Benefits, Risks, and Future of Vaccines and the Pandemic

Our vaccine safety monitoring system works. Reports of blood clots led to quick investigation, quick action, and transparency about what is known, not known and next steps. Vaccines remain our way out of the pandemic. 1/14
Global collaboration has been critical throughout the pandemic. Public health and medical experts around the world are collaborating to determine whether the events associated with AstraZenenca vaccine are the same as these events which may be associated with the J&J shot. 2/14
Tech transfer is crucial. The pandemic is the world’s most important problem. mRNA technology is our best solution. Create high-quality manufacturing platforms and hubs around the world to improve vaccine access. mRNA technology is an insurance policy against the pandemic. 3/14
mRNA vaccines are easier to tweak for vaccine-escape variants, less subject to production delays, easier and quicker to scale. May be more effective against infection, and may be safer also. ALL licensed vaccines are safe and effective; mRNA is the most promising technology. 4/14
We also need more efforts like Moderna’s to study vaccine thermostability at non-freezing temperatures, and other efforts that may help get mRNA vaccines to places and communities that are harder to reach. 5/14
Vaccines are one of the most important public health interventions ever, saving billions of lives. As with any medical intervention, there may be a small risk. Rotavirus causes deadly diarrheal disease in young children. The story of rotavirus vaccines is instructive. 6/14
In 1999, the Rotashield vaccine was withdrawn from the US market because of a rare, serious complication. Other countries followed suit. This decision led to literally MILLIONS of preventable child deaths around the world until a new vaccine was introduced 7 years later. 7/14
There’s still a low risk of serious complications associated with rotavirus vaccines but benefits of vaccination FAR outweigh the risks. Thus the US and countries around the world continue to vaccinate children against rotavirus, looking carefully for possible complications. 8/14
Serious events possibly associated with J&J vaccine being investigated. The pandemic continues. About 1 in 200 people with Covid die from it. 6 reports of CVST among almost 7 million people who got J&J; no known reports of such events associated w/ Pfizer/Moderna vaccines. 9/14
Analysis of risks and benefits guide recommendations for vaccines, including against Covid. This is uncomfortable. We weigh “sins of commission” more heavily than “sins of omission”. But if a vaccine helps many thousands more people than it may harm isn’t this the way to go?10/14
Globally, benefits of the vectored vaccines (J&J, AZ) will FAR outweigh risks in ALL communities in which Covid is spreading and for all populations at high risk of complications of Covid. 11/14
The more people vaccinated with available vaccines, the lower the case rates, the more lives saved, the sooner we will get to the new normal. I still think we’re likely to crush the curve of infections by summer and be in the new normal in the fall in the United States. 12/14
We must balance the risks posed by Covid with extremely low potential risks of getting vaccinated. Fundamentally, the case for scaling up mRNA vaccine platforms globally just got even stronger than when we advocated for this 6 weeks ago. 13/14
Scaling up production of mRNA vaccines won’t be simple. Life rarely is. But technological transfer of the most promising vaccine technology isn’t just the right thing to do altruistically, it’s essential to the health and safety of every person, everywhere in the world. 14/end

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More from @DrTomFrieden

9 Apr
The US vaccination campaign is facing a fundamental challenge: getting the vaccine where it’s needed most. Millions of Americans are still unprotected, many of them at high risk of severe illness. Our 4th surge is beginning. Lives are at stake. 1 of thread/
1 in 3 people in the US have gotten at least one dose of vaccine—but that means 2 in 3 haven’t. Millions of people age 50-64 and 65+ who haven’t yet been vaccinated can still get Covid and are at much higher risk of severe illness or death, especially with the new variants. 2/
Some states are doing much better than others reaching older people: NH, VT, ME, RI, CT, MA, SD have given >1 dose to more than 85% of residents 65+ years old. In TN, WV, MS, Alabama, HI, and PR that proportion is less than 70%. 3/
Read 18 tweets
2 Apr
Covid Epi Weekly: The Centrality of Equity

Lots of good news on vaccines, but the virus and variants are gaining ground. Variants are spreading rapidly in the US, driving (along with premature opening) the fourth surge that’s now underway. 1/
I had planned to stop Friday night threads, but couldn’t help sharing thoughts on this week’s developments—there have been so many.

Fourth surge is building. Cases up 8%, test positivity up to 5.1%. Michigan situation worse, other states could follow. 2/
News on vaccines just keeps getting better. CDC study of mRNA vaccines found that Pfizer and Moderna vaccines blocked 90% of infections. Vaccinated people won’t spread much disease. HUGE implications for guidance for fully vaccinated people and the trajectory of the pandemic. 3/
Read 22 tweets
27 Mar
Covid Epi Weekly: An Epidemic of Vaccine Inequity

As predicted, a US 4th surge appears to be beginning, fueled by variants and reopening. Cases up 7%. Positivity inching up, to 4.7%. Because of vaccination, deaths won't increase substantially. We must solve vaccine inequity. 1/
Michigan hospitalizations are increasing rapidly esp. among 40-49 y.o. Middle and high school 30% increase in cases associated with outbreaks in tandem with increased community transmission. Fewer people staying home, similar to prepandemic levels. Harbinger of spring surges? 2/
Important new data on the mental health harms of the pandemic in the US. Large increases in depression and anxiety, especially among young people and those with less education. Treatment hasn’t kept up. At least 12 million more Americans are struggling.3/
Read 23 tweets
26 Mar
It's very unlikely that SARS-CoV-2 was created in a lab. The genetic information strongly suggests that the virus evolved naturally.
Is unintentional lab release a possibility? Yes, as the review commission has noted.
The last human case of smallpox was the result of a lab error in the UK. It is believed—though not proven—that a flu strain accidentally released in the former Soviet Union in the 1970s spread around the world.
Read 6 tweets
24 Mar
Vaccination is the way out of this pandemic. Five facts about Covid vaccines:
The risks of infection are vastly higher than the risks of vaccination. Even healthy young people can become severely ill, die, or suffer long-term harm from Covid infection.
Covid vaccines prime your immune system to fight the virus, then disappear. They don't stay in your body.
Read 6 tweets
20 Mar
Covid Epi Weekly. Progress and Peril.

Vaccinations have already saved 40,000+ lives in the US and the pace keeps increasing. But explosive spread of variants in Brazil and lower interest in vaccination are ominous portents.

A 4th surge is likely, but a less deadly one. 1/thread
First, the epi. Cases have stopped decreasing in many places and are increasing in some. Vaccinations are preventing deaths. Cases (~50,000/d) and test positivity plateauing nationally, with a concerning trend of PCR test positivity increasing slightly to 4.3% last week. 2/
The faster decline in deaths is striking and undoubtedly from vaccination. Look how steep the red line is below. Because vaccination rates in people over 65, especially those in nursing homes, are so high, the lethality of the virus is, as a result of vaccination, decreasing. 3/
Read 20 tweets

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