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Eric Feigl-Ding Profile picture
@DrEricDing
Jul 23, 2021 • 30 tweets • 14 min read • Read on X
⚠️ANOTHER EFFICACY DROP—Not good—Israel 🇮🇱 Ministry of Health just released another vaccine efficacy update due to #DeltaVariant—only 39% Pfizer VE for #COVID19 infection, 40.5% for symptomatic, 88% for hospitalization, 91% for ICU/low oxygen/ death. More—waning efficacy too—🧵 ImageImage
2) Gets worse, 🇮🇱 report also reveals waning potency, showing just 16% effectiveness against transmission among those 2nd-shot vaccinated in January, 44% VE if vaccinated in February, 67% VE if 2nd shot in March, 75% if vaccinated in April. Partly also age effect—but still bad. Image
3) I’m trying to find good things in the report—the 88% efficacy against hospitalization and 91% VE for severe #COVID19 death is good. But it is much weaker than the 93% reported 2 weeks ago for hospitalization, and 98% from May.

gov.il/BlobFolder/rep… Image
4) Let’s now look at breakthrough rates by when someone got their vaccination— you clearly clearly see than January vaccinated people currently have the most breakthrough per capita, followed by Feb… and so on. This is partly age (elderly vaxxed first) but possibly also waning. Image
5) This worrisome news is not just my perspective, the Israeli govt is quite worried too. They warn of “decreasing potency” i24news.tv/en/news/corona…
6) but is it just elderly effect in the weaker Jan/Feb potencies? Not sure… if you look at breakthrough rate in age 60+ versus 16-59, the 16-59 have similar if not higher breakthrough rate if comparing Jan vs Jan, Feb vs Feb of same month! That implies waning not just age. ImageImage
7) here was 2 weeks ago… VE was 64% for preventing infection in early June. 94% in May. But now it’s 39-40%. Gee.
8) Let me be clear—vaccines are amazing miracle. But we can’t just rely on just vaccines alone—must do other mitigation to get us out of the pandemic. Epidemiology models show that because #DeltaVariant so contagious, we *must must must* add masks and other NPI measures! ⬇️
9) Boosters—Biden WH Officials Now Expect Vulnerable Americans to Need Booster Shots—The growing consensus that at least some Americans will need a booster is tied in part to research suggesting that Pfizer’s vaccine is less effective after ~6 months. nytimes.com/2021/07/23/us/…
10) “Senior officials now say they expect that people who are 65 and older or who have compromised immune systems will most likely need a third shot from Pfizer or Moderna.”
11) “That is a sharp shift from just a few weeks ago, when the administration said it thought there was not enough evidence to back boosters yet.
12) “On Thursday, a key official at @CDCgov said the agency is exploring options to give patients with compromised immune systems third doses even before regulators broaden the emergency use authorization for coronavirus vaccines, a step that could come soon for Pfizer vaccine.
13) “Dr. Amanda Cohn, the chief medical officer of CDC immunizations division, told an advisory committee to the agency that officials were “actively looking into ways” to provide certain people access to booster shots “earlier than any potential change in regulatory decisions.”
14) there is some debate about the new 🇮🇱 ~40% efficacy data. Some say unvaccinated are tested more—true, but in that case, then we’d find relatively more cases in the unvaccinated, which would make the vaccine efficacy look BETTER, not worse (seen here).
timesofisrael.com/israeli-uk-dat…
15) Thus to rephrase—if unvaccinated are tested more than vaccinated, then we would fine more of the milder / asymptomatic infections in unvaccinated relatively, and that would make the vaccine efficacy look relatively higher, not lower. So that is unlikely to explain the VE dip.
16) another debate is that early vaccinations “reflect time that has passed since vaccination, but also… often people with health conditions and who are more prone to infection, such as the elderly.” We discussed this above—but again age isn’t explaining this—60+ & <60 similar. ImageImage
17) Some others say “oh it’s a smaller dataset than UK”—yeah but it’s still VERY significant. Notice how the 95% confidence intervals’ lower bounds all exclude zero—and by comfortable cushion of certainly. And the 40% VE’s upper bound excludes 88% from 🏴󠁧󠁢󠁥󠁮󠁧󠁿 data. So these are diff. Image
18) also if we look at just the elderly age 60+ (stratification is one form of adjustment in epidemiology), we still see the jump up among the January vaccinated even among these elderly. This implies this is an effect by time (stratified adjusted roughly for age), not just age. Image
19) given the new data—in following the precautionary principle—we need to now urgently reconsider reimposing mask mandates again. @CDCDirector - it is time. Tick tock ⏰
20) Whenever you see vaccine efficacy —keep in mind vaccines are amazing. But data suggest we need to also do both vaccines & public health measures (rather than rely on treatments). Iron lung machines was a good polio treatment, but it could never eradicate polio until vaccines.
21) Welp—there’s discussions among epidemiologists now whether we can hold the #DeltaVariant down. With a R0=6 we can just barely. But with an R0=8 it’s much harder under 60% efficacy and 64% vaxxed. What is the estimated R0 range of Delta? 5-8 ➡️ more contagious than smallpox.
22) large numbers of experts (including @JeromeAdamsMD) now support masks even if vaccinated. @CDCDirector needs to update mask rules ASAP now in light of the new data^
23) #DeltaVariant cases ➡️ hospitalizations. Period. The “link is broken” disinformation machine is running wild that they aren’t correlated anymore. Completely false. Do not fall for that nonsense. Hospitalizations rising in UK and US and Israel.
24) Vaccines are a miracle but we need other mitigation against #DeltaVariant. Iceland is one of the most heavily vaccinated countries in the world… but yet… and yes their ICUs are filling up too.
25) sure looks like we are headed to 3rd shot boosters… both the original vaccine booster as well as a #DeltaVariant tailored booster according to Pfizer. Their internal data also shows waning. finance.yahoo.com/news/pfizer-bi…
26) This is not good. Even under rosy optimistic scenarios, containing #DeltaVariant was already hard. But it’s not easy…. see details 🧵
27) REMINDER— even *mild* COVID still leads to drop in intelligence according to UK 🇬🇧 studies on #COVID19 survivors. The cognitive drop is stronger as it gets more severe, but even significant in the mild cases too! Avoid infection not just hospitalization!
28) Another reminder: mild breakthrough #COVID19 infections can still cause transmission. This is why we mask even if vaccinated! It slows and helps stop the spread. Mask and vaccinate … not just ‘or’.
29) we are mostly pretty certain boosters are coming… the issue is not if but when… and who first.
30) Pfizer reports 12% symptomatic efficacy after 4 months. But it was mostly data from the pre-#DeltaVariant era. Just FYI.

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More from @DrEricDing

Eric Feigl-Ding Profile picture
Apr 25
📍Let this sink in—a world leading virologist @RickABright who has studied H5N1 bird flu says he is pausing all his milk consumption until he sees proof from both FDA & USDA that pasteurized milk is safe to drink. Pausing milk because of his concern over lack of transparent data.
Why are scientists pausing milk intake? Because there still isn’t enough data on safety of pasteurized milk. There has been data on other viruses in the past that survive pasteurization. See detailed thread 🧵 below.
3) also avoid raw and undercooked eggs for now just to be safe…
Read 4 tweets
Eric Feigl-Ding Profile picture
Apr 24
Testing conducted by the FDA on pasteurized commercially purchased milk has found genetic evidence of the H5N1 bird flu virus. ➡️But the testing, done by PCR cannot distinguish between live virus or fragments of viruses that could have been killed by the pasteurization process.

The FDA said it has been trying to see if it could grow virus from milk found to contain evidence of H5N1, which is the gold standard test to see if there is viable virus in a product. 📌The FDA *does NOT explicitly say FDA laboratories were unable to find live virus in the milk samples, but nevertheless it does state that its belief that commercial, pasteurized milk is safe to consume has not been altered by these findings.

(Sound familiar? Just like blanket assuming a virus “isn’t airborne”, “cannot transmit without symptoms”, “no human to human transmission” errors during COVID). That said, I will am hopeful that no live virus will be found in confirmation. But let’s be precautious.
statnews.com/2024/04/23/h5n…Image
2) PPE and safety googles or face shield recommended for dairy farmers and anyone handling raw milk 🥛. Also they warn about poor fitting respirators for children (who may work near dairy— like I used to help on a dairy farm as a kid in rural Pa). Image
3) people working with cattle 🐄 should also “avoid eating drinking smoking chewing gum in contaminated areas or touching eyes.” And people exposed should wear PPE should be monitored for symptoms for 10 days. Image
Read 10 tweets
Eric Feigl-Ding Profile picture
Apr 13
📈Measles epidemic trajectory is worsening in the U.S.—it has NOT flattened as some claimed. The surge continues—comparison of newest versus recent outbreak graph. Majority are unvaccinated, but there’s enough unvaccinated in many clusters for outbreaks.
cnn.com/health/measles…

Image
Image
2) here is another way to visualize the measles epidemic. Another annoying thing is that although 95% not double vaccinated, 5% of the previous 113 cases were vaccinated— which means that there is waning immunity or vaccine breakthrough with sufficiently big outbreak possible.
3) I specifically wanted about this issue that pockets of unvaccinated could still trigger outbreaks, and vaccine breakthroughs possible due to vaccine waning & if surrounded by pockets of low vaccinations. See my warning oped below. 👇
Read 6 tweets
Eric Feigl-Ding Profile picture
Apr 10
🐄—"Experts fear that H5N1 avian flu… may have been transmitted through a type of cattle feed called “poultry litter”—mix of poultry poop, spilled feed, feathers, and other waste scraped from the floors of industrial chicken and turkey production plants."
telegraph.co.uk/global-health/…
Europe does not allow cattle to be fed poultry feed. US does. This helps explain why US is seeing a cow outbreak of avian flu.
3) CDC warns against chicken and bird exposures and direct contact with poop. Yet why the hell are we feeding cattle poultry litter??? Corporate farms are so stupid and greedy.
Read 12 tweets
Eric Feigl-Ding Profile picture
Apr 9
Global CO2 levels and temperatures. But but but we scientists are merely “fear mongering” according to deniers. How about just facing reality? How about precautionary warnings to protect human lives?

@ed_hawkins @MrMatthewTodd #climatecrisis Image
Oh this seems totally fine.
Image
I think we are screwed at this point on limiting temperature rise by 1.5 C. It’ll still take a miracle to avoid 2 C.
Read 5 tweets
Eric Feigl-Ding Profile picture
Apr 8
📍BIRD HUNTING AVIAN FLU DEATH—WHO reports that a 21 year old young man with no underlying conditions suddenly died of #avianflu in Vietnam. He started with a cough/fever, but died 12 days later with severe pneumonia and ARDS. ➡️He had only gone bird hunting recently. BE CAREFUL.
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2) "From 2003 to 25 March 2024, a total of 888 worldwide human cases of influenza A(H5N1), 463 deaths (52% CFR), reported to WHO from 23 countries. Almost all cases of human infection with avian influenza A(H5N1) linked to close contact with infected live or dead birds, or contaminated environments."
who.int/emergencies/di…
3) It is interesting that WHO had to point out he had no contact with any sick or dead birds. Only hunting. And he had gone bird hunting the prior month in Feb 2024. And no other contact with people since. The latency period seems rather long.
Read 8 tweets

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