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29 May 18, 3 tweets, 3 min read
Two new postdoc positions now open to work in our group at @CCDD_HSPH
@CCDD_HSPH One is on a cool new project to incorporate pathogen #sequence data in to analysis of #vaccine #efficacy #trials .
academicpositions.harvard.edu/postings/8296
Another on flexible topics including but not limited to #AMR (especially as it relates to #vaccines), dynamics of multistrain pathogens, or #vaccine #trial modeling academicpositions.harvard.edu/postings/8298

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More from @mlipsitch

Marc Lipsitch Profile picture
2 Aug
usually agree with both @StevenSalzberg1 and @nataliexdean. In this case agree with the cautious view. Even if safety were known (which I don’t think it is for this) RCT r really important for efficacy. Alternatives, which both @nataliexdean & I work on, are full of pitfalls.
pubmed.ncbi.nlm.nih.gov/27453361/
The article by @StevenSalzberg1 just gets some things wrong. Published test of eg the Oxford vaccine had 126 and 253 vaccinated, enough to detect adverse events if occur in 2.3% and 1.4% respectively.
Read 7 tweets
Marc Lipsitch Profile picture
3 Jul
@DiseaseEcology @US_FDA @rebeccajk13 @Steve_Bellan I may not be explaining well, and it's a subtle thing I'm trying to say. I think it is important to know effect on serologic infection. My point is that there may well be a vaccine that 1) makes disease less likely/severe, 2) makes shedding much less and 3) permits seroconversion
@DiseaseEcology @US_FDA @rebeccajk13 @Steve_Bellan Such a vax would look good on the disease endpoint (esp if they use our approach or similar to correct for missed infections), but null on the infection endpoint. This vaccine would be very good for herd immunity (and direct protection) but the analysis might miss that fact.
@DiseaseEcology @US_FDA @rebeccajk13 @Steve_Bellan Basic issue I think is that infection and infectiousness => seroconversion but seroconversion !=>infectiousness
Read 5 tweets
Marc Lipsitch Profile picture
2 Jul
This week @US_FDA called for confirmed infection (+-symptoms) as a primary or secondary endpoint in #SARSCoV2 #vaccine trials. Last year @rebeccajk13 @Steve_Bellan Rui Wang and Matt HItchings we recently proposed efficient, unbiased approach: academic.oup.com/aje/article/18…
Link to the FDA guidance fda.gov/regulatory-inf…
One subtle point: preventing infection detected serologically (without symptoms) may be a very difficult endpoint for many vaccines.
Read 6 tweets
Marc Lipsitch Profile picture
23 Jun
I agree with a lot of this thread. Primarily - in any time, but especially these days, it is inspiring to see a government agency release data, get bad press, and respond by releasing more data and asking for expert input.
Also impressive was the evidently hard-working, experienced, resourceful team of people trying to make this program a success, and the consistent effort to confront unsatisfactory numbers with feasible means for improvement. Given mission to make TTI successful, very impressive
But I think behind the NYT story and behind other critiques of tracing for example nationalgeographic.com/science/2020/0…
Read 18 tweets
Marc Lipsitch Profile picture
19 Jun
On its face (and maybe even after some careful consideration), this article is concerning. The First Covid Vaccines May Not Prevent Covid Infection a.msn.com/00/en-us/BB15t…
It points out as as been noted before blogs.sciencemag.org/pipeline/archi… that the Oxford vaccine in macaque studies does not prevent (or even visibly reduce) the nasal shedding of virus RNA -- infection and perhaps contagiousness are the same, but vaccinated macaques don't get sick
and have much less virus RNA in their lungs
(from biorxiv.org/content/10.110…) -- concern originated with Bill Haseltine forbes.com/sites/williamh…
Read 18 tweets
Marc Lipsitch Profile picture
7 Jun
My conclusion is that we should be trying to work together to fight injustice, reduce transmission, and where possible resume some normal activities, including protests.
Any effort to assign numbers to one activity is full of assumptions, including the assumption that R stays constant over time -- something we can change if we choose by making greater efforts to suppress transmission.
I offer the comparison simply to point out the risk of trying to assign responsibility to one decision in the face of all the dependencies -- consequences of infectious disease cases are dependent on the transmission environment, which is in our control.
Read 7 tweets

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