1) There are a lot of questions about how fully vaccinated individuals should behave. I don't have good solutions either, but I have some thoughts. First of all, we are seeing more and more data about how well vaccination works in a real live setting. There are recent studies...
2) ...from Israel (nejm.org/doi/full/10.10…; thelancet.com/journals/lance…) and Scotland (papers.ssrn.com/sol3/papers.cf…) showing high vaccine effectiveness in the population. That is just awesome and a reason to celebrate for all of us. On the other side you need to keep in mind....
3)...that vaccination, while highly effective, doesn't remove all risk. There are cases of symptomatic infection even after two vaccinations, keep that in mind. These cases might be mild, but they can occur. The protection you can expect from being vaccinated is driven....
4)....by many factors. How well the vaccine works in general is an important one. How well the vaccine works in an individual is another important one (not all people respond similarly to vaccination). Another important factor is how much virus is around. If virus circulation....
5)...in a given population is very high, your baseline chance of getting infected is very high. If that chance is cut down by 95% that's great. But there may still be a good chance that you catch the virus. If virus circulation is low, your baseline chance is also low. If you...
6)...cut that risk again by 95%, you end up with basically no risk at all. And the same applies to risky behavior. And that is one reason, why we need to still distance and mask up. However, at least in my book there are exceptions. And those exceptions have again to do with...
7)...how high your risk is. Interactions of people who are fully vaccinated with other people who are fully vaccinated (or immune due to previous infection) likely come with a very low risk for everybody involved. That's why I am not necessarily an opponent of e.g.....
8)....the green passport that Israel is using. There may be ethical concerns about that which have been discussed elsewhere, but I think it also is a strong incentive to get vaccinated. I know people have very strong opinions about this, and we need to be cautious, even...
9)....when vaccinated people interact. I think mass gatherings, even when vaccinated masked people are involved would currently be a bad idea. But e.g. two fully vaccinated elderly couples that have dinner together? A vaccinated HCW who is now....
10).....visiting vaccinated elderly parents in a 'normal' way? I am not sure if I would be opposed to that. I think we need to be cautious and need to stay vigilant about risk. But we should also allow people who have immunity to at least normalize some of their interactions...
11)....either other immune individuals. I don't think this should apply to any public rules and public guideline. For now, everybody should wear a mask in a professional setting, in public transport etc. But I think we should....
12)....start to get back to normal, in little steps, were risk is low, especially when it comes to interactions between immune individuals. Let's hope the variants don't throw us a curveball.
13) I know, this will start a heated discussion. But one worth having. Stay safe!
14) PS: Yes, its complex.
15) Update! The CDC guidelines for this are now out. And they say more or less the same as my tweets 😉
cdc.gov/coronavirus/20…

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More from @florian_krammer

1 Apr
@MarcusFahn A) Virale Glykoproteine sind oft kleine Maschinen, die die Fusion der viralen Membran und der Zellmembran ermoeglichen. Erst dann kann das virale Genom in unsere Zellen rein und anfangen die Kontrolle zu uebernehmen. Diese Protein binden and unsere zellulaeren Rezeptoren....
@MarcusFahn B).....in der 'Praefusionskonformation'. Dann aendert sich diese Konformation schlagartig in die 'Postfusionskonformation' und dabei werden die virale und die Zellmembran verbunden. Stellen sie sich einfach eine Stahlfeder vor, die zusammengedrueckt ist und von einer Klammer....
@MarcusFahn C)...gesichert wird. Das ist die 'Praefusionskonformation'. Wird die Klammer entfernt, springt die Stahlfeder schlagartig auf. Das waere dann die 'Postfusionskonformation'. Jetzt ist es so, dass Antikoerper die die Praefusionskonformation binden oft stark neutralisierent....
Read 7 tweets
1 Apr
1) Ein paar Infos zu Sputnik V, weils grad alle interessiert. Der Impfstoff ist eine Kombination aus zwei Adenovirus Vektoren, und zwar Adenvirus Typ 5 und Adenovirus Typ 26. Adenovirus Typ 26 is selten, da gibts wenig Vektorimmunitaet die Probleme bereiten kann....
2).....Wenn wir von Vektorimmunitaet sprechen, geht es um neutralisierende Antikoerper gegen das Vektorvirus selbst. Wenn man viele davon hat, wird der Vektor neutralisiert bevor er in unsere Zellen eindringen kann und das wirkt sich negativ auf die Immunantwort....
3)...aus. Weil wenn weniger Vektor in die Zellen kommt, wird weniger SARS-CoV-2 Spike Protein hergestellt und dann ist die Immunantwort schwaecher. Wie gesagt, bei Ad26 Vektoren kein Problem. Bei dem Schimpansenadenovirus das von AstraZeneca eingesetzt wird auch nicht, ....
Read 10 tweets
15 Mar
1) The NDV-S vaccine that Peter Palese's lab (with some help from Adolfo García-Sastre's and my lab) developed was injected into first volunteers today in Vietnam (Phase I). @McLellan_Lab contributed his HexaPro construct.
vtv.vn/video/ban-tin-… (starts at minute 2:16)
2) The vaccine is based on an NDV vector that has SARS-CoV-2 spike on its surface. This version of the vaccine is inactivated (a life, intranasal version is in development as well) and can be produced at low cost in existing influenza vaccine production capacity.
3) And it worked very well in protecting mice and hamsters from SARS-CoV-2 challenge. Here are some references for anybody interested. ncbi.nlm.nih.gov/pmc/articles/P… and ncbi.nlm.nih.gov/pmc/articles/P…
Read 4 tweets
14 Feb
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....
Read 11 tweets
10 Feb
1) Dr. Paunic's excellent Tweet started a lot of discussions about how much we know about immune responses to SARS-CoV-2 vaccines in immunosuppressed patients. Of course, trials in some patient populations are under way. But, getting the results will take some time.....
2)...and there are so many different types and degrees of immunosuppression. Also, a lot of affected people are getting themselves tested for antibodies after vaccination. A systematic approach to collect and analyze all that data globally would be great.....
3)...and maybe somebody (a scientific society? a research team?) can take that on and generate a database to which physicians and patients can contribute data? Just throwing that idea out there.
Read 4 tweets
7 Feb
1) Es geht hier nicht nur um Tirol. Es waere sehr wichtig B.1.351 (und in Zukunft aehnliche Varianten, speziell welche mit der E484K Mutation) schnell zu finden (aka alles Sequenzieren, und zwar innerhalb von Stunden, nicht Tagen)....
2)..., lokal zu Tracen und wenn noetig lokale Massnahmen zu treffen. Und zwar ohne politische Reibereien. Daten und Sequenzen muessen ohne Barrieren zwischen Bund und Laendern geteilt werden. Contact Tracing von Faellen muss schnell und reibungslos funktionieren.
3) Es geht ja nicht darum, ein Bundesland zu bestrafen, sondern darum solche Varianten schnell unter Kontrolle zu bringen. Vielleicht sollte man ein paar mobile Sequenzierlabors einrichten die man vor Ort schicken kann. Ich mein, ein MinION braucht recht wenig Platz.
Read 5 tweets

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