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Eric Feigl-Ding Profile picture
@DrEricDing
Apr 12, 2021 • 18 tweets • 9 min read • Read on X
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The most important vaccine in Latin America—SinoVac’s CoronaVac reports new trial results from Brazil 🇧🇷—

Efficacy against symptomatic #COVID19–50.7%. Moderate & severe: 83.7% / 100%. Delayed 2nd dose no issue. Neut. titres lower in age>=60 against #P1.🧵
papers.ssrn.com/sol3/papers.cf… Image
2) Results 12,396 people randomized in Brazil. It seems 2nd dose efficacy wasn’t much diff than 14 days after 1st dose. And delaying 2nd dose didn’t seem to hurt. And a second dose >21 days actually showed no drop in efficacy. ImageImage
3) As for lab antibody neutralization titres, vaccinated people had no real difference for seroconverting (having antibodies) against different variants. That said, among those who seroconverted, neutralization titres was lower among those age 60 and above against #P1 🇧🇷 variant. Image
4) Overall though, there was no real efficacy difference by age. But keep in mind — this trial was mostly conducted months ago before the large nationwide surge of the #P1 across Brazil 🇧🇷—this trial enrolled people July-Dec 2020, & likely didn’t capture much of #P1 March surge. Image
5) Across comorbidities, it was similar. Though a hint of a diff efficacy among CVD patients. Image
6) Local adverse reactions was higher (normal). But systemic adverse reactions were not higher. Image
7) As shown here, almost all adverse reactions were local to injection site, not systemic. Image
8) But there was oddly a significantly 13% relative higher relative rate of cardiovascular disease in the vaccine group (70.5% vs 62.3%) among those with comorbidities. What’s up with that? There was no discussion in the paper. It seems to maybe mix prevalence + new incidence? Image
9) I don’t know what to make of the slightly higher obesity in vaccines. Again, the % is high, so maybe it mixed both existing prevalence plus new onset? This needs an explanation. Image
10) And to be clear—the authors say #P1 was not observed in the study (like I said before, trial was mostly before the nationwide surge). Only #P2 (the other Brazil 🇧🇷 variant) was observed. Image
11) But good news is that seroconversion was equal between the variants. It’s could be because CoronaVac is an inactivated virus—ie full presentation of (dead) virus, not just the spike protein. Some experts theorize this could make CoronaVac better against variants. Unclear. Image
12) Yes, the 50% efficacy is much lower than the 95% efficacy seen with mRNA vaccines. But maybe the redeeming quality maybe that inactivated vaccine could be better against variants! We’ll see.
apnews.com/article/beijin…
13) To be fair, the trial results do confirm another observational study (not trial) in Manaus when it had 75% #P1. It also found 50% efficacy. However it dropped to 35% when asymptomatic cases added. See 🧵 below.
14) Previously, SinoVac reported 83.5% efficacy in Turkish trial. And 65% efficacy in Indonesia rural. reuters.com/article/health…
15) I do want to point out that efficacy could differ a lot across vaccines due to other reasons like local spread and by type of vaccines. For mRNA ones— Pfizer & Moderna, they reported difference neutralization (not efficacy) by variants. #P1 was moderately poor. #B1351 worst.
16) CoronaVac has also previously reported favorable immune results in kids 3-17. “antibody levels triggered by Sinovac’s CoronaVac were higher than those seen in adults aged 18 to 59 and in elderly people in earlier clinical trials”

google.com/amp/s/mobile.r…
17) Wanna know what is better than merely Phase 1/2 results? Real efficacy results of ~100% in teenagers 12-15 for Pfizer!

Even better? Hopefully FDA approval soon!
18) CoronaVac is so all over the place. Here is a Chilean study.

“protection with only 1 dose is estimated to be 3%; for those with 2 doses with less than 14 days is 27.7%; and 56.5% effectiveness for those who have the second dose more than 14 days ago.” emol.com/noticias/Nacio…

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More from @DrEricDing

Eric Feigl-Ding Profile picture
Mar 28
My god—Earthquake (a Richter ~7.7) causes a skyscraper to collapse in Bangkok. Hope all the construction workers made it out.
2) this skyscraper collapse was captured from a distant car’s dashcam while on a highway

3) another view of the collapse. For those who lived through 9/11, this collapse is a bit triggering.
Read 5 tweets
Eric Feigl-Ding Profile picture
Mar 27
Welp—kiss public health & medical research infrastructure in America goodbye for the next 4 years. RFK Jr plans to cut 10,000 jobs from Trump HHS. Image
2) this will not make America healthy again… not by a long shot. So dangerous and irresponsible.
3) “Kennedy is set to announce Thursday the planned changes, which include axing 10,000 full-time employees spread across departments tasked with responding to disease outbreaks, approving new drugs, providing insurance for the poorest Americans and more”.
Read 5 tweets
Eric Feigl-Ding Profile picture
Mar 15
SICKENING—Trump’s DHS just deported a surgeon from Brown University Medical School—who is here legally on an H1B visa that doesn’t expire until 2027, and has committed no crimes. Trained in the U.S. at Ohio State, University of Washington, and Yale as a **transplant surgeon** (one of the most difficult surgical fields in all of medicine!!!), she is a highly trained doctor on kidney transplants, which cannot be easily replaced. Her phone was seized at the border. A federal judge handed down an injunction against her deportation—but she was already deported on a plane en route to Paris. Brown’s kidney transplant clinic is now strained by her deportation.Image
Image
2) Full text:

PROVIDENCE — A Rhode Island doctor who had traveled to Lebanon to see her parents was prevented from re-entering the United States at Boston’s Logan International Airport on Thursday evening, her lawyer and a colleague said.

Dr. Rasha Alawieh, 34, who lives in Providence, has been working at Brown Medicine’s Division of Kidney Disease & Hypertension since last July, and she [has] been part of the transplant service at Rhode Island Hospital, according to Dr. George Bayliss, the organ transplant division’s medical director. She has been studying and working in the United States for about six years, he said Friday.

The US consulate in Lebanon had issued her an H-1B visa, which is given to people in specialty occupations requiring expertise. The visa was valid through mid-2027, said Thomas S. Brown, an attorney representing her and Brown Medicine.

Alawieh was detained when she returned to Logan airport, and family members are afraid that she is about to be deported to Lebanon, he said.

“We are at a loss as to why this happened,” Brown said. “I don’t know if it’s a byproduct of the Trump crackdown on immigration. I don’t know if it’s a travel ban or some other issue.”

He said her phone has been seized and he has not been able to contact Alawieh.

Bayliss said a lawyer filed a petition with the US District Court in Massachusetts, and Judge Leo T. Sorokin issued an order saying Alawieh should not be moved outside of Massachusetts without 48 hours notice. But he said that message apparently did not reach immigration officials in time, and a plane carrying Alawieh left for Paris.

“This is outrageous,” Bayliss said in an interview. “This is a person who is legally entitled to be in the U.S., who is stopped from re-entering the country for reasons no one knows. It’s depriving her patients of a good physician.”

A US Customs and Border Patrol spokesperson, Ryan Brissette, was not able to immediately answer questions about Alawieh on Friday evening.

Bayliss said Alawieh graduated from the American University of Beirut medical school and came to the United States for a nephrology fellowship at Ohio State University. She then landed a transplant fellowship at University of Washington and had a residency in the Yale hospital system before starting at Brown Medicine last July, he said.

“She’s really a very humble and able person,” Bayliss said. “She takes care of her patients. She is talented and thoughtful and a great addition to our division.”

Bayliss said Alawieh went to Lebanon to visit parents and planned to be gone for two weeks. He said she texted a colleague at 6:30 p.m. Thursday saying she was back in Boston, but then her family heard from immigration officials.

Dr. Paul Morrissey, surgical director of the organ transplant division at Brown University Health, said Alawieh works on getting people in Rhode Island on the list for a kidney transplants, and that’s a crucial job at a time when there has been a lot of focus on the need for kidneys and their equitable distribution.

He said Alawieh should not have had any problem traveling out of the country with an H-1B visa.

“It’s an unfortunate set of circumstances,” Morrissey said. “It’s putting a strain on our office. Her work has been exceptional.”

bostonglobe.com/2025/03/14/met…Image
3) There is a new Trump ban against many countries, including tourist visa bans against all countries in the red and orange lists. This list is still tentative. And it shouldn’t have affected people with existing visas, such and the Brown kidney transplant surgeon Image
Read 8 tweets
Eric Feigl-Ding Profile picture
Mar 14
I’ve said it before, and I’ll say it again… once upon a time, liberals did have our own “Leftist Joe Rogan”… his name was Joe Rogan…

Here he is advocating for socialized medicine, healthcare for all, and supporting labor unions to protect workers.
2) Recall, Rogan was once pro Obama and pro Bernie Sanders, and pro Yang Gang, and anti Trump. It’s sad he has since failed to the dark side. But like Vader… maybe he can be redeemed someday and come back to the light.
3) *Fallen, not failed (above).

Joe Rogan was also pro gay rights and pro DACA and pro helping inner city communities that suffer economic and social injustices. It’s sad what he has become. I feel we should try to pull & welcome him back someday. Everyone can be redeemed.
Read 4 tweets
Eric Feigl-Ding Profile picture
Feb 26
BREAKING—FDA suddenly cancels meeting to update next season’s flu vaccines, with zero explanations. Any delays will jeopardize next year’s vaccine supply chain. Image
2) Folks who follow me know that I’m no bullshitter. I criticized past pandemic response right and left, and have called balls and strikes without bias. And I often say things that doctors & epidemiologists are whispering among themselves but don’t say publicly. (Cough cough) ⬇️
3) While I don’t recommend hoarding… I think stocking up on flu antivirals, which you can obtain prophylactically (preventively) from doctors if you ask nicely why you’re high risk, can be a good idea. I know many doctors, epidemiologists and virologists who do for their family.
Read 6 tweets
Eric Feigl-Ding Profile picture
Feb 26
Doctors are debunking RFK Jr’s claim that 20 hospitalized measles cases in Texas are there for mainly quarantine. Doctors on the ground say the 20 kids hospitalized are having trouble breathing. Oh and they are all unvaccinated against measles, which RFK Jr neglects to mention. Image
2) RFK Jr told Trump today there’s now 2 measles deaths.
3) RFK Jr is a tear with his FDA today. A dark Darwinian future lies ahead for America.
Read 4 tweets

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