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…
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…
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…
JAMA paper showed same findings; pain at injection site main adverse reaction. Although CD4/CD8 cells measured, not reported upon in the paper. Neutralizing antibody titers here measured with 3 injections and results shown here:
Then, phase 3 trial conducted in UAE with 31, 000 participants. Results here were given as 100% effective in preventing moderate and severe COVID-19; overall 86% efficacy rate if mild disease included; 99% seroconversion rate of neutralizing antibody (other phase 3 trials too)
This chart shows you falling cases in UAE - job market apparently improving. Nice that they have 4 vaccines approved by now.…

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More from @MonicaGandhi9

23 Feb
Some of this discussion after this article came out yesterday which shows that asymptomatic infection (transmission thereby) will reduce after vaccination reminded me how wed some are to continuing a narrative of fear. Remember how we used to say that "the clinical trials
designed to tell you if asymptomatic infection was reduced because post-vaccination regular asymptomatic screening was not done?" Well, here you have this done among HCWs after vaccination - swabbing just to make sure there is no virus in the nose & 86% of the time (these
are EXPOSED health care workers, they are around others), there was NO virus in that nose. Okay, what about the remaining 14%? Take these two papers please- tweeted details before so please read those.……
Read 6 tweets
22 Feb
UK (rolling out better than any other large country) on efficacy of Pfizer& AZ vaccines on reducing hospitalizations and transmission in real-world. By 4th week, Pfizer & AZ 1st dose reduce risk of hospitalization from Covid-19 by 85% & 94%, respectively…
okay that's 1 dose. 1 dose. If you blocked death by 94%, we would have 30,000 deaths from COVID-19 this year in the US instead of 500,000. Spectacular efficacy. So, like UK let's do 4 things: 1) 1 dose to all first; 2) 12 weeks between; 3) Approve more vaccines; 4) mix if have to
Also, we have never had time in history while we are rolling out vaccine in the throes of a pandemic. Means that we must do everything in our power to save lives in US - improve vaccine roll-out by these same procedures as UK…
Read 4 tweets
21 Feb
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?)…
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.
Read 4 tweets
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:…
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…
Read 9 tweets
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!…
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
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…
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

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