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.

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More from @HelenBranswell

16 Jul
1. @CDCgov announced today that a case of #monkeypox has been detected in Dallas. The person recently returned to the US from Nigeria. The person was traveling alone.
A thread.
2. @CDCgov, state/local health authorities are looking for people who traveled on 2 flights with the person who later was diagnosed with #monkeypox. The 1st was a direct red-eye flight from Lagos, Nigeria to Atlanta that arrived July 9. The second was from ATL to Dallas July 9.
3. #Monkeypox is related to smallpox. It is less dangerous, but it's not not dangerous. About 1 in 100 people infected with the strain that has infected the person in Dallas die from it.
Read 4 tweets
7 Jul
1. @WHO DG @Drtedros says the world is in a perilous position re: #Covid19. The global toll has topped 4M, vaccine nationalism has left many countries with little access to vaccine. That health workers in many countries are still unvaccinated is "morally abhorrent."
2. "Now is the time for the world to come together ... to end the acute phase of this pandemic," @drtedros said during today's @WHO #Covid19 press conference. "It's not charity," he said of working out ways to share vaccines & therapies. "It's the best way to end the pandemic."
3. @WHO's expert panel on vaccines, SAGE, recommends that older people & health workers around the world be vaccinated before young children, because the risk to the former is so much greater, Anne Lindstrom (spg?) from WHO tells the daily newser.
Read 6 tweets
23 Jun
1. The impact of #Covid19 vaccines on the US epidemic. This graphic, from today's #ACIP meeting, speaks volumes.
I will try to tweet from the meeting, but it might be intermittent. First up: myocarditis & pericarditis in some people who've received mRNA vaccines.
2. #ACIP will also be discussing #Covid19 booster shots. Committee was just told it's not yet clear *if* boosters will be needed, but that it's important to plan for boosters if it becomes clear they are needed.
3. #ACIP hearing an explanation of traditional (ie not vaccine-related) myocarditis & pericarditis. The former is mostly seen in males & rates are higher in 15-18 yos than in younger children.
Read 22 tweets
19 Jun
1. Earlier this week @CDCgov served notice it is suspending importation of dogs from countries with a high canine #rabies risk.
An event happened this week that is a stark illustration of why CDC is taking that step.
A thread.
2. The day @CDCgov's notice appeared in the Federal Register, a Pennsylvania lab reported that a dog imported to the US from Azerbaijan on June 10 tested positive for #rabies. This is exactly what the new policy is trying to prevent.
3. The dog was part of a shipment of 33 dogs & 1 cat. Those animals will have to be found & quarantined for months. Animals that have been in contact with them may need to be revaxxed against #rabies. This is a TON of work. The animals were distributed across 8 states.
Read 5 tweets
19 Jun
1. Guinea's latest #Ebola outbreak is over, @WHO declared today. The outbreak flared earlier this year in an area that 5 yrs earlier had been engulfed in the biggest Ebola event in history. This one was historic too — triggered by virus from a survivor. statnews.com/2021/03/12/bom…
2. The outbreak was declared in mid-February, one of two #Ebola flare ups African countries fought this year as they battled Covid. The other was in DRC, in the area of the 2018-2020 North Kivu-Ituri outbreak. It has also been stopped.
3. There were immediate fears that #Ebola would spread across Guinea's borders, as the virus did in 2018. But the Guineans, with help from @WHO & other partners, kept this from becoming a big outbreak. There were probably 23 cases in this outbreak, 12 of them fatal.
Read 4 tweets
20 Mar
1. A #flu thread:
There remains almost no influenza activity in the US this year. Nearly three-quarters of a million flu tests have been conducted; just over 1,600 have been positive. Last week 27 people in the country tested positive for flu. Image
2. These graphs come from @CDCgov's weekly #flu report, FluView. The red arrow points to this year's epidemic "curve" such as it is. Many years there is a fair amount of flu B at this time. I guess it could still come but I'm not worrying about it. cdc.gov/flu/weekly/ind… Image
3. Only 1 child in the United States has died from #flu this winter. Extraordinary. Image
Read 4 tweets

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