(1/7) Spectacular news from Novavax. The efficacy of their vaccine matches Pfizer & Moderna, but it doesn't have the same ultra-cold storage requirements. ❄️

UK phase 3 trial results:

95.6% original COVID-19
85.6% UK 🇬🇧 strain (#B117)
89.3% efficacy overall
(2/7) Importantly, the vaccine was tested in a large number of people (>15,000) in the UK, aged 18-84 years.

Almost a third (27%) were aged over 65 years.
(3/7) The company also announced results of a smaller phase 2 trial of their vaccine in South Africa (>4,400 people).

⚠️ Over 90% of cases that were detected in the trial were attributable to the South African variant, which did affect the vaccine's efficacy.
(4/7) Overall, the efficacy of the Novavax vaccine against what was predominantly the South African variant of COVID-19 was 49.4%.

However, 6% of participants had HIV.

When efficacy was examined in the people without HIV, it was 60% against the South African 🇿🇦 variant.
(5/7) The company now plans to immediately develop a vaccine for the South African variant, either as a third booster dose, or as a combination vaccine that will protect against the different variants.

Testing is expected to begin in the second quarter of 2021.
(6/7) This is excellent news, which shows that we now have a vaccine which is suitable for use throughout the world.

Unlike the mRNA vaccines, the Novavax vaccine is a protein subunit vaccine, which can be stored in a standard refrigerator.
(7/7) Full press release here:

📄ir.novavax.com/news-releases/…

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More from @DrZoeHyde

28 Jan
(1/5) Does the Oxford/AstraZeneca vaccine only have an efficacy of 6% in people aged >=65 years?

Almost certainly not. It’s likely similar to the figure for efficacy overall - 62%.

Previous data show immune response is similar in young & old people.
➡️ thelancet.com/journals/lance…
(2/5) The problem with the trial is that it only recruited 660 people aged >=65 years, and there was only one infection in the placebo group and one in the vaccine group in this age range.

This is almost certainly explained by chance, and doesn’t mean the vaccine didn’t work.
(3/5) Had there been more older people in the trial, there would likely have been more infections, and they would probably mostly have been in the placebo group, as occurred in younger people.
Read 5 tweets
25 Jan
(1/17) Study of 2482 parents and 2482 children aged 1-10 years from Baden-Württemberg, Germany, showing that between 22 April and 15 May 2020, parents were more likely to have antibodies against SARS-CoV-2 than children (1.9% vs. 0.9%).
jamanetwork.com/journals/jamap…
(2/17) In 56 families where at least one parent or child had antibodies, the combination of a positive parent and negative child was 4.3 times more likely than a positive child and negative parent.
(3/17) On the surface, this might sound like children are less susceptible to infection, and are less likely to transmit the virus than adults.

This is a genuine possibility, but I think there’s another, better explanation.

These weren’t just any parents...
Read 18 tweets
22 Jan
(1/6) It may seem hard to believe, but Western Australia has recorded no community transmission of COVID-19 since April 2020.

How? A lockdown to eliminate the virus, followed by border controls and quarantine to keep it out.

#ZeroCOVID is possible.
abc.net.au/news/2021-01-1…
(2/6) But Australia’s an island, I hear you say. That’s true, and it certainly makes elimination easier. However, Australia had major outbreaks elsewhere.

The state of Victoria has recorded 20,433 cases & 820 deaths, mostly during a second wave in August.
dhhs.vic.gov.au/victorian-coro…
(3/6) If unchecked, these outbreaks would have spread to the entire country. They didn’t because of internal border controls. Travel within Australia was restricted.

There is no reason why a similar red zone/green zone strategy couldn’t be implemented elsewhere. e.g., in Europe.
Read 6 tweets
21 Jan
The latest round of random testing in England shows infections plateaued in children & rose slightly in teenagers (during a time of distance learning), while infections rose markedly in adults. Overall, 1.5% of population infected; highest since May 2020.
spiral.imperial.ac.uk/handle/10044/1…
Although infections rose in adults, children (aged 5-12 years) and teenagers (aged 13-17 years) were still more likely to be infected than all other age groups except young adults (aged 18-34 years).

1 in 58 children and 1 in 44 teenagers are currently infected.
In contrast to official data which suggested new infections are decreasing in England, the results of the random testing showed no decrease (and possibly an increase instead).
Read 4 tweets
19 Jan
I see people quite excited about a study of households in Wuhan, which suggested children and teenagers were less likely to get infected, but more likely to transmit than adults. However, there are some odd things about it, and I’m sceptical. Read on...
thelancet.com/journals/lanin…
The first issue, is that many people were not tested unless they had symptoms.

We know that children are more likely to be asymptomatic than adults and, lo and behold, children and teenagers were less likely to be tested than adults in this study.
The study was conducted between 2 December 2019 and 18 April 2020.

Prior to 23 February, testing was often symptom-based. Over 80% of cases occurred before this date, and just under half of contacts were not tested.
Read 13 tweets
13 Jan
“How did it get transmitted? Was it in the air conditioning? Was it movement, was it picking up something? We just don’t know those answers yet.”

I think we do: #COVIDisAirborne.

No more mistakes. The UK strain (B117) isn’t forgiving.
#auspol #COVID19Aus
We’ve evidence to suggest the virus can be carried over long distances by air conditioning.

For example, in this study, viral RNA was detected in a hospital ventilation system more than 50 metres away from patients.
We also know that infectious virus can be cultured from air samples collected at a distance of at least 2 metres from people with #COVID19.

It’s not just fragments of viral RNA that can be found in the air, but complete, infectious virus.
Read 4 tweets

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