Also risk for those with more comorbidies, and this includes those with immunocompromised disease. But if you survive, you are proteted for 9ms...

5/x More detail now. Here's the risk table. we call it a forest plot. The red dot represents risk 🔴. The lines represents uncertainty. Adjusted risk is at the bottom, 0-25x. I've added orange boxes- 🟧 , for the #immunocompromised.

6/x. What do they say? 👇

7/x Anything else they found? If you add in age, particularly above 70, then the risk climbs. Previous risk factors like ethnicity, deprivation, BMI, urban/rural no longer drive risk. #immunocompromised DOES! @SGriffin_Lab

8/x Why does this matter? There are half a million immunocompromised people in the UK. Many are still shielding, still in isolation, still unable to work, see friends or hug loved ones. They are #forgotten500k, unheard and calling on us to notice.

9/x Prophylactic antibody therapies like #evusheld give back an “immune” system to those who are immunocompromised. It is given in a similar way to a vaccine and it prevents infections. Studies from Israel/France/US show it is working well, even against omicron

10/x 32 countries are delivering additional levels of protection this winter to protect immunocompromised patients who have not responded to the coronavirus vaccine, using new therapies, not available in the UK- prophylactic antibody therapies.

11/x Thanks to patients, clinicians @AlexRichter3 @ProfBMT + myself as champions, the clinical community has also sprung into action. Patients, 125 clinicians from 17 medical specialities & 4 nations are bringing online professional organisations/charities for a call to action.

12/x No one is sure if DHSC will offer protection or consider a pilot to protect #immunocompromised patients with #evusheld this Winter. Budgets might be an issue. However, patient power has seemingly swung into action. They are asking in mass about what they need. @hughesthenews

13/x We are yet to know if the data will be actioned, or levers pulled by @DHSCgovuk. Thank you to @EdinburghUni for another amazing hard hitting article putting a microscope to the risk to the population from COVID-19 and #immunocompromised. #Tourdeforce.

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