Yes, we are uncertain about how much vaccines will cut transmission. Yes, they probably will and here’s why.

Enough complaining about how we discuss vaccines. The public can understand the nuances.

My latest for the @nytimes:
nytimes.com/2021/02/23/opi…
New data coming out all the time, so I was pleased to see this well-timed preprint. Pfizer-BioNTech reduces infection by >80% in this observational study.

papers.ssrn.com/sol3/papers.cf…
And also adding @apoorva_nyc's very complementary perspective here:

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More from @angie_rasmussen

24 Feb
I agree that “COVID Zero” is an unrealistic fantasy at this point but the comparisons to flu lose a lot of steam scientifically when you consider that “Zero flu” is unachievable for different reasons.
There are hundreds of subtypes of influenza circulating in many wild animal species, notably migratory birds. Flu can be transmitted from those birds to humans or to other animals such as pigs.
That has unpredictable effects on transmissibility in people, pathogenicity, and cross-reactivity with prior immunity.
Read 8 tweets
19 Feb
Seeing this get lots of traction. Vaccine hesitancy/skepticism is a problem, but I don't agree with the pearl-clutching about "messaging," as if vaccine hesitancy is something new caused by dour, pessimist scientists being honest about uncertainty.
Vaccine hesitancy has been a problem since long before COVID-19, and has pretty much impacted every single vaccine, even ones that have been around for decades and have been used to safely immunize millions or even billions of people (MMR).
So let's go through this. Yes, it's true we need to do better at persuading front-line HCW, especially LTC workers, and folks in the military. NBA players? Sure, why not.
Read 24 tweets
17 Feb
I agree with >100 of my colleagues that SARS-CoV-2 is on the way to becoming endemic, meaning it never stops circulating. But just because elimination is unlikely doesn’t mean we are doomed to an eternal pandemic. nature.com/articles/d4158…
Lots of pathogens are endemic, including the 4 common cold CoVs. Just because we can’t eliminate them completely doesn’t mean we can’t control the public health impact.

With SARS-CoV-2, we can in the short term by reducing transmission and in the long term through vaccination.
I think that headlines proclaiming that the virus is “here to stay” are misleading in that they imply living the way we are now will last forever. That’s not the case (and @nickyphillips_ is a thoughtful reporter and I never got the impression she was fearmongering when we spoke)
Read 8 tweets
15 Feb
I understand what Dr. Frieden is trying to say here but this makes it sound like vaccines will drive the emergence of new variants and compel the virus to mutate in new and scary ways. That’s just not true. I’ll try to clarify.
Immune status of a population can be an evolutionary selection pressure, but that assumes there’s enough replication going on for mutations to be under positive selection.
This means that we might see more/better immune escape variants emerge if these scenarios occur:
1. Widespread community transmission with slow vaccine uptake
AND/OR
2. Vaccines don’t provide any protection against infection and transmission continues unchecked after vaccination.
Read 10 tweets
13 Feb
2021: sure 2020 was bad, now how about we do more 2020 stuff except with more 2014 thrown in to make it extra tragic and horrible.
And regarding Dr. @amymaxmen’s hypothesis about bats in West Africa carrying Ebola, yep, thanks to PREDICT we think probably multiple species of bats do. sciencemag.org/news/2019/01/b…
To make things extra lousy, in January PREDICT teams working with Sierra Leonean scientists also found Marburg virus in its known bat host, R. aegyptiacus, in Sierra Leone:
scitechdaily.com/ebola-like-mar…
Read 6 tweets
9 Feb
People should be aware that this investigation occurred in an extremely complex political and diplomatic landscape.

I agree with Dr. Gottlieb here, but people need to understand the context for why this hypothesis was investigated.
Determining a virus' origin, whatever that may be, is an extremely long process. It can take decades. It sometimes never happens. It was never going to happen in two weeks.

This mission is the start of a much longer process that will likely take years.
wsj.com/articles/coron…
Ebola's been around for 40+ years and we think it circulates in bats, but we still haven't proved it by isolating infectious virus. We've only just sequenced a full genome in a bat. This isn't Outbreak where they find the host monkey or whatever and instantly end the pandemic.
Read 10 tweets

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