So I was very privileged to get vaccinated with J&J/Janssen this morning. I was originally supposed to get Pfizer. Let me explain why I switched, even though J&J is slightly less effective overall. A short thread:
Last week when I made the appointment for me and my husband when we became eligible, I was elated to get access right in time for a big life change: moving my family to Canada.
Many of you know I’m moving to Canada later this month to start a lab @VIDOInterVac. I’m so excited about this but I couldn’t help but think: will I be able to get my second dose of Pfizer in Canada?
Even though Pfizer is authorized there, Canada has not been able to get up to speed as quickly as the US in terms of distribution and they’ve also recommended delaying the second dose up to 16 weeks, which is unsupported by any data I am aware of.
While the first shot clearly confers very good protection, it’s unclear how long that lasts, but very clear that the second shot is needed for complete protection. And I had no idea how to get my booster dose in Canada on schedule (even the extended schedule).
The idea of trying to navigate my vaccine doses across 2 distinct systems was daunting and uncertain. So when my mom got a hot tip that J&J appointments were available at her local Fred Meyer, I jumped at the chance to get one and done.
Unfortunately they only had one appointment, so my husband is getting his first dose of Pfizer as we speak. He will be coming back to the US to settle our affairs before moving permanently within the 6 week window that has been studied & will be able to get his second dose here.
Unlike my husband, I am staying in Canada to get us settled there and get my new lab up & running & not coming back in the near future, so I am now protected by my single dose of J&J. Why am I telling you all this?

To share my belief that the best vaccine is the one in your arm.
This way someone in the US can benefit from the Pfizer shot I would have had, and also I won’t be taking away precious doses from Canadians, who are battling surging B.1.1.7 in many provinces including the one I am moving to. Every dose matters in this race.
And even though we will both continue to take precautions to reduce transmission risk to us and others, we now have both done our part in the overall effort to get on schedule, by-the-book immunizations up and transmission down.
Even though the vast majority of people aren’t in the weird position of trying to move abroad during a pandemic and will never have to grapple with this calculus, I couldn’t be happier with my J&J shot even though it’s not quite as effective overall as the mRNA vaccines.
All the vaccines are safe and incredibly protective against severe COVID-19. They will keep you from getting really sick. They will keep you out of the hospital. They will save your life. They will help sustainably end transmission in the population.
The bottom line is, unless your provider says otherwise, you should get whichever vaccine you can, as soon as you can. I am so, so happy to have J&J. I am so, so happy my husband got his first Pfizer shot. I am so, so happy both my parents got 2 shots of Moderna.


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More from @angie_rasmussen

6 Apr
Great thread. There are 2 problems with much of the variant coverage.

On one side, we have:

On the other, we have:
Nothing to worry about here, because (T cells/herd immunity/scientists are being negative again)

Neither side is 100% wrong or right
Here's what we know:

Yes, variants have emerged. Yes, they are a problem.

Some, like B.1.1.7 are more transmissible and more virulent.

Some, like B.1.351 and P.1, may have *some* capacity to *partially* evade adaptive immunity (B cells/T cells).
But we can address both of these threats:

-Continuing to take precautions (masks, distancing, ventilation, etc) to reduce exposure risk

-Getting vaccinated ASAP. No variant has shown the ability to *completely* evade adaptive immunity. Vaccines still work against the variants.
Read 11 tweets
2 Apr
For all those wondering how variant mutations can screw up antibody responses, have I got the preprint for you!

Buckle up for a long ride down epistasis & biochem road, thanks to this great study by @Dr_MattMcCallum and colleagues in the @veeslerlab & collabs at @Vir_Biotech.
First, some background. All the variants have different constellations of mutations in SARS-CoV-2 spike. This is the protein on the surface of the virus particle (virion) that bind the receptor ACE2 and allow the virus to enter & infect cells.

It looks like this (h/t @profvrr):
As you can see from the above virion, spike is a 3D structure on the surface of the virion. Antibodies bind all over the surface of the spike protein. Some of these bind to important parts of spike that render the virus non-infectious, or neutralize it.
Read 36 tweets
31 Mar
BREAKING: Major and Champ Biden are dogs who do normal dog things
And all the people saying normal dogs don't poop in the house has never owned a senior dog or a pug of any age.
Also BREAKING: Ripley thinks Major and Champ seem cool and she’d like to compare indoor pooping techniques with them at some point
Read 4 tweets
31 Mar
I’ll always make time for @apoorva_nyc, especially about great news like this: top line trial results show safety, robust antibody production, & 100% efficacy in 12-15 year olds!
W/ the wise & wonderful @VirusesImmunity, @JenniferNuzzo, & Kristin Oliver.…
Approach the efficacy data cautiously, because it was based on just 18 cases, all in the placebo group, but this is what we’d expect to see: the vaccine works in adolescents at least as well as in adults (maybe better, at least in terms of antibody responses).
While this data still needs to be evaluated by FDA and we need to see the full trial data, parents of teens can rest easier knowing their kids will likely be able to get vaccinated before school starts in the fall.
Read 5 tweets
30 Mar
Barely out and already my feed is filling up with (some pretty racist) complaints that this report is incomplete and dissatisfying.

But did you really expect a 2 week mission to yield a definitive answer about SARS-CoV-2 origins?

Origin investigations take years, even decades.
The purpose of this mission was really to lay the groundwork for collaborative studies moving forward.

Like it or not, that requires working cooperatively with China.

Like it or not, @WHO isn't equipped to conduct an audit of WIV's freezers or records or interrogate its staff.
This report contains some new information: about excess mortality, ILI, environmental testing, retrospective sample testing, animal testing. It also acknowledges there is a lot more to do.
Read 9 tweets
21 Mar
2 things have been troubling me lately:

1. The notion that recognizing the nuances & uncertainties of SARS-CoV-2 transmission is somehow "denying" that respiratory transmission occurs.

2. This is all @WHO's fault for giving bad guidance.

Are these true? Let's look at the data.
1. SARS-CoV-2 is a respiratory virus. That means it infects cells of the respiratory tract in both the upper (nose) and lower (lungs) airway. Naturally, this means you become infected after exposure to virus via inhalation, direct contact (droplets), or indirect contact (fomites)
Infection occurs not from exposure to purified virus, but from virus that's emitted in particles of saliva and mucus that an infected person exhales (or speaks, sings, etc).

Go outside on a cold day and breathe out. That cloud of steamy breath? Those are respiratory particles.
Read 48 tweets

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