Eric Feigl-Ding Profile picture
Apr 12, 2021 18 tweets 9 min read Read on X
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

Sep 6
⚠️ZERO ANIMAL CONTACT HOSPITALIZATION for H5 Bird Flu—the CDC has now confirmed the first ever U.S. human case “without a known occupational exposure to sick or infected animals”—which make this Missouri case very worrisome. Maybe community transmission.
cdc.gov/media/releases…
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2) H5 outbreaks in cattle have not been reported in Missouri, but outbreaks of H5 have been reported in commercial and backyard poultry flocks in 2024.

—>>so it doesn’t seem to have come from cows in the state. So maybe from birds?
3) So if rarely test, how did we even find it?

“While other novel flu cases have been detected through the country's national flu surveillance system, this is the first time that system has detected a case of H5. Targeted H5-outbreak specific surveillance has been conducted as part of ongoing animal outbreaks and has identified all the other cases. In this case, the specimen from the patient originally tested positive for flu A, but negative for seasonal flu A virus subtypes. That finding triggers additional testing.”
Read 4 tweets
Aug 30
BREAKING—the FDA has just authorized the new Novavax vaccine, tailored to JN1 related variants. Anyone age 12 and over are eligible. You may receive it 2 months after a prior version of COVID-19 shot (and prior infection, though FDA memo didn’t specify).
fda.gov/news-events/pr…
Image
2) Also, the FDA has further authorized a 2nd shot of the new 2024-2025 formulated Novavax shot for people who are immunocompromised, at the doctor’s discretion. (Bullet point #4 below) Image
3) NAMING—Do not just refer to the shot as “2024” Keep the nomenclature of the new COVID shot straight - the newest one adapted for JN1-related variants is called the “2024-2025 formula”, while the old one was called the “2023-2024 formula”. The old one is no longer authorized. Image
Read 6 tweets
Aug 29
Scientists have discovered more than 1,700 ancient viruses deep inside a Tibetan glacier. Most of them are completely new to science. These ancient viruses are now being thawed out from glaciers and Siberian tundras.
e360.yale.edu/digest/ancient…
2) This is no joke.

Arctic zombie viruses in Siberia could spark terrifying new pandemic, scientists warn

Threat of outbreak from microbes trapped in permafrost for millennia raised by increased Siberian activity

theguardian.com/society/2024/j…
3) The reason permafrost is a good storage medium isn’t just because it’s cold; it’s an oxygen-free environment that light doesn’t penetrate. But current Arctic temperatures are warming up to 4x faster than rest of 🌏, weakening the top layer of permafrost
cnn.com/2023/03/08/wor…
Read 5 tweets
Aug 14
JUST IN— W.H.O. Declares Global Emergency Over New Mpox Outbreak. The threat this time is deadlier. Since the beginning of this year, the Democratic Republic of Congo alone has reported more than 14,000 mpox cases and 524 deaths. Those most at risk include women and children under 15. The outbreak has spread through 13 countries in Africa, including a few that had never reported mpox cases before.

(Gift 🎁 link)
nytimes.com/2024/08/14/hea…Image
2) public health emergency of international concern— Also known as PHEIC, this is a status given by WHO to “extraordinary events” that pose a public health risk to other countries through the international spread of disease.

cnn.com/2024/08/14/hea…
3) The Africa Centres for Disease Control and Prevention declared the outbreak a public health emergency of continental security the day before — the first such declaration by the agency since its inception in 2017.
Read 15 tweets
Jul 19
Concerning—CDC now says that 42 states are seeing rising rates of #COVID19 again—with levels high or very high in 35 states (and rising). COVID wastewater levels have already surpassed last summer’s peak and climbing fast. #CovidIsNotOver
cdc.gov/forecast-outbr…


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2) Substantial 28% increase in one week. Question is how high it will go. It’s a new variant (mostly KP2 and KP3 and JN1), which are evasive against past infection and past vaccines.
3) COVID is surging in many countries worldwide. Eg in Italy where deaths are also climbing once again. New variants, new surges.
Read 4 tweets
Jul 3
A girl using cover name JANE DOE testified under oath at Ghislaine Maxwell’s criminal trial that she was introduced to Trump by Jeffrey Epstein when she was 14 years old. Pass it on.
Trump’s name appears 7 times in Epstein’s latest files. They regularly called each other according to phone logs. Trump says Epstein is a “terrific guy”. And he traveled on flights, according to logs, to Epstein’s island multiple times.
3) THIS STUFF IS NEW—not old Epstein-Trump info. New information regarding Epstein's child trafficking activities was released 7/2/24. Documents from 2016 are now out of date and do not show the depth of Trump's dealings with Epstein... READ MORE:

nymag.com/intelligencer/…
Read 4 tweets

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