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Monica Gandhi MD, MPH Profile picture
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8 Jan, 4 tweets, 1 min read
Perhaps ID doctors at blame for not explaining well enough to teachers that 1) risk can be mitigated by non-pharmaceutical interventions (masks, distancing, ventilation) even with new variant; 2) vaccines will make you safe; 3) vaccines will reduce transmission (although you safe
know you care about transmission; 4) surface/toilet transmission not factors. I would be happy as ID doctor to get on Zoom and explain modes of transmission to any group of teachers and how vaccines work. Will make talk easy and answer any ?. Please take me up on it in SF!
will show you all the data. Not on how school opening safe since I know not as convincing to some but on how virus works, how vaccines work, how the immune response works, will show you all data and go over all of it. Please take me up on it. So sorry if we are at fault.
I will make this talk completely data-driven, just show you the virus and how the vaccines work, how immunity works, will not bring political agenda to it (I promise!), please let me explain the infectious diseases of the virus as I feel we must be at fault for all the confusion!

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More from @MonicaGandhi9

Monica Gandhi MD, MPH Profile picture
9 Jan
Please allow me to go back to this question of "do vaccines prevent transmission?". What do vaccines do? Stimulate antibody (from B cells) and T cell responses (not often measured) and then a "boost" of 2nd dose helps stronger memory B/T cell to form. Image
Once you get vaccinated, should be able to block both the entry of the virus into your body & we certainly know symptomatic disease blocked by 95% (Moderna/Pfizer). However, latter trials just didn't look at asymptomatic infection & didn't swab every week because time of essence
But Oxford/AztraZeneca trial did swab every week & asymptomatic infection reduced substantially so we can say with relative confidence now that what is EXPECTED to happen will happen- the person who got the vaccine is safe from disease (what really matters) & spreading to others
Read 5 tweets
Monica Gandhi MD, MPH Profile picture
8 Jan
Pfizer study shows vaccine should work against this B.1.1.7 UK and South Africa variant of SARS-CoV-2. mRNA sequence in Pfizer vaccine likely propietary but Pfizer took a virus with the N501Y mutation and tested it in plasma of 20 vaccine recipients
apnews.com/article/intern…
The blood from these 20 people who got the vaccine were able to "neutralize" (kill, basically) the virus which means vaccine should work against this mutation. Now, the S. Africa strain has other mutations so more need to be tested but it is a good study! Also, if a variant does
arise that the vaccine may not work against, the mRNA technology can apparently easily be "tweaked" to help a modified vaccine work against a new variant. To explain this a bit more, you know how we need an influenza shot every year? This is because influenza A has two proteins
Read 9 tweets
Monica Gandhi MD, MPH Profile picture
6 Jan
Wanted to address this one-dose, two-dose vaccination question. NO ONE to my knowledge is suggesting that one dose only be given; suggestion was whether 2nd dose could be given later to allow current supplies of 1 dose to vaccinate more. What would be evidence for this?
In the AstraZeneca/Oxford trial, Lancet paper did not mention this but the data presented to UK showed that extending time between doses led to MORE immunogenicity. Here is slide below (12 weeks >9 weeks >6 weeks) Image
Known in vaccine world that we don't want too short of an interval between doses, okay to give booster shots after a long time (which is why - if childhood vaccines have gaps- we just start where we left off, not repeat). Why 2 doses better than one? To build memory immune system
Read 6 tweets
Monica Gandhi MD, MPH Profile picture
3 Jan
Wanted to give 6 little tidbits on vaccines:
1) Know U.S. roll-out has been slower and I think will start becoming faster now after holiday
2) Designs of all 3 trials summarized before (Pfizer/BioNtech, Moderna, AztraZeneca) has primary outcome of preventing symptomatic disease &
secondary outcome of preventing severe infection. All 3 performed well, meaning almost ALL of the severe infections were in placebo arms. That is goal - to prevent what is scary about #COVID-19, severe outcomes
3) Pfizer/BioNtech vaccine needing -70 C temps slowing roll-out
Moderna likely to hasten roll-out
4) AztraZeneca data (with weekly swabbing) indicates that vaccines prevent asymptomatic transmission as well so unlikely to spread it after vax
5) Makes sense vaccines will prevent asymptomatic & symptomatic disease as antibodies/T-cells
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
31 Dec 20
Since the UK just approved the AstraZeneca/University of Oxford COVID-19 vaccine today, I wanted to summarize the results of the interim analysis of their Phase 3 trials published in Lancet on December 8 with some slides:
thelancet.com/journals/lance…
This slide shows you that t...
Image
Read 10 tweets
Monica Gandhi MD, MPH Profile picture
31 Dec 20
Back to testing and the paper from my excellent colleagues at UCSF! Mass testing campaign- Among 3,302 persons tested for SARS-CoV-2 by rapid antigen (BinaxNOW) & RT-PCR, rapid assay sensitivity 100% using RT-PCR Ct thresholds of 30- specificity 99.9%.
pubmed.ncbi.nlm.nih.gov/33367619/
This think is SUCH an important pivotal paper! Discussion "SARS-CoV-2 pandemic control calls for fast, low-barrier, high-performing field assays.. US has purchased 150 million BinaxNOWTM cards, yet ..use to date has been limited.. our data show that these tests are readily ..."
deployed in a field setting at scale for children & adults.. can rapidly identify persons with high levels of virus including thosewho are asymptomatic..leading to immediate public health action". Okay so if this has a very low false positive rate (0.01%) and high sensitivity
Read 7 tweets

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