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Prof. Akiko Iwasaki Profile picture
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7 Feb, 9 tweets, 5 min read
How well do various vaccines reduce severe COVID disease & death? Awesome @YaleMed students, @dariusdariusdar, @ChaneyKalinich, @Larson_HaleighT & Caroline Valdez put together summary tables from vaccine trials. Remarkable ability of vaccines to ⬇️ severe/lethal COVID! 🧵(1/n)
The phase 3 Pfizer BioNTech two-shot mRNA vaccine trial data. All the tables here and below indicate the # COVID-related death in the vaccinated as the right-most column (which is ZERO). (2/n)

nejm.org/doi/full/10.10…
The phase 3 Moderna two-shot mRNA vaccine COVE trial. (3/n)

nejm.org/doi/full/10.10…
The phase 3 trial of AstraZeneca Oxford Chimp Adeno ChAdOx1 vaccine. Two-shots - Standard doses 1 and 2 or Low dose 1 + Standard dose 2. (4/n)

papers.ssrn.com/sol3/papers.cf…
Novavax recombinant spike protein + Matrix M adjuvant two-shot vaccine efficacy data. (5/n)

ir.novavax.com/news-releases/…
For more, see
Johnson & Johnson single-shot Janssen Ad26.COV2.S Phase 3 ENSEMBLE trial efficacy data. (6/n)

jnj.com/johnson-johnso…
Efficacy of Gamaleya Sputnik V rAd26 rAd5 two-shot vaccine interim analysis (after 21 days from first dose). (7/n)

thelancet.com/journals/lance…
Here is a great thread related to this by @MonicaGandhi9 👇🏽 (8/n)

With all these vaccines, some approved, EUA, others soon to be approved, we can bring down the number of severe & lethal COVID. The variants are here, but current vaccines still protect from severe disease & vaccines for the variants are coming. We will get through this! (End)

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More from @VirusesImmunity

Prof. Akiko Iwasaki Profile picture
13 Jan
Top 10 most downloaded articles in 2020 includes our review in the @AnnualReviews Virology - “Seasonality of Respiratory Viral Infections” by @MiyuMoriyama et al! It’s free to download: arevie.ws/3aYt32Y

Here let’s highlight other relevant pieces on the same topic (1/n)
Just to recap, seasonal factors that drive respiratory tract viral infections are mainly these three;

1) ⬇️ Temperature
2) ⬇️ Humidity (esp. indoor)
3) ⬇️ Sunlight/Vitamin D

(2/n)
A twitter thread that demonstrates the importance of humidity on antiviral defense through mucociliary clearance measured by @Ericsongg. (3/n)

Read 11 tweets
Prof. Akiko Iwasaki Profile picture
10 Jan
What is the relevance of viral load in #COVID19 disease severity? A very talented @YaleMSTP student @SilvaJ_C found that saliva viral load to be a better predictor of disease than nasopharyngeal viral load. Here is a thread to explain the findings. (1/n)

medrxiv.org/content/10.110…
I preface by saying that numerous fantastic studies by many have demonstrated nasopharyngeal viral load to correlate with disease severity and mortality, while others do not find such correlation. Here are some of these studies. (2/n)
Being at @yale, the birthplace of #SalivaDirect and everything saliva bc of awesome colleagues like @awyllie13 @NathanGrubaugh @VogelsChantal et al, we had access to both saliva and nasopharyngeal (NP) samples from the same patients to do direct comparisons. (3/n)
Read 13 tweets
Prof. Akiko Iwasaki Profile picture
1 Jan
My first tweet of 2021 is going to be about 1 dose vs. 2 dose vaccine. I have tweeted in the past of the immunological advantages of a 2 dose vaccine. However, given the enhanced transmission variants on the rise, we need a modified strategy. (1/n)

theatlantic.com/science/archiv…
We typically give vaccines in more than one dose to increase 1) quantity, 2) quality, 3) longevity of antibody responses. This holds true for most vaccines including mRNA vaccines. Here is what I tweeted about this before. (2/n)

However, the 2 dose vaccine with limited number of vaccine means only half the people getting vaccinated at this time. If the virus is spreading slowly, we want to do the right thing and give the most vulnerable 2 doses and others to wait. (3/n)
Read 11 tweets
Prof. Akiko Iwasaki Profile picture
30 Dec 20
Inspired by this tweet by @TheMenacheryLab, I reached out to the wonderful colleagues at the @serimmune to see if the other mutations found in the B.1.1.7 variant would evade antibody responses generated by the wild type #SARSCOV2. (1/n)
According to this report, B.1.1.7 harbors non-synonymous mutations in the following viral genes, resulting in truncation, deletions and amino acid changes. Would these mutations result in evasion from antibodies generated by wild type virus? (2/n)

virological.org/t/preliminary-…
To probe this possibility, @serimmune used their technology platform based on bacterial display peptide libraries, next generation sequencing & machine learning to reveal antibody reactivity against WT and B.1.1.7 viral antigens. (3/n)

serimmune.com/technology.html
Read 11 tweets
Prof. Akiko Iwasaki Profile picture
26 Dec 20
What aspects of antibody responses determine the outcome of #COVID19? In this new preprint by @carolilucas @sneakyvirus1 et al., we found that the early timing of antibody response (before 14 days of symptom) in infected person is key to recovery. (1/n)

medrxiv.org/content/10.110…
As others have shown, we found that antibody levels from COVID patients correlated with disease severity.

journals.plos.org/plospathogens/…
wwwnc.cdc.gov/eid/article/26…

However, patients with lethal COVID did not have the highest level of anti-S or anti-RBD antibodies. What’s going on? (2/n)
To understand better the features of antibody responses in patients who died vs. survived, we compared their time course. We found a delay in antibody responses in lethal disease. We also noted patients with very high neutralizing Ab (HN) with very early antiviral Abs. (3/n)
Read 11 tweets
Prof. Akiko Iwasaki Profile picture
12 Dec 20
New exciting collaboration work with @Aaronmring lab reveals diverse and functional autoantibodies in #COVID patients.

Our findings provide clues for why COVID affects many organs, induce range of symptoms that are long lasting.

Thread (1/n)

medrxiv.org/content/10.110…
How do we look for autoantibodies against a wide range of self antigens? The @aaronmring lab developed a high-throughput autoantibody discovery technique called Rapid Extracellular Antigen Profiling (REAP) against 2,770 extracellular and secreted proteins "exoproteome" 💪🏼 (2/n)
A large fraction of #COVID patients had autoantibodies to multiple self antigens. The more severe the disease, more autoantibodies they had.(3/n)
Read 14 tweets

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