White House task force briefing from Jeff Zients, Dr. Fauci and Dr. Walensky with questions about delta variant. Great briefing with bottom line: 1) Vaccines work against delta, both adenovirus/DNA and mRNA vax, 88% against symptomatic infection, 96%
against severe disease with Pfizer (Scotland data); 92% with AZ 2 doses 2) J&J neutralizing Abs under study with delta, but no reason to suspect doesn't work (like AZ) and no need for mRNA booster after J&J without data 3) When WHO makes recs on masking for world, reflects 10.7%
of population being vax'd, not 67% 1st vax rate by July 4 which has been achieved in US 4) Country doing well with outbreaks of delta in unvaccinated counties; CDC will deploy surge teams for testing, treatment, vaccination 5) Vaccines safe & effective 3 billion doses given out
in world so far. FDA has own time schedule for approval but no reason to think won't happen soon (EUA going to full approval) 6) Does not send mixed message for White House to have fireworks, celebrate 4th when such an achievement (67% 1st dose vax) reached by this date
Please do watch the White House task force briefing all the way through to get a true handle of the situation in this country with the delta variant- you will find it very helpful- thank you!
J&J data shows today (Dr. Fauci had hinted this would come out) that the vaccine produces a strong neutralizing antibody response to the delta variant. Good news for those concerned about needing another vax with J&J wsj.com/articles/j-j-c…
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J&J VACCINE AND VARIANTS: Wanted to go over paper from yesterday. 19 million worldwide have received 1 dose J&J (including health care workers S. Africa as condition of trial who are seeing a lot of virus right now with high rates community transmission) biorxiv.org/content/10.110…
Remember about J&J which is that - in its phase I/II clinical trial, antibody and CD4/CD8 (T cell) responses increased over time. Not that high at 2 weeks (which may account for lesser effectiveness in ENSEMBLE trial when looking at that time point) nejm.org/doi/full/10.10…
Immune response increased over time out to 59 days when phase I/II stopped reporting. So, this study took participants from ENSEMBLE who had received 1 dose J&J (n=8, 47-91 years, 71 days after shot) and exposed their blood (test tube) to variants (alpha, beta, gamma, delta).
I & others quoted in this LA Times article about the effectiveness of the vaccines against the delta variant (and LA & masks): Dr. Fauci "“If you are vaccinated, you have a high degree of protection — so you need not wear a mask, either indoor or outdoor" latimes.com/california/sto…
Dr. Ghaly: "The data is clear: Nearly all new COVID-19 hospitalizations and deaths are preventable. The vaccines work and they protect us,” Me: "The rise in coronavirus cases in Israel may reflect the healthcare system there still testing...
vaccinated people for coronavirus infection, even if they have no symptoms.". If no symptoms & low viral load in nose (like 5 studies have shown us now), " I don’t call that a vaccine failure. I call that a success, because that’s exactly what your vaccine is supposed to do.
"The Delta variant, which is now responsible for most coronavirus infections in England, is not driving a surge in the rate of hospitalizations there, according to data released by Public Health England on Thursday." nytimes.com/2021/07/01/hea…
"The data suggest that countries with high vaccination rates are unlikely to see major surges in hospitalization rates from Delta. Nearly 75% of adults in England — including 95 % of those 80 or older — have had at least one shot, according to the agency’s numbers."
NIH-sponsored study similar to SIREN in UK where HCW, workers were swabbed weekly (!) Dec 14, 2020-April 10, 2021. Even with circulating virus, 81% vaccine effectiveness with 1 dose; 91% with 2 doses, even asymptomatic infection. Only 5 breakthrough nejm.org/doi/10.1056/NE…
infections in 3975 participants after full vaccination; only 11 breakthroughs after 1 dose. All milder infection breakthroughs than COVID infections in nonvaccinated. Importantly, CT values were higher in those breakthrough infections in vax'd (40% lower viral load).
Kind of reminds you of the other many many studies that show massive reductions in asymptomatic infections after vaccines, right? And there are also other studies that show low viral loads if do get breakthrough so hard to transmit
DO I NEED AN mRNA VACCINE BOOSTER AFTER A J&J SHOT? The answer to this is that no one knows, actually. Humility in COVID means we change our recommendations with changing data. And I also think there is no harm. But I don't see how the data indicates this yet.
Remember that J&J and mRNA vaccines actually not that different - J&J has DNA inside an adenovirus "vector" (that brings it in) and mRNA vaccines have mRNA inside a lipid envelope. The DNA from J&J gets "transcribed" into mRNA and that is the same mRNA in mRNA vax.
That mRNA is then "translated" into a part of the spike protein by your machinery and you see that spike protein, think it's different, and raise a vigorous immune response against it (antibodies; now we know memory B cells; memory T cells). Some vaccines need repeated boosters