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Eric Topol Profile picture
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27 May, 4 tweets, 3 min read
The B.1.617.2 variant has now become dominant in the UK, associated with rising hospital admissions. It's also starting to rise in the US. While vaccinations protect against it, the 1st dose has only ~30% efficacy.
See @jburnmurdoch's new 🧵
It is looking more and more like B.1.617.2 will be the next challenge for the US fo face w/ only 40% of its population fully vaccinated and 50% with 1 dose.
The advance UK warning on B.1.1.7 led to aggressive US vaccination which fended off a new (4th) surge.
Can we rally again?
"Of 49 people hospitalized with the new variant in Bolton, only 5 have been vaccinated with both doses"
ft.com/content/c77dce…
Recall 2 dose efficacy vs B.1.617.2:
mRNA (@Pfizer) 88%
@AstraZeneca 60%
khub.net/documents/1359…
It's not just India/UK/US.
B.1.617.2 gaining quickly in Japan, Singapore, Australia, NZ, & other countries, see covariants.org
It combines the high infectiousness of B.1.1.7 and some immune evasion features not seen with that variant, which explains why 2nd dose is key

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More from @EricTopol

Eric Topol Profile picture
24 May
Just published @Nature
After even mild covid infections there are, in addition to memory B cells, bone marrow plasma cells are induced to provide long-term protection > 1 yr
nature.com/articles/s4158…
@TheBcellArtist @WUSTLmed
(NB vaccination still provides further protection) Image
I'm thinking of the participant donors of this study who had a bone marrow aspirate (and many twice) so we could learn from them. A very tough procedure to go through once, no less twice, to advance science. Heroes and good to see they were acknowledged Image
More on this enduring, likely multi-year protection derived from covid vaccines or infections, indexed to this paper
nytimes.com/2021/05/26/hea… by @apoorva_nyc
Read 4 tweets
Eric Topol Profile picture
15 May
A current status comparison between California, the US state with lowest covid cases/capita, and the UK
Although the 1st dose of vaccination rate is comparable, California has >5X test positivity, >3X hospitalizations, and 10X deaths
Potential explanations for these gaps include: (1) the faster rate the UK achieved their 1st dose vaccination and lag time to see the effect in CA, and (2) more aggressive mitigation measures used in the UK
and (3) important point was the strict by age UK vaccination roll out, now 38+ years, whereas the US only used that strategy initially
Read 4 tweets
Eric Topol Profile picture
15 May
There are many misconceptions about the Yankee cluster of post-vaccination infections. We can learn from the best studied cluster in a skilled nursing facility of 46 such cases with genomic sequencing of the virus from 28 pubmed.ncbi.nlm.nih.gov/33914720/ @CDCMMWR /1
This outbreak was indexed to 1 unvaccinated individual with overdispersion (superspreader); no indication of transmission between the others. The mRNA vaccine effectiveness of 94.4% vs severe illness among elderly residents is striking /2
A variant (R.1) w/ E484K mutation was noted in all cases sequenced
Let's contrast w/ the 8 Yankees post-vaccination infections who had PCR testing 3 times a day, 7 of 8 have had no symptoms, and we have no denominator of non-cases or genomic sequencing. Very incomplete! /3
Read 4 tweets
Eric Topol Profile picture
5 May
Most important new report today, and highly encouraging: Real world vaccine effectiveness (E) in >380,000 people in Qatar to B.1.1.7 (UK) and B.1.351 (South Africa) variants, *100% E vs severe illness both*👍 @NEJM
nejm.org/?query=feature… Image
Text and Extended Table
1. One dose is not sufficient, especially B.1.351 which has a significant immune evasion property (most of all variants to date)
2. E vs infection of any type (PCR +) very solid 75% for B.1.351 ImageImage
Updating the evidence table for the essential point that we have vaccines that provide protection against all variants Image
Read 7 tweets
Eric Topol Profile picture
4 May
A country that has prevailed vs B.1.1.7
Those states that were in trouble?
No longer the case. In descent or flat.
Overall cases are down 30%, hospitalizations and deaths down ~10% over the past 2 weeks
Here's the lineage (variant) map of the US through the pandemic, based on 360,000 sequences. Dark blue is B.1.1.7 that became dominant throughout. The only other major variant competing now is P.1 (Brazil) at 2% prevalence
outbreak.info/location-repor…
By getting nearly 150 million Americans vaccinated, the US averted pronounced surges, the worst seen in many countries, such as the UK and Israel, and throughout most of Europe
Read 5 tweets
Eric Topol Profile picture
2 May
We are fortunate that vaccines induce such a strong immune response and provide protection from all of the virus variants that have evolved to date
Case in point
Had our vaccines not been protective vs B.1.1.7 (UK), the variant with >50% increased transmissibility and increased lethality, the country, w/ >147 million vaccinated, would not look like this right now
wsj.com/articles/u-k-c… @Brabbott42
Another real world evidence case in point
Brazil's success vs P.1 in decreasing morality with Sinovac and Astra-Zeneca vaccines
medrxiv.org/content/10.110…
Read 4 tweets

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