More vaccine news, this time from phase 3 trial of Johnson&Johnson:
According to the company, their vaccine based on an adenovirus was 66% effective at preventing moderate and severe #covid19, 28 days after vaccination.

prnewswire.com/news-releases/…
Good news:
- Big study with 45,000 participants across multiple countries
-Vaccine was 85% effective in preventing severe disease overall
- all hospitalisations and deaths in placebo group
- efficacy against severe disease increased over time (no cases in vaccinees after day 49)
Most importantly:
This is a single-dose vaccine and only needs standard refrigeration.
That means of vaccines so far it is the easiest to distribute.
And plan is to produce one billion doses this year, so protection for one billion people hopefully.
The bad news:
Again a clear signal that vaccines are less efficacious against variant 501Y.V2
"The level of protection against moderate to severe COVID-19 infection was 72% in the United States, 66% in Latin America and 57% in South Africa, 28 days post-vaccination.”
As Tony Fauci just said at the presser:
“We can see that we are going to be challenged. .... It's really a wake up call for us to be nimble and to be able to adjust as this virus will continue for certain to evolve and to mutate as we get more pressure."
But let me end on a positive here:
Protection against severe disease was the same in South Africa and other regions.
Overall this is great news for now for the world.
We have to vaccinate the world and at the same time prepare vaccine updates.
For those wondering who has bought doses of Johnson&Johnson vaccine so far:
EU was biggest buyer so far.

Here is a graph taken from
bloomberg.com/graphics/covid…
On regulatory process:
Application expected "late next week to FDA and followed soon after by a number of regulatory filings including to the EU and the rest of the world”, says Mathai Mammen of Johnson and Johnson.
Mathai explains his hypothesis on why vaccine is good against severe disease in SA too:
"reason we have such great activity against severe disease is that that's the form of disease where T cells are important, and B.1.135 has not been able to step around T cell activity"

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More from @kakape

28 Jan
Just listened to a fascinating webinar by @ShabirMadh presenting the results from Novavax trial in South Africa and UK.
So will turn this into a brief thread to give some context on what we know so far and what the trial results (probably) mean:
First of all, this vaccine uses a more traditional approach than the mRNA vaccines we have been talking about a lot: It essentially consists of particles studded with the crucial spike protein plus an adjuvant to induce a potent immune response.
The study: This was a phase 2 study with just over 4400 participants and initially designed to look at HIV- people only.
@ShabirMadh says they had “ to really work hard to get Novavax and everyone else to agree to do a sample of HIV-infected individuals”, which is crucial in SA.
Read 15 tweets
28 Jan
“The world is at a critical juncture. With the emergence of new, more transmissible variants globally ... every country is now at risk of returning to square one unless we redouble our efforts to supress #Covid19 everywhere”, says @JeremyFarrar in new statement.
@JeremyFarrar “Vaccine nationalism doesn’t serve anyone. At the moment, vaccines are in short supply. But the new variants are an urgent warning of what is coming… .
It is in the national interest of all countries to bring infections down globally as much as possible."
@JeremyFarrar “Vaccinating a lot of people in a few countries, leaving the virus unchecked in large parts of the world, will lead to more variants .... The more that arise, the higher the risk of the virus evolving to an extent where our vaccines, treatments and tests are no longer effective."
Read 4 tweets
27 Jan
Getting a lot of questions about vaccines and variants and why @moderna_tx is developing a booster based on variant discovered in South Africa if vaccines are thought to protect against it.
So a quick thread.
And story is up here:
sciencemag.org/news/2021/01/v…
@moderna_tx First of all, there are several ways in which new variants can worsen the situation:
They can be deadlier, more transmissible or more likely to infect people who have been infected already or received vaccines - or, of course, a combination of these.
@moderna_tx The biggest problem for the world RIGHT NOW are variants with increased transmissibility, because that means measures have to be stricter for the virus not to spread and if it does spread it means more disease and death before the world is vaccinated.
Read 15 tweets
25 Jan
"A year ago today, fewer than 1500 cases of #COVID19 had been reported to @WHO, including just 20 cases outside China”, says @DrTedros at WHO presser. "This week, we expect to reach 100 million reported cases.”
@WHO @DrTedros "Numbers can make us numb to what they represent: every death is someone’s parent, someone’s partner, someone’s child, someone’s friend”, says @drtedros. "Vaccines are giving us hope, which is why every life we lose now is even more tragic."
@WHO @DrTedros "Last week, I said that they will distribute on the brink of a catastrophic moral failure if it doesn't deliver equitable access to vaccines”, says @DrTedros. "Two new studies show that it wouldn't just be a moral failure. It would be an economic failure."
Read 16 tweets
21 Jan
New @ECDC_EU risk assessment on variants of concern says likelihood of them spreading in Europe is very high, likely leading to more transmission and death. “Stricter NPIs are needed to reduce transmission and relieve the pressure on healthcare systems.”

ecdc.europa.eu/en/publication…
Detection:
- “Member States need to increase the level of surveillance and sequencing of a representative sample of community #COVID19 cases”
- “Member States should prepare laboratories for a higher demand for testing”
Curbing transmission:
- compliance with stricter non-pharmaceutical interventions than those currently implemented, and strengthened case detection with contact tracing
- non-essential travel should be avoided
- accelerate vaccination of high-risk groups
Read 5 tweets
18 Jan
Today’s presentation from South Africa on 501Y.V2 (the second variant of concern in case you've lost count) is very interesting.

Regrettably it only adds to concerns about potential immune escape from this variant:

When convalescent sera from 44 people infected in first wave in South Africa was confronted with 501Y.V2, antibodies from 21 out of 44 did not recognize the variant.
Important to remember that our immunity is not just due to antibodies, but also T cells. So fingers crossed!
There are other caveats: Vaccine- induced immunity may be very different from natural immunity, for instance.

This is just one data point, but as so often in the last weeks I would have preferred different data 🤷‍♂️
Read 4 tweets

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