This report that has me somewhat concerned about vaccine escape by a variant. Most previous reports were neutralizing antibody studies. These are clinical results.

Astra Zeneca vaccine was only 10% effective against the B.1.351 variant in South Africa. nejm.org/doi/full/10.10…
Among 39 mild to moderate cases with this variant, 20 occurred in placebo group and 19 in vaccine group. Means: No protection seen.

I'm still optimistic that there will be protection against severe disease and deaths.
There were no severe cases of COVID in this study. No hospitalizations or deaths. It's a small study (n=2021).

Time will tell. Even more reason to consider vaccinations from a global standpoint. Because leaving parts of the world unvaccinated is self defeating.
Here is the efficacy table overall for this study. @NEJM

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More from @VincentRK

19 Mar
Astra Zeneca COVID vaccine update.

1/ Out of ~20 million people who received this vaccine, 16 have developed cerebral venous sinus thrombosis in EU/UK. @EMA_News

Germany 7
Italy 3
Norway 2
Spain 1
UK 3

In addition, 2 cases were reported from India.
2/ There were also 7 cases of DIC.

3/ All of the EU /UK events were in people less than 55.

4/ 9 deaths.

ema.europa.eu/en/news/covid-…
5/ The rate of DIC and cerebral venous thrombosis appear higher than expected baseline.

6/ Since these adverse events are very rare, the risks of COVID high, & the high efficacy of the vaccine, the @EMA_News recommended that the benefits of the vaccine outweighed the risks. Image
Read 4 tweets
19 Mar
Paradigm shifts in multiple myeloma.

1/ Change in diagnostic criteria. MDE not CRAB. @TheLancetOncol Image
2/ Treatment of high risk SMM. Early preventive therapy with Len or Len/dex significantly delays end organ damage in high risk SMM. @SagarLonialMD @mvmateos ImageImage
3/ Role of Transplant.
Early versus Delayed Transplant. Similar overall survival at 8 years means selected patients with standard risk myeloma can opt to delay transplant if feasible. ImageImage
Read 5 tweets
18 Mar
COVID and thrombosis.

There's concern about 11 people who developed central venous thrombosis following COVID vaccine.

But what about COVID itself?
A brief summary:

1/ COVID has been associated with central venous sinus thrombosis. Singapore 2 cases. ncbi.nlm.nih.gov/pmc/articles/P…
Read 5 tweets
18 Mar
>2000 COVID deaths a day in the EU. Lots more seriously ill. Astra Zeneca vaccine (& all other approved vaccines) are 100% effective in preventing hospitalization & deaths.

The potential risk reported is a rare form of blood clots in 11 out of 17 million vaccinated.
This is how good the vaccines are in preventing this worst pandemic of all time. 👇👇
The risk benefit equation hugely favors vaccination. I'm glad the @EMA_News recommended to resume vaccinations. wsj.com/articles/astra…
Read 4 tweets
18 Mar
Sometime depth of expertise makes you so blind, you miss the big picture.
Depth of expertise and critical appraisal are different skill sets. Not every expert has both.
Depth of expertise and make the right risk benefit judgment calls are also different skill sets. Not every expert has both.
Read 4 tweets
16 Mar
Astra Zeneca vaccine and blood clots. Here's what we know:

11 people in Europe with central venous sinus thrombosis out of 17 million who have received the vaccine.

7 in Germany
3 in Norway
1 in Spain

Almost all <50 years of age.
Austria has 2 serious thrombotic events.
What we don't know:

1) Whether blood clots and vaccine are causally related.
2) Whether the central venous thrombosis rates are higher than expected.
3) Whether the patients had any unique underlying problems.
4) Why this has not occurred in the UK.
What we have to consider:

Incidence and Risk of clots (if confirmed) versus incidence and risk of COVID.
Read 11 tweets

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