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Shane Crotty Profile picture
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26 Feb, 6 tweets, 2 min read
(iv) Durability of immunological protection against COVID-19 is still unknown for each of these vaccines.
(v) The J&J 1-dose does quite well against the SA variant. That's a big deal! In contrast, the AstraZeneca vaccine appears to have almost no efficacy against that variant (~10% efficacy in confirmed cases).

(vi) Lastly, the J&J vaccine had substantial increases in neutralizing antibodies after two doses (T cells were not reported post-boost).
nejm.org/doi/full/10.10…
J&J has an ongoing 2-dose COVID-19 vaccine clinical trial, and it is therefore reasonable to expect very high protective immunity in that 2-dose J&J trial.

So, no perfect interpretation. Well, it's not a perfect world. The new J&J vaccine definitely works, and my advice is that you take whichever of these three vaccines you are offered in America (Pfizer, Moderna, or J&J). It is WAY better than not being vaccinated!
Protection against hospitalization-level COVID-19 disease, and SARS-CoV-2 variants of concern, are both a big deal.

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Shane Crotty Profile picture
26 Feb
The J&J COVID-19 1-dose vaccine data have been filed with the FDA and are under review there (probably final decision tomorrow).
Here are my thoughts on the J&J 1-dose COVID-19 vaccine, now that the data are public.🧵

(Janssen=J&J = Johnson & Johnson) Vaccine name: Ad26.COV2.S
Executive summary:
🔵 1-dose. Very convenient! And easy to store.
🔵 Essentially 100% protective against death or hospitalization. Very good!
🔵 69% protection against symptomatic COVID-19. Just ok.
🔵 Similar protection against the South Africa variant (72%-->64%). Very good!
The FDA EUA package data are consistent with the statements in the J&J vaccine press release several weeks ago.

Here's my tweet thread from then:
Read 22 tweets
Shane Crotty Profile picture
26 Feb
An important and fascinating long COVID topic, @DanielGriffinMD
🧵
Obviously I can only speculate for now. Actually, let's be really clear:

SPECULATION

IF there is an effect of COVID vaccines on long COVID (I don't want anyone to have unrealistic hopes without there being data from a well-designed clinical study!), the simplest options are:
1. The strength of the vaccine immunization serves to reset a homeostatic baseline to the immune system.

2. Exactly as Akiko said so well:

Read 7 tweets
Shane Crotty Profile picture
26 Feb
Excellent paper on the human B cell response to COVID-19, by the fantastic Laura Walker. 🧵

immunology.sciencemag.org/content/6/56/e…
1,213 human monoclonal antibodies (!), showing substantial affinity maturation of the B cells over time.
A substantial fraction of the Spike-specific response is to RBD. Consistent with other work.
Read 7 tweets
Shane Crotty Profile picture
16 Feb
This was really PHENOMENAL news. A big deal for the future of vaccine development broadly. And a big deal in the HIV vaccines field.🧵
Not only was a positive signal seen in 97% of vaccinated people, the signal was fantastically strong!
As noted by Bill Schief in his talk, this is probably the first vaccine trial to succeed in confirming its intended mechanistic hypothesis. A big moment for germline targeting vaccine design strategies!
Read 8 tweets
Shane Crotty Profile picture
8 Feb
Well, that's a nice surprise!
What happens if you have had COVID infection before and you get a COVID vaccine?
Some observations last week are summarized here:
In a new pre-print by the excellent @McGuire_Lab , they report a big jump in neutralizing antibodies after a single COVID RNA vaccine immunization (Pfizer or Moderna).

That is the same thing observed by @florian_krammer and the Sajadi labs.
medrxiv.org/content/10.110…
Read 5 tweets
Shane Crotty Profile picture
8 Feb
The AstraZeneca/Oxford (AZ) COVID vaccine (ChAdOx) results in South Africa are concerning. 🧵

* The AZ vaccine had 75% efficacy against mild COVID through October 2020.

* But only 22% efficacy more recently, with the SA variant  (aka B1351 or 501Y.V2)

facebook.com/HealthZA/video…
Penny Moore and Alex Sigal and colleagues now report on antibodies from AZ ChAdOx vaccinated people, and there was a dramatic loss of function against the B1351 variant. It appears to be more than a 20x reduction. A complete loss of neutralization in most individuals (~80%).
First, what to think of the antibody neutralization loss?

It is much steeper than reported by multiple groups elsewhere for COVID19 cases or other COVID vaccines. Multiple labs reported ~2x drop in neutralization of B1351 or related virus, with antibodies from vaccinated people
Read 16 tweets

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