I am a little confused by this @nytimes reporting by @MarcSantoraNYT and @RebeccaDRobbins on the new AZD1222 data. First of all, the claim that this data is the “first” to document evidence that a COVID vaccine can result in a reduction in transmission seems to be wrong. Image
In fact, just last week, Israeli researchers documented a 50% reduction in both symptomatic and asymptomatic infections in individuals who took a single dose of the Pfizer mRNA shot in a retrospective cohort study. medrxiv.org/content/10.110…
This is a preprint, but so is the new Astra data! Furthermore, the original AZD1222 publication in the Lancet in December *also* reported on preliminary PCR positivity in asymptomatic individuals in COV002 as well. thelancet.com/action/showPdf… Image
Finally, one cannot ignore the fact that despite the laudatory quotes, today’s data does not really change the basic assumptions about AZD1222 we had in December. That is, the vaccine is around 70% effective in preveting symptomatic COVID.
Reducing the dose on the prime or boost shot, or increasing the length between prime and boost *may* increase efficacy. But we note that the efficacy estimates on these alternative dosing schemes do not appear to be stat. significant different than that for the standard approach.

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More from @jbkrell

5 Feb
The @Dereklowe piece sort of misses the point. Yes, there is no idle mRNA vaccine production capacity in the pharma industry that could simply be repurposed to make more COVID-19 vaccines. But we could rapidly *build* more capacity, as we did across the world last year. 🧵
Before we get deep into the weeds, lets remember, in January/Feb, the world had basically no commercial scale mRNA vaccine production capacity. By December, private industry (with a lot of public funds) built 3 billion+ doses / year scale capacity
So what happened? Companies like @pfizer, @BioNTech_Group, and @LonzaGroup (which makes the bulk of finished drug substance for @moderna_tx ) rapidly built mRNA vaccine production capacity inside existing manufacturing facilities.
Read 19 tweets
2 Jul 20
When I was 22, I watched a friend become HIV+ cuz he couldn't afford Truvada PrEP which cost s$1,300/m but costs <$6 to make. CDC invented & patented PrEP, but they refused to stop Gilead's price gouging for yrs. Today, the the same thing is happening with remdesivir for COVID.
Last month, @cmorten2 & I showed that not only did (h/t @zainrizvi ) the US government spend >$70 million on developing & inventing the drug, the government is legally entitled to be co-owners of the patents for remdesivir. prep4all.org/news/remdesivir
This means that USG can license remdesivir to generic manufacturers while paying no (or very little) $ to Gilead. Remember remdesivir costs less than $1 to make a dose, yet Gilead charges over $350 a dose for it. Our government could stop this price gouging today, but will they?
Read 4 tweets
6 May 20
This is an important q from @mynameisjro. The convo around physical distancing reminds me a lot of the pre-PrEP conversations about HIV prevention. THREAD but tl;dr u can shame as much u want, but it doesn't change the fact that our methods of COVID control are not sustainable.
I am NOT saying we should stop physical distancing. But the idea that we can ask people to not see friends, lovers, family etc. for a basically unlimited period of time is BS. Let's not repeat the mistakes of the HIV epidemic in our response to this plague. 2/n
1 of the reasons the HIV epidemic was allowed to run out of control in US queers starting in the early 90s is because we were more focused on shaming queer ppl than finding effective ways to prevent HIV. And a lot of that had to do with the shame around "barebacking". 3/n
Read 11 tweets
15 Feb 19
@Surgeon_General @POTUS @NIAIDNews @HRSAgov @IHSgov @VP @gregggonsalves @fcraw4d Respectfully, that is bullshit. HIV epidemics in PWIDU are not "unprecedented" and interventions to bring them under control, like needle exchange, have been well understood since the 1980s. You and @VP could of implemented needle exchange sooner, but didn't, so Hoosiers suffered
@Surgeon_General @POTUS @NIAIDNews @HRSAgov @IHSgov @VP @gregggonsalves @fcraw4d 2. The idea that you did not know that SC was at risk for an HIV epidemic is also BS. Increases in overdoses had been happening in IN since 2004, local officials recommended needle exchange in 2008, there was a huge HCV outbreak in IN in 2010-11, but still no needle exchange.
@Surgeon_General @POTUS @NIAIDNews @HRSAgov @IHSgov @VP @gregggonsalves @fcraw4d Even in the midst of the peak of the epidemic, more than two months after it was identified @VP refused to allow needle exchanges, preferring to "pray", rather than understand science. This is not success.
Read 4 tweets

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