Thread by @HelenBranswell

1. @CDCgov's vaccine advisors, #ACIP, are meeting today. I'll try to tweet, but also writing so tweets may be spotty.
Issues are: The suspected link between the J&J #Covid vaccine & Guillain Barre syndrome & whether immunocompromised people should get an additional dose of vax.

2. On the issue of whether immunocompromised people should get +1 dose of #Covid vax, don't expect a decision today. The emergency use authorizations that allow use of the vaccines specify how many doses can be given. Until @US_FDA changes that, #ACIP can't recommend more doses.

3. J&J presented #ACIP some new immunogenicity data for their 1 dose vaccine just now, with data by variant type. The T-cell responses are similar across all variants, the company shows. Persistent humoral and cellular immune responses, over 8 months.

4. J&J argued to #ACIP that their 1 dose #Covid vaccine prevents far more illness than it may potentially cause through TTS (clotting) & GBS — in the red circle. Blue bars show Covid hospitalizations & deaths averted in low, medium & high transmission settings per 1M doses.

5. During many #ACIP meetings, the public comment session are often dominated by anti-vaxxers. (There is always a public comment session; speakers are chosen by draw.) Today is different. Many immunocompromised people pleading for a recommendation for an additional dose for them.

6. #ACIP's #Covid vaccine work group reports that analyses still support use of the J&J vaccine. Even with TTS (rare clotting risk) & possible Guillain Barre syndrome (GBS) link, the vaccine benefits far outweigh its risks.

7. #ACIP chair Jose Romero spoke about his state's experience; he's Arkansas' Health Sec. Cases caused by Delta are surging; deaths are on the rise. It's important to have J&J's 1-dose vax available, Romero said. Some people will not come back for a 2nd dose.

8. But 2 #ACIP members, Pablo Sanchez & Sarah Long both expressed concern over continued use of the J&J #Covid vaccine. He said he would currently recommend one of the mRNA vaccines over the J&J.

9. Now: @CDCgov's Sarah Oliver, a master at explaining data in clear terms, is laying out for #ACIP what's known about #Covid vax responses in immunocompromised people, who make up 2.7% of US adults. These people get sicker from Covid; less likely to get a good take from vax.

10. I am not clear if #ACIP & @CDCgov are legally able to recommend additional doses of #Covid vaccines while @US_FDA's EUAs stipulate the mRNA vaccines are 2-dose vaxes & J&J's is 1 dose. But CDC is making clear it isn't going to move on this till FDA alters the vaxes' status.

11. #ACIP member Camille Kotton, director of a transplant clinic, says the immunocompromised community knows it is at very high risk because they don't get adequate protection from the standard vax regimen. Many have taken matters into their own hands, getting an additional jab.

12. Kotton is worried about immunocompromised people getting additional vax doses in an unregulated, unmonitored way. She also worries about equity — high info people are doing this; others are being left behind. "Our hands are really tied with the current regulatory situation."

13. #ACIP member Keipp Talbot made an impassioned plea for people to get vaccinated as a way to protect those who cannot get enough protection from the #Covid vaccines. We all know someone in this situation, she said. We live with them, work with them, worship with them.

14. #ACIP adjourns. No indication when next it will convene but secretary Amanda Cohn tells the group meetings are envisaged for August. That suggests some decisions — maybe additional doses for immunocompromised people? Moderna vaccine for 12-18 yos? — will need to be taken.