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Monica Gandhi MD, MPH Profile picture
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21 Feb, 4 tweets, 2 min read
2 camps emerging in "experts" which I find astonishing, directly linked to school debate. One camp (@MartyMakary, I, others) linking lowering cases/hospitalizations in US directly to roll-out of vaccine + natural immunity from infection (20% in US?)
ama-assn.org/delivering-car…
The other camp is saying people are "being good" after winter surge and holiday badness of visiting which is why cases/hospitalizations decreasing. Now, the same journalists who feel nervous to say the word "immunity" even with vaccines are also reporting on how harmful
school closures are for children and society. But these two threads are linked -if you can't report on how amazing these vaccines are (and always interview those who say - well, the variants), you will directly generate fear which will keep schools closed until next fall.
So, as journalists, please consider reporting on good news, the power of immunity, how the T cell response from vaccines is in-breadth & protects against severe disease even with variants (not 'maybe', 'definitively') if you really want to inform the school debate scientifically.

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More from @MonicaGandhi9

Monica Gandhi MD, MPH Profile picture
22 Feb
Helpful to understand more about the Sinopharm vaccine & UAE roll-out. 4 vaccines approved in the UAE: Sinopharm, Pfizer-BioNTech, Sputnik V and Oxford-AstraZeneca. As of Feb 20, 2021, UAE has already vaccinated 56% of its population, 2nd highest in world
gulfnews.com/special-report…
Sinopharm is an inactivated virus vaccine developed in China (but phase 3 trial elsewhere as cases too low in China). We like to look at the phase I/II trial data first which was published in Lancet. Two-dose with 4 μg vaccine 3-4 weeks apart
thelancet.com/journals/lanin…
We are now used to seeing T-cell responses being measured in the safety/immunogenicity phase but not measured in Lancet paper; neutralizing Ab titers went up with time out to measured 42 days. Pain/fever most common AEs. Next -phase 2 results in JAMA
jamanetwork.com/journals/jama/…
Read 6 tweets
Monica Gandhi MD, MPH Profile picture
17 Feb
When will there be enough evidence that vaccines reduce asymptomatic carriage (e.g. risk of transmission) to be able to change guidelines for vaccinated people not being a risk to unvaccinated? Also, how should vaccinated people be tested (if at all?) given PCR sensitivity issue?
As we discussed before, this Singapore study is the most compelling I've seen that asymptomatic infection less likely to transmit (4 fold) than symptomatic infection: thelancet.com/journals/lance…
And this study from Catalonia, Spain also told us that viral load of index cases is the most predictive factor of spreading the virus to others
thelancet.com/journals/lanin…
Read 9 tweets
Monica Gandhi MD, MPH Profile picture
15 Feb
Simplest way I can think of to fix the vaccine supply shortage is to authorize J&J vaccine tomorrow (instead of waiting for Feb 26 FDA hearing date). Then you will say - oh no, not as effective? And I will say yes, it is for severe disease & variants!
abc7news.com/covid-19-san-f…
And you will say, show me the data on J&J vaccine again? And I will say please please watch this short 30 minute video (6 minutes to 36 minutes) - all data here and a rhapsody in blue to T cells
And you will say - honey, I don't have time to watch you prattle on for 33 minutes - show me the key slides? And I will say - I really want you to see ALL the data but okay here
Read 5 tweets
Monica Gandhi MD, MPH Profile picture
12 Feb
This study is going to tickle your T cells! A lot of what will happen with the variants will be determined by how well your vaccine-induced T-cell response cross reacts to them. Here is UK study of vaccinated people (Pfizer x 2) then exposed to new
researchsquare.com/article/rs-226…
variants circulating (B.1.1.7 UK, B.1.351, SA) compared to cohort who recovered from natural infection (with non-variants) in spring 2020. Those who had recovered from natural infection with the "spring" (non-variant) virus had less effective antibody responses (reduced with UK
variant, couldn't neutralize the B.1.351 strain). But T cells remained protective likely because it forms responses to epitopes ('bits') across the whole spike protein. Same true with those who got 1 dose of vaccine- robust and complex T-cell response to the variants
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
1 Feb
okay let's put it specifically from NYT since everyone thinks I am Pollyanna: "In official language of research science, vaccine is typically considered effective only if it prevents people from coming down with any degree of illness..."
nytimes.com/2021/02/01/bri…
"With a disease that’s always or usually horrible, like ebola or rabies, that definition is also the most meaningful one.
But it’s not the most meaningful definition for most coronavirus infections. Whether you realize it or not, you have almost certainly had a coronavirus. "
"Coronaviruses have been circulating for decades if not centuries, and they’re often mild. The common cold can be a coronavirus. The world isn’t going to eliminate coronaviruses — or this particular one, known as SARS-CoV-2 — anytime soon. Yet we don’t need to eliminate it for"
Read 5 tweets
Monica Gandhi MD, MPH Profile picture
1 Feb
Efficacy refers to how a drug/vaccine does in a clinical trial; effectiveness refers to how it does in the "real world". Nice preprint on the effectiveness on the Pfizer vaccine which has arrangement with Israel to get data weekly as it rolls out
medrxiv.org/content/10.110…
503,875 individuals (mean age 59·7 years); 351,897 had 13-24 days of follow-up. Cumulative incidence of infection was 0·57% days 1-12 and 0·27% days 13-24. Relative risk reduction 51.4% after 1st dose with more expected after 2nd. Real world looks as good as trial, exciting!
By the way, for my academic friends, this is clearly being reviewed at Lancet with the decimal point in the middle and the "evidence before this study" part at the beginning!
Read 6 tweets

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