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Eric Feigl-Ding Profile picture
@DrEricDing
Jan 25, 2021 • 22 tweets • 11 min read • Read on X
BREAKING—Good & bad news—The Moderna #COVID19 vaccine fully protected against the UK 🇬🇧 #B117 variant... but was 6x less efficient at neutralizing the South African #B1351 variant in lab test. Moderna is testing a newly synthesized booster for it—3rd shot. washingtonpost.com/health/2021/01… Image
2) To be clear—6x less efficient doesn’t mean no protection against #B11351, it’s still good but not as good as before. As a precaution, Moderna announced it will launch two new studies—including adding a third shot of its current vaccine to boost its two-dose regimen.
3) press release is very cautiously worded—“6-fold reduction in neutralizing titers was observed with B.1.351 variant relative to prior variants. Despite this reduction, neutralizing titer levels w/ B.1.351 remain above levels expected to be protective.”
investors.modernatx.com/news-releases/…
4) “The two-dose regimen of the Moderna COVID-19 Vaccine at the 100 µg dose is expected to be protective against emerging strains detected to date. Nonetheless, Moderna today announced its clinical strategy to proactively address the pandemic as the virus continues to evolve.”
5) “First, the Company will test an additional booster dose of its COVID-19 Vaccine (mRNA-1273) to study the ability to further increase neutralizing titers against emerging strains beyond the existing primary vaccination series.”
6) “Second, the Company is advancing an emerging variant booster candidate (mRNA-1273.351) against the B.1.351 variant first identified in the Republic of South Africa. The Company is advancing mRNA-1273.351 into preclinical studies and a Phase 1 study in the U.S.”
7) “to evaluate the immunological benefit of boosting with strain-specific spike proteins. Moderna expects its mRNA-based booster vaccine (whether mRNA-1273 or mRNA-1273.351) will be able to further boost neutralizing titers in combination with all leading vaccine candidates.”
8) “We are encouraged by these new data, which reinforce our confidence that the Moderna COVID-19 Vaccine **should** be protective against these newly detected variants,” said Stéphane Bancel, Chief Executive Officer of Moderna.

*emphasis mine.
9) “Out of an abundance of caution and leveraging the flexibility of our mRNA platform, we are advancing an emerging variant booster candidate against ( #B1351 variant ) to determine if it will be more effective to boost titers against this and potentially future variants.”
10) “The in vitro study assessed the ability of mRNA-1273 to elicit potently neutralizing antibodies against the new #SARSCoV2 variants, using sera from 8 Phase 1 clinical trial participants (aged 18-55 years) who received two 100 µg doses of mRNA-1273...
11) “and separately using sera from non-human primates (NHPs) immunized with two doses of 30 µg or 100 µg of mRNA-1273.”

➡️They tested blood of both humans and primates who were vaccinated with **2 FULL DOSES**.
12) Pfizer also says their vaccine works against the #B117, however the @GuptaR_lab says they found a ~3.8-fold lower neutralization among blood of 15 Pfizer-vaccinated individuals to the #B117 variant.
13) But much more worrisome was the recent data that found blood from 48% of people previously recovered from #COVID19 in the 1st 2020 wave in South Africa did not recognize the new #B1351 variant — “complete immune escape”. 90% had lower neutralization.
14) To be clear, the South Africa research was done by their CDC @nicd_sa and tested the E484K mutation in the #b1351, which is also shared by the Brazil 🇧🇷 #P1 variant. This PQ was the variant also detected in Japan among 🇧🇷 travelers.
15) But the South Africa 🇿🇦 and Brazil 🇧🇷 variants have worried WHO director @DrTedros enough to put out a warning.
16) Moderna adds

“For B.1.351 variant... pseudovirus neutralizing antibody titers were approximately 6-fold lower relative to prior variants.

➡️These lower titers may suggest a potential risk of earlier waning of immunity to the new B.1.351 strains.”
17) this is why South Africa’s CDC @nicd_sa put out this stunning statement last week on the “reinfection” potential of the new #B1351 variant. Because of the 48% of recovered #COVID19 patients with “complete immune escape”
18) Given the similarity of the South Africa 🇿🇦 and Brazil 🇧🇷 variants (they both share the troublesome E484 mutation that has shown antibody escape in 9 out of 11 blood samples from convalescent people), many expect both variants might have vaccine efficacy lowering issues. Image
19) For the Pfizer vaccine #B117 mutation, there are conflicting studies—Pfizer/BioNTech’s own study shows no drop in B117 neutralization (left), but the @GuptaR_lab study of Pfizer vaccinated patients shows a 3.8-fold drop (right). Trying to figure out why divergent results. ImageImage
20) there is now also concern the #B117 variant might have roughly a ~30% increased risk of death. 7 out of 10 studies supports it. Here’s the walk thru thread 🧵 on it...
21) Hence because of the greater contagiousness of #B117 and possible higher mortality risk, we should all upgrade our masks....
22) Efficacy drop is *NOT* 1/6th of 95%. It’s not a 1/6th direct efficacy correlation.

There are other ways to neutralize a virus like with T cells too—that’s not measured usually. Only a trial can show the % efficacy. I expect it still >50%. Likely 70-90%.

➡️Take the vaccine!

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More from @DrEricDing

Eric Feigl-Ding Profile picture
Mar 28
My god—Earthquake (a Richter ~7.7) causes a skyscraper to collapse in Bangkok. Hope all the construction workers made it out.
2) this skyscraper collapse was captured from a distant car’s dashcam while on a highway

3) another view of the collapse. For those who lived through 9/11, this collapse is a bit triggering.
Read 5 tweets
Eric Feigl-Ding Profile picture
Mar 27
Welp—kiss public health & medical research infrastructure in America goodbye for the next 4 years. RFK Jr plans to cut 10,000 jobs from Trump HHS. Image
2) this will not make America healthy again… not by a long shot. So dangerous and irresponsible.
3) “Kennedy is set to announce Thursday the planned changes, which include axing 10,000 full-time employees spread across departments tasked with responding to disease outbreaks, approving new drugs, providing insurance for the poorest Americans and more”.
Read 5 tweets
Eric Feigl-Ding Profile picture
Mar 15
SICKENING—Trump’s DHS just deported a surgeon from Brown University Medical School—who is here legally on an H1B visa that doesn’t expire until 2027, and has committed no crimes. Trained in the U.S. at Ohio State, University of Washington, and Yale as a **transplant surgeon** (one of the most difficult surgical fields in all of medicine!!!), she is a highly trained doctor on kidney transplants, which cannot be easily replaced. Her phone was seized at the border. A federal judge handed down an injunction against her deportation—but she was already deported on a plane en route to Paris. Brown’s kidney transplant clinic is now strained by her deportation.Image
Image
2) Full text:

PROVIDENCE — A Rhode Island doctor who had traveled to Lebanon to see her parents was prevented from re-entering the United States at Boston’s Logan International Airport on Thursday evening, her lawyer and a colleague said.

Dr. Rasha Alawieh, 34, who lives in Providence, has been working at Brown Medicine’s Division of Kidney Disease & Hypertension since last July, and she [has] been part of the transplant service at Rhode Island Hospital, according to Dr. George Bayliss, the organ transplant division’s medical director. She has been studying and working in the United States for about six years, he said Friday.

The US consulate in Lebanon had issued her an H-1B visa, which is given to people in specialty occupations requiring expertise. The visa was valid through mid-2027, said Thomas S. Brown, an attorney representing her and Brown Medicine.

Alawieh was detained when she returned to Logan airport, and family members are afraid that she is about to be deported to Lebanon, he said.

“We are at a loss as to why this happened,” Brown said. “I don’t know if it’s a byproduct of the Trump crackdown on immigration. I don’t know if it’s a travel ban or some other issue.”

He said her phone has been seized and he has not been able to contact Alawieh.

Bayliss said a lawyer filed a petition with the US District Court in Massachusetts, and Judge Leo T. Sorokin issued an order saying Alawieh should not be moved outside of Massachusetts without 48 hours notice. But he said that message apparently did not reach immigration officials in time, and a plane carrying Alawieh left for Paris.

“This is outrageous,” Bayliss said in an interview. “This is a person who is legally entitled to be in the U.S., who is stopped from re-entering the country for reasons no one knows. It’s depriving her patients of a good physician.”

A US Customs and Border Patrol spokesperson, Ryan Brissette, was not able to immediately answer questions about Alawieh on Friday evening.

Bayliss said Alawieh graduated from the American University of Beirut medical school and came to the United States for a nephrology fellowship at Ohio State University. She then landed a transplant fellowship at University of Washington and had a residency in the Yale hospital system before starting at Brown Medicine last July, he said.

“She’s really a very humble and able person,” Bayliss said. “She takes care of her patients. She is talented and thoughtful and a great addition to our division.”

Bayliss said Alawieh went to Lebanon to visit parents and planned to be gone for two weeks. He said she texted a colleague at 6:30 p.m. Thursday saying she was back in Boston, but then her family heard from immigration officials.

Dr. Paul Morrissey, surgical director of the organ transplant division at Brown University Health, said Alawieh works on getting people in Rhode Island on the list for a kidney transplants, and that’s a crucial job at a time when there has been a lot of focus on the need for kidneys and their equitable distribution.

He said Alawieh should not have had any problem traveling out of the country with an H-1B visa.

“It’s an unfortunate set of circumstances,” Morrissey said. “It’s putting a strain on our office. Her work has been exceptional.”

bostonglobe.com/2025/03/14/met…Image
3) There is a new Trump ban against many countries, including tourist visa bans against all countries in the red and orange lists. This list is still tentative. And it shouldn’t have affected people with existing visas, such and the Brown kidney transplant surgeon Image
Read 8 tweets
Eric Feigl-Ding Profile picture
Mar 14
I’ve said it before, and I’ll say it again… once upon a time, liberals did have our own “Leftist Joe Rogan”… his name was Joe Rogan…

Here he is advocating for socialized medicine, healthcare for all, and supporting labor unions to protect workers.
2) Recall, Rogan was once pro Obama and pro Bernie Sanders, and pro Yang Gang, and anti Trump. It’s sad he has since failed to the dark side. But like Vader… maybe he can be redeemed someday and come back to the light.
3) *Fallen, not failed (above).

Joe Rogan was also pro gay rights and pro DACA and pro helping inner city communities that suffer economic and social injustices. It’s sad what he has become. I feel we should try to pull & welcome him back someday. Everyone can be redeemed.
Read 4 tweets
Eric Feigl-Ding Profile picture
Feb 26
BREAKING—FDA suddenly cancels meeting to update next season’s flu vaccines, with zero explanations. Any delays will jeopardize next year’s vaccine supply chain. Image
2) Folks who follow me know that I’m no bullshitter. I criticized past pandemic response right and left, and have called balls and strikes without bias. And I often say things that doctors & epidemiologists are whispering among themselves but don’t say publicly. (Cough cough) ⬇️
3) While I don’t recommend hoarding… I think stocking up on flu antivirals, which you can obtain prophylactically (preventively) from doctors if you ask nicely why you’re high risk, can be a good idea. I know many doctors, epidemiologists and virologists who do for their family.
Read 6 tweets
Eric Feigl-Ding Profile picture
Feb 26
Doctors are debunking RFK Jr’s claim that 20 hospitalized measles cases in Texas are there for mainly quarantine. Doctors on the ground say the 20 kids hospitalized are having trouble breathing. Oh and they are all unvaccinated against measles, which RFK Jr neglects to mention. Image
2) RFK Jr told Trump today there’s now 2 measles deaths.
3) RFK Jr is a tear with his FDA today. A dark Darwinian future lies ahead for America.
Read 4 tweets

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