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16 Jun, 4 tweets, 2 min read
Just a reminder how damn lucky we are to have hit 95% efficacy of 2 mRNA vaccines, setting such an unexpectedly high bar, right from the get go, in November 2020.
nytimes.com/live/2021/06/1…
Using the variants as the explanation for low @CureVacRNA efficacy doesn't work, IMO, when the known ones, with substantial immune evasion, beta and delta, are not on the list
B.1.1.7 (alpha) is a variant of concern, globally dominant. It has essentially little/no immune escape. If there's beta or delta in the VOCs that should have been stipulated. The only other 1 is gamma (P.1) w/ intermediate evasion, not shown to materially affect other vaccines
Agree fully w/@Dereklowe on most likely explanation for @CureVacRNA poor results. Not about the variants.
"the CureVac vaccine does not use any modified mRNA bases"
blogs.sciencemag.org/pipeline/archi…

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More from @EricTopol

Eric Topol Profile picture
18 Jun
The Delta variant: updates from the new @PHE_uk report
assets.publishing.service.gov.uk/government/upl…
1st dose vaccine (either AZ or Pfizer) quite protective vs hospitalization
Fully vaxxed vs unvaxxed:
Infections 7.7% vs 67%
Hospitalizations 8% vs 48% Image
Delta's secondary attack rate is coming down some in the latest dataset. Its enhanced transmission over alpha appears to be more in the 40-60% range

Reinfections by sequencing data: 311/1260 were Delta ImageImage
This 71-page report is rich. And that 60% of infections are getting sequenced (91% are Delta) is quite impressive.
It makes the output from CDC and the genomic surveillance in the US particularly weak
Read 6 tweets
Eric Topol Profile picture
14 Jun
Just published @TheLancet
The #DeltaVariant experience in Scotland
thelancet.com/journals/lance…
1. #VaccinesWork ("AZ appeared less effective than Pfizer")
2. Younger, unvaccinated got the delta infections
3. Doubling of hospital admissions compared with alpha (B.1.1.7) variant Image
Details from over 19,500 infections and 377 hospital admissions, the extraordinary prospective Scotland dataset ImageImage
The doubling of hospital admissions compared with alpha doesn't mean it's more pathogenic. The 60% increase in contagiousness could do that
More @FT @mroliverbarnes ft.com/content/885d9a… Image
Read 4 tweets
Eric Topol Profile picture
11 Jun
Trying to figure out how @US_FDA approved the alzheimer's drug w/o adequate evidence, against their Advisory Committee, but has yet to approve full licensure for mRNA vaccines—which could save lives, prevent the toll of the delta variant, and promote durable US🦠 containment
When was the last time 350 million doses of anything were administered under an emergency authorization?
Never
Now add the extraordinary track record of safety and 95% efficacy and effectiveness.
Time to make a statement @DrWoodcockFDA
Just a reminder these were not typical Biologic Licensing Applications (BLAs). Sections were serially submitted and reviewed for months before the final applications were filed.
Full licensure is a BFD.
Nothing else would have as big and rapid an impact on US vaccinations.
Read 4 tweets
Eric Topol Profile picture
6 Jun
With a strong vaccination campaign, the United States was able to reduce the B.1.1.7 (alpha) variant's toll to a bump in cases
What might happen with B.1.617.2 (delta) which is ~50% more transmissible, and more evasive to our immune response? /1
It will be hitting us with a far less case burden, as we approach containment for the 1st time.
But still much vulnerability d/t half the population unvaccinated and ~40% fully vaccinated
2 doses appear to be needed to get to high ~90% effectiveness /2
We'll likely see a bump in cases and adverse outcomes (magnitude uncertain) largely among unvaccinated, and a challenge to get to containment in a fully reopened country, prolonging the pandemic here /3
Graphic adapted from @tomhcalver @thetimes
Read 4 tweets
Eric Topol Profile picture
4 Jun
The extraordinary book, The Premonition, by Michael Lewis, is the subject of our conversation. It gets behinds the scenes of public health/CDC long before and during the pandemic. We spoke just days before the fatal car accident of his 19-year-old daughter
medscape.com/viewarticle/95…
Our deep condolences.
He had no hesitation for this discussion to be posted —he really wants the story to reach the medical community.
It stitches together these people. Michael is perhaps the best storyteller of our era; it's truly fascinating and germane pre- & intra-pandemic Image
Lewis traces back 15 years before the pandemic to show the inadequacies of the CDC and US public health resources. CDOR Center for Disease Observation and Reporting. The metaphor of watering plastic flowers Image
Read 4 tweets
Eric Topol Profile picture
27 May
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…
Read 4 tweets

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