1/ New data in the last day on how well natural immunity and vaccine-induced immunity protect us against the Delta variant.

Here's the take-home message:
2 doses of Pfizer or Moderna vaccine will protect you,
even against the Delta variant.
2/ Published in the @NEJM
nejm.org/doi/full/10.10…

Delta is 2.4-3.3x less susceptible to neutralizing Abs elicited by prior infection or Pfizer/Moderna vaccination as compared to the early WA1/2020 variant.

The dotted line represents protective immunity.
3/ Published in @Nature:
nature.com/articles/s4158…

Left:
Low neutralizing antibody (nAbs) levels by 12 months after natural infection
4x decrease in nAbs vs Beta & Delta compared to Alpha

Right:
Dramatic bump in nAbs levels if vaccinated after infection, including vs Beta & Delta
4/ nature.com/articles/s4158…

Left: nAbs 3 weeks after Pfizer

Right: nAbs 8 weeks after Pfizer (i.e. 5 weeks after 2nd dose)

You need the second dose to assure neutralization versus Beta & Delta.

The dotted line represents limits of detection.
5/ nature.com/articles/s4158…

12m after infection:
50% neutralizers vs Beta variant
47% neutralizers vs Delta variant

12m after infection + vaccination:
100% neutralizers vs all variants

Natural infection alone doesn't protect vs variants.
mRNA vaccination after infection does.
6/ nature.com/articles/s4158…

Week 3 after Pfizer vaccine (just prior to 2nd dose):
6% neutralize Beta
13% neutralize Delta

Week 8 after Pfizer vaccine (5 weeks after 2nd dose):
81% neutralize Beta
94% neutralize Delta
7/ Immunity is NOT on/off.
8/ Immunity is on a spectrum or gradient.

nAbs = neutralizing antibodies

We can overcome immune-evading variants (e.g. the Beta & Delta variants) with higher nAbs titers.

This is why you need to be vaccinated—even if you've had COVID—if you want to be protected vs variants.

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More from @celinegounder

7 Jul
1/ I really appreciated @EricTopol's guest essay in the @nytimes: nytimes.com/2021/07/01/opi…

I agree with much of this, but a few thoughts...
2/ There are really two questions here:

- How long will it take the FDA to grant full approval and why does it take that long?

- Will a full approval lead to greater confidence in the COVID vaccines and uptake among those not yet vaccinated?
3/ Regarding the first question:

I agree with @EricTopol:

I don't understand why the FDA approved aducanumab for treatment of Alzheimer's. There's limited data on its efficacy and there are real risks.

3 FDA advisory board members resigned in protest of this approval.
Read 26 tweets
1 Jul
1/ What should you do if you got one shot of J&J COVID vaccine with the Delta variant spreading?
2/ The Delta variant is spreading in the U.S. as it did in the UK, as did the Alpha variant before it. The Delta variant is more infectious than other variants and can evade the immune response to older variants.
3/ The Pfizer, Moderna, and J&J vaccines remain effective in preventing severe disease and death from the Delta variant, but we see a significant drop in overall vaccine effectiveness with the J&J vaccine versus the Delta variant.
Read 6 tweets
9 Jun
1/ Our 4 Americas:
Free America celebrates the energy of the unencumbered individual.
Smart America respects intelligence & welcomes change.
Real America commits itself to a place & has a sense of limits.
Just America demands a confrontation with what the others want to avoid.
2/ "In Free America, the winners are the makers, and the losers are the takers who want to drag the rest down in perpetual dependency on a smothering government."
3/ "In Smart America, the winners are the credentialed meritocrats, and the losers are the poorly educated who want to resist inevitable progress."
Read 7 tweets
9 Jun
1/ This is how infectious diseases
that threatened EVERYONE
quickly become the scourge of the MOST VULNERABLE among us:

theatlantic.com/ideas/archive/…
2/ To forget is the definition of privilege: Image
3/ To close the book on the story is a privilege: Image
Read 5 tweets
9 Jun
1/ Dr. David Baltimore, the Nobel laureate who claimed there was a “smoking gun” supporting the lab-leak theory, now says he regrets using the phrase and doesn’t agree that it validates the lab-leak theory.
latimes.com/business/story…
2/ The now-famous "furin cleavage site" of SARS-CoV-2 doesn't prove the lab-leak theory either way: Image
3/ There's nothing really special about the furin cleavage site: Image
Read 4 tweets
4 Jun
1/ The 1+ year-old COVID pandemic meets the 40+ year-old HIV pandemic:
latimes.com/science/story/…
36-year-old woman with HIV was unable to clear COVID for 8 months. The virus mutated and mutated and mutated.
2/ The SARS-CoV-2 virus infecting this woman developed 13 mutations in its Spike protein and at least 19 other mutations elsewhere in its genetic code.
3/ COVID is surging in other African regions... countries where the prevalence of HIV/AIDS is high:
theguardian.com/world/2021/jun…
Read 4 tweets

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