Do we need a third dose of @pfizer #vaccine? I spoke with @ShyannMalone about the data (and lack thereof). Key point to remember: antibodies are *supposed* to decline with time. Not a compelling indication for booster. Show us B/T cell data please.
Not enough time to discuss "why not?" - as vaccines are safe, effective, and plentiful. They are definitely NOT plentiful outside of the US - extra stockpiles could potentially be shared to reduce cases elsewhere (and the variants that arise from them).
Data stronger to consider third dose in immunosuppressed patients. Reasonable given the small population size, outsized benefit.
We'll see what data @pfizer is sitting on. Important to be skeptical (since boosters will pad Pharma bottom line) but not cynical. Despite the profit motive, boosters may be the right choice if the data directs us that way.

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More from @fperrywilson

13 Jul
How can we be most rational about rare adverse events after vaccination? I discussed the risk of #GuillainBarre syndrome after the @JNJNews #vaccine with @ShyannMalone this morning. Some thoughts in this thread (1/n)
2. I have been speaking with several "on the fence" people. Not yet vaccinated, not fully opposed to vaccination. They are all intelligent, thoughtful individuals. They can quote me the numbers in terms of risk, and acknowledge the very low risk of adverse events post-vaccine.
3. They do not seem to have a misunderstanding of the raw numbers, though they do tend to have a pessimism bias: "sure, the risk may be 1 in 100,000, but I just know I'll be that one".
Read 9 tweets
30 Jun
JUST OUT in @NEJM: Safety / Efficacy data for @novavax COVID-19 vaccine.
-89.7% efficacy against symptomatic COVID-19
-86.3% against alpha variant (B.1.1.7)
-96.4% against other variants
-NO hospitalizations, NO deaths in vaccine arm
DOI: 10.1056/NEJMoa2107659

Brief thread:
@NEJM @Novavax The @novavax vaccine is a (spike) protein-based vaccine, with an adjuvant that psychs up the immune system. This is older tech, like pertussis / Hep B vaccines - and may (?!) be more acceptable to those who are a bit nervous about mRNA vaccines.
@NEJM @Novavax This report is on the UK trial - 15,000 participants. Half got placebo, half the vaccine (which is 2 doses, 21 days apart).
UK means this is mostly white people, though US data seems similar.
Read 11 tweets
14 Feb
Folks, we need to talk about this Vitamin D trial. I have no stake in this game - take Vitamin D if you want but this pre-print is super sus. (THREAD)
papers.ssrn.com/sol3/papers.cf…
The paper is presented as a randomized trial of vitamin D supplementation in hospitalized patients with COVID. Interesting and important question! And the results appear dramatic: Image
If true, this would be one of (if not THE most) effective treatments for COVID. But there are problems...
Read 16 tweets
19 Jan
Thread to discuss our new RCT (ELAIA-1) appearing in @bmj_latest that showed some unexpected results in the world of electronic alerts for acute kidney injury.
bmj.com/content/372/bm…
We know that AKI goes unrecognized and, in theory, undertreated from large retrospective studies like this one from @dmoledina:
sciencedirect.com/science/articl…
Acknowledging that reality, many health systems (including the @NHSuk, have institute automated "alerts" for AKI).
Read 25 tweets
8 Dec 20
Looking through the @pfizer data submitted to #vrbpac now. Fascinating stuff here. Thread. 1/
Baseline characteristics. Not bad. ~10% Black. Would have liked to see more >=75 years old. 2/
Efficacy overall (that's the 95% you keep hearing about) and stratified by age group.
Looks similar whether > or < 55 years of age. 3/
Read 15 tweets
28 Oct 20
Thread:
Even a mediocre vaccine can end the pandemic. But there are some caveats. I wrote about this on vox.com last week,
vox.com/21528373/vacci…
but here are the highlights: (1/n)
Let's assume that, on average, every person with COVID-19 can infect 2 additional people (a bit lower than the R0 of 2.5 but makes math easier). (2/n)
To stop the pandemic, we need to prevent disease in 1 out of every 2 people.
So if the vaccine is 100% effective, we'd need to vaccinate 50% of the population.
(Technically vaccinate or infect 50% of the population but trying to stay simple.)
(3/n)
Read 13 tweets

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