Important data on "breakthrough" infections: CDC says 5,800 infections documented so far in the US, of which 396 (7%) needed to be hospitalized. About 77 million people have been fully vaccinated in the US.
cnn.com/2021/04/14/hea…
CDC says a "little over 40% of the infections were in people 60 or more years of age" but hard to draw too many conclusions from that given that the preponderance of the vaccinated are in that age group, too.
We knew these infections would occur, and that some could lead to severe disease and even death. In this article alone, three different experts used the phrase "not surprising" to describe the phenomenon. Vaccines are not 100% protective.
washingtonpost.com/health/2021/04…
So one nitpick with the CNN story linked first: the article states the CDC data is "the first indication the vaccines do not protect completely against severe disease and death," when that is not the case
We've had previous real world data that breakthrough infections, including those leading to severe disease and hospitalizations, were occurring among fully vaccinated people. For example, Israeli studies like this one
nejm.org/doi/full/10.10…
Important to keep in mind, though, that when these breakthrough infections do occur, the evidence indicates they’re "not as bad as they would have been had the person not been vaccinated" in most cases.
vox.com/science-and-he…
And, "the number of breakthrough infections that accumulate depends on how much virus is out there circulating in the community" so important to continue to reduce transmission through vaccines and non-pharmaceutical interventions, which makes such events even rarer.
Some context from Israel - the apparent proportion of breakthrough cases really is very small

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More from @joshmich

13 Apr
In light of J&J news, of primary concern with regard to vaccine confidence in the US is the 15-20% of adults still on the fence about getting vaccinated. Could the pause, and the messaging around it, change minds from "wait and see" to "no thanks"?
kff.org/coronavirus-co… Image
The most common concerns about vaccines in the "wait and see" group revolve around safety and side effects, so if a perception takes hold - for whatever reason - that a vaccine is "unsafe" it could have implications for willingness to be vaccinated especially in this group. Image
Can't predict how things will play out here, but concerning precedent that several European countries saw a decline in confidence in the AstraZeneca vaccine after a week-long pause initiated for similar reasons as we're seeing for J&J
dw.com/en/european-tr…
Read 6 tweets
19 Jan
30% of Israel's population has received at least 1 dose of Covid-19 vaccine, but no indications yet that case numbers are coming down there (chart).

A few reasons why this might be:

1) Cases reported now were infected 7+ days ago, when vaccinations were lower Image
2) Less than 500,000 (out of ~2.7 M vaccinated) have so far received a 2nd dose. A single dose is "less effective than we hoped" in providing protection, according to Israeli health leaders.
theguardian.com/world/2021/jan…
3) Israel has vaccinated by age, starting with older persons, vaccinating to date:
80% of 70+
68% of 60-69
50% of 50-59
28% 40-49

Older ages are protected from severe disease, but younger ages typically contribute most to transmission
timesofisrael.com/israelis-aged-…
Read 6 tweets
9 Jan
Beyond the scientific and epidemiological reasons to doubt the lab escape theory of pandemic origin, let’s not forget that no US or allied intelligence has emerged with even a whiff of evidence that a lab was the origin by accident or intention.
To believe the lab escape theory you also have to believe the Chinese have mounted a successful, extended campaign to eliminate incriminating evidence and muzzle officials and scientists who knew or might have suspected it came from a lab.
It’s a pretty big secret to hold on to, especially for a sizeable group of people that includes an international network of scientists, other workers, and families -- many of whom are not exactly in the secrecy business.
Read 17 tweets
1 Jan
That the US might adopt a 1 dose regimen or significantly delayed 2nd dose for vaccines already authorized seems more fanciful thought experiment than tractable policy. Pretty much all institutions and incentives are lined up against such a change and not without reason.
Current vaccines are authorized via EUAs from FDA, which both clearly state terms of use including a two-dose regimen. Moderna’s EUA says the vaccine is “administered as a series of two doses 1 month apart…”
“…Individuals who have received one dose of Moderna COVID-19 Vaccine should receive a second dose of Moderna COVID-19 Vaccine to complete the vaccination series.”
modernatx.com/covid19vaccine…
Read 20 tweets
31 Dec 20
CDC now provides more data on vaccine distribution and administration by state, agency, etc. Worth a look and a bookmark.

A few things that jumped out to me, in a short thread.

covid.cdc.gov/covid-data-tra…
2.17 million doses distributed through the federal pharmacy partnership prgm for long-term care, but only 167,149, or 7.8%, administered. This is the phase 1a component that needs to make up the most ground.

If this program were a state, it would easily be the worst performer.
States/jurisdictions' overall progress in administering the vaccines they have received continues to vary widely.

DC has administered over 50% of its vaccines on hand, while Kansas has administered just over 10%.
Read 6 tweets
30 Dec 20
Worth noting that Kathleen Hicks, President-elect Biden's pick for the number 2 spot at the Pentagon, would be that unusual senior defense official with some background in global health, as it relates to national security.
She's co-authored reports on the Department of Defense and global health, such as this one from 2009
csis-website-prod.s3.amazonaws.com/s3fs-public/le…
From that report: If "virulent diseases can destabilize economies and entire political systems, then it is in the national security interest of the US to address the causes of diseases and develop effective systems to detect and contain them."
Read 6 tweets

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