Florian Krammer Profile picture
Feb 14, 2021 11 tweets 2 min read Read on X
1) Ich hab einen Vorschlag. Der AstraZeneca Impfstoff wirkt gegen alle in Europa zirkulierenden SARS-CoV-2 Viren ausser B.1.351. Aber B.1.351 ist bisher selten, auch in Gegenden wo man es in Europa detektiert hat (z.B. Tirol). Jetzt gibts viel Widerstand gegen den Impfstoff....
2)....und alle wollen die RNA Impfstoffe. Von denen gibts aber nicht genug im Moment. Eine der Hauptsorgen ist, dass es nicht klar ist ob man mit einem an Varianten angepassten RNA Impfstoff auf AstraZeneca 'draufimpfen' kann wenns notwendig wird bzw....
3)....wenn sich rausstellt dass die 'normalen' RNA Impfstoffe gegen alle Varianten gut wirken, ob man dann mit denen nachimpfen kann wenn man schon den AstraZeneca Impfstoff bekommen hat. Aus immunologischer Sicht waere sowas vermutlich kein Problem. Ganz im Gegenteil....
4) ...., Kombinationen von verschiedenen Impfstoffplatformen werden oft in klinischen Studien eingesetzt um bessere Immunantworten zu bekommen. Da gibt es viele Beispiele bei Influenza, HIV oder auch Ebola etc. Aber natuerlich waere es gut, wenn man fuer die Kombination....
5)....AstraZeneca gefolgt von RNA Impfstoffen Daten haette. Ohne Daten kann man natuerlich nicht einfach anfangen das so in der Bevoelkerung einzusetzen. In Grossbritannien hat man mit einer solchen Studie schon begonnen..... nature.com/articles/d4158…
6) Aber ich glaube es waere gut, wenn man das auch anderswo in Europa, zum Beispiel in Tirol, testen koennte. Das muss keine Phase III Studie sein, sondern koennte eine recht kleine 'open label' Studie sein in der man sich Immunogenitaet und Sicherheit in einer kleinen Anzahl...
7)...von Freiwilligen (z.B. 100 zwischen 18-59 Jahren und 100 60+ jaehrige) anschaut und mit 2x AstraZeneca und 2x RNA Impfstoff vergleicht. Sowas kann in recht kleinen Landeskliniken umgesetzt werden. Kompetente Kliniker die die Studie durchfuehren koennen und....
8)...kompetent Virologen/Immunologen die sich die Immunantwort, vor allem auch gegen Varianten anschauen koennen gibts auch. Freiwillige wird man sicher auch finden. Das wuerde Daten zur Sicherheit einer solchen Kombination liefern und natuerlich wuerden wir sehen was....
9)...immunologisch passiert und wie gut und vor allem wie breit die Antikoerperantwort im Vergleich zu 2x AstraZeneca und 2xRNA Impfstoff ist. Sollte es dann notwendig werden 'draufzuimpfen' haette man Daten schon und koennte schnell reagieren. Wenn sich rausstellt, dass die...
10)...Kombination besser ist, koennte man darueber nachdenken, die Impfplaene umzustellen. Ich glaube so was waere sehr vertrauensfoerdernd und wuerde auch signalisieren dass unsere Regierungen dem Virus nicht nur mit Massnahmen hintennachlaufen, sondern proaktiv was machen.
11) Ausserdem ist Impfstoff um das durchzufuehren vorhanden. Und da man nur sehr wenige Dosen fuer die Studie braucht, nimmt man auch Leuten die die Impfung jetzt zuerst bekommen sollen nichts weg. Nur so ein Vorschlag.

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More from @florian_krammer

Feb 25
1) I am reviewing some of the literature re antigenic distances between XBB.1.5 nd JN.1 and how well the XBB.1.5 vaccine works right now. I'll post random papers here. Just for nerds. (this is not a story, just a bunch of papers).
2) Interesting paper from Qatar re protection of infection from JN.1 reinfection. Take home message is probably that JN.1 is antigenically distant from XBB.1.5. medrxiv.org/content/10.110…
Image
3) Nice paper from the Netherlands (@dirkeggink) looking at XBB.1.5 vaccine effectiveness against XBB.1.5 and JN.1. Take home message: Vaccine works.
medrxiv.org/content/10.110…
Image
Read 18 tweets
Aug 28, 2023
1) Our preprint describing 3 years of our PARIS study is live. There are a few interesting observations I wanted to highlight. This was the work of a large team but the lead is really @VivianaSimonLab medrxiv.org/content/10.110…
2) First, here is an overview of the spike titers of all the study time points. We had 501 individuals in the study and measure their anti-spike binding antibodies on a regular basis. Image
3) The first take home message is: Antibody decay after mRNA vaccination is biphasic. First a steep drop, then a stabilization phase. The graph here shows titers after the primary immunization series. Blue is previously naive individuals, orange is hybrid immune. Image
Read 17 tweets
Aug 12, 2023
1) I feel this paper by Mattias Forsell's group is often overlooked but shows something very important: Binding antibody to SARS-CoV-2 spike - in the absence of strong neutralizing antibodies to a new variant - predict protection from mortality. .thelancet.com/journals/lanep…
2) Individuals with the lowest antibody titer have the highest risk, individuals with higher titers are protected. Of course, we are not talking about protection from infection or protection from symptomatic disease by binding, non-neutralizing antibodies here, but protection.... Image
3) ...from severe outcomes. Why is this important? Neutralizing antibodies (which likely are the main protective factor when it comes to protection from infection or symptomatic disease) often drop steeply against new variants while binding antibodies are in most cases.....
Read 7 tweets
Aug 7, 2023
1) In a recent study with @gabagagan, Anass Abbad, Juan Manuel Carreño and @VivianaSimonLab we wanted to see how much crossreactivity exists in the post-COVID era to spikes beyond SARS-CoV-2. We expressed all the spikes shown in the tree below and got going. Image
2) We ran ELISAs with longitudinal samples from people who had received the primary vaccination series of COVID-19 mRNA vaccines including naive individuals (grey) and people who previously had SARS-CoV-2 infections (black). Image
3) Titers actually went up for all sarbecoviruses and even for most other betacoronaviruses (with the exception of nobecoviruses where there was no increase in reactivity for one of the two spikes tested).
Read 10 tweets
Mar 17, 2023
1) I just talked with students in class about similar situations in France and Spain in the last few years. Aedes mosquitos are present in the US and Europe and are a nice vector for dengue. Once the virus is established in local mosquito populations its hard to get rid off.
2) And climate change helps the mosquitos to move north, extending the potential range for viruses like dengue, chikungunya, Zika etc. This is also happening for some tick species, e.g. Hyalomma ticks in Europe which can carry Crimean-Congo Hemorrhagic Fever Virus.
Read 5 tweets
Feb 9, 2023
1) What should be done about avian influenza. Very easy. Master seed viruses and vaccines specific to the panzootic H5N1 need to be produced (which is likely in progress for a some time already, the CDC is really good at this and BARDA has manufacturing contracts for it).
2) It needs to be assess if these viruses are sensitive to the three classes of drugs we have against influenza. To my knowledge that has been done, looking good. There is likely also significant immunity to the N1 because humans have been exposed to pH1N1 which...
3) ...is now the seasonal H1N1 strain and features and avian origin N1 (see 1968 H2N2/H3N2 cross-protection for literature). Then, physicians need to be informed about the possibility that an atypical influenza they detect is H5N1. They need to review the tests they are running..
Read 7 tweets

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