US Vaccine Progress: Over 50% of the eligible population (140 million out of ~265 million) have had at least 1 dose of COVID vaccine.
Herd Immunity (80%):
125 million to go with vaccine alone.
Only 70 million more to go if we also include people who have had COVID & recovered
Two assumptions: I'm assuming ~30% of children & adults have had COVID & recovered (30 million confirmed; 60 million unconfirmed).
Also assuming all people who got need 2nd dose to be fully vaccinated will eventually get it (recognizing this is not happening & we need to fix it)
I'd prefer 125 million more people as the minimum target for vaccination. But suspect cases will decrease quite a bit if we get 70 million more vaccinated.
The last 50 million will be hard. We will need to overcome vaccine hesitancy through people they trust.
The one issue we need to be cautious of that may affect the calculations is the extent of protection current vaccines offer against bad variants. I am still confident that current vaccines will protect from severe disease from variants. But wish we had more data.
The other issue is duration of protection offered by the current vaccines. We hope that the duration is long. Even years. But need more data which of course means we need time.
My guess is that we will need periodic boosters.
Other issues to keep in mind:
1) Efficacy of vaccines in immunosuppressed people
2) Efficacy of vaccine in the face of high viral dose exposures. Studying infection patterns following vaccination in healthcare workers vs age matched general population will help with this.
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Viral dose is an important factor in severity of COVID. As India waits for vaccines, I urge people in India to wear masks and avoid crowds. This is the best way to reduce viral dose, and repeated exposures.
Lower viral dose will reduce severity of illness. And reduce deaths.
For over a year we have been saying that masks play a role in reducing viral dose, and at this point I'm more convinced than ever before. Have to unearth old tweets and graphics.
Severity of COVID is influenced by many factors, but unfortunately most of these are not in our control. Not easily "changeable": age, obesity, comorbidities, type of mutant variant, genetics, etc.
The one factor that is in our control is reducing viral dose at exposure.
This is a plea to the US government to help India. What you can do:
-Help with Oxygen & Oxygen generators
-Release Astra Zeneca vaccine supplies
-Lift the export ban & send them raw materials for vaccines
As bad as this looks. It's 10 times worse. The Indian people need you.
This is not only the right thing to do. It is also wise. If this absolutely stunning and dramatic spike is due to a bad COVID variant, then it is going to affect us.
It will be self defeating to crush COVID only to let a bad COVID variant get us again.
Please act urgently.
It is not everyday that a request like this goes out. On April 16 new cases were 180,000 per day.
It is a week since this request. It is now 300,000 new cases per day. Urgent will be an understatement. @adarpoonawalla
Studies were reporting 40-50% seroprevalence in big cities in India even by December. The same cities (eg. Delhi, Mumbai, Chennai) are now totally overwhelmed with COVID.
Updated Risk of vaccine related cerebral venous sinus (or splanchnic vein) thrombosis associated with low platelets
Astra Zeneca
1 in 100,000 (EU)
1 in 250,000 (UK)
J&J
1 in 500,000 overall.
1 in 150,000 for women age 18-49.
No risk seen with Moderna or Pfizer vaccines.
The risks are extremely low. Awaiting CDC panel recommendations on J&J pause.
The pause was justified. To determine the numerator & the denominator. CDC panel has voted today to resume vaccinations with the J&J vaccine. statnews.com/2021/04/23/cdc…