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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
Jun 16
📍 THE 17 FIRED MEMBERS OF CDC’s VACCINE ADVISORY COMMITTEE (ACIP) speak out…

📍“As former ACIP members, we are deeply concerned that these destabilizing decisions, made without clear rationale, may roll back the achievements of US immunization policy, impact people’s access to lifesaving vaccines, and ultimately put US families at risk of dangerous and preventable illnesses.” 🔥

Full text:

Vaccines are one of the greatest global public health achievements. Vaccine recommendations have been critical to the global eradication of smallpox and the elimination of polio, measles, rubella, and congenital rubella syndrome in the US. They have also dramatically decreased cases of hepatitis, meningitis, mumps, pertussis (whooping cough), pneumonia, tetanus, and varicella (chickenpox), and prevented cancers caused by hepatitis B virus and human papillomaviruses.1 Recent scientific advancements enabled the accelerated development, production, and evaluation of COVID-19 vaccines, leveraging novel technologies that are estimated to have prevented approximately 1.6 million hospitalizations and 235 000 deaths in the US alone.2
For more than 60 years, the Advisory Committee on Immunization Practices (ACIP)—codified in the federal regulations (42 USC 217a: advisory councils or committees)—has served as a panel of experts that reviews the most up-to-date evidence on vaccines and monoclonal antibodies (eg, against respiratory syncytial virus [RSV]), providing sound recommendations to the US Centers for Disease Control and Prevention (CDC) regarding how vaccines should be used. ACIP recommendations are the cornerstone of the immunization program in this country. First, they serve as guidance and are the national standard for the use of Food and Drug Administration (FDA) authorized and licensed vaccines, providing a unified and trusted approach to vaccinations for the diverse array of immunization providers across the US. Second, they ensure science-based and tested immunization schedules that are optimized for well-timed protection against serious diseases. Third, the recommendations affect insurance coverage and safeguard broad access for vaccines. Fourth, ACIP’s continued monitoring of disease epidemiology and scrutiny of vaccine safety inform timely updates to recommendations that have maintained the trust and protection of the population. This transparent and ongoing surveillance of vaccines is one of the most stringent around the world, historically making the deliberations and decisions of this committee a beacon for immunization programs globally, while also serving as the foundation for recommendations harmonized with leading medical organizations in the US.3,4
ACIP committee members have always been selected through a rigorous process based on their expertise in immunology, epidemiology, pediatrics, obstetrics, internal and family medicine, geriatrics, infectious diseases, and public health. Historically, committee members were chosen because they worked at hospitals, clinics, health departments, universities, and other organizations where they dedicated themselves to caring for patients, conducting research, and helping to prevent and treat infectious diseases. Members’ deep understanding of immunization issues ensured that vaccine policies were grounded in scientific evidence, aligned with the needs of economically, socially, and medically diverse US communities, and always considered the public value, trust, and acceptability of vaccines.
Despite recent suggestions to the contrary, health care providers and the US public trust ACIP. For the past 18 years, the National Immunization Survey has shown that 99 of every 100 children in the US have received at least some recommended vaccines by 2 years of age, consistent with acceptance of ACIP recommendations implemented by trusted clinicians (National Immunization Survey - Childof Healthy People 2030).…Image
2) Full text part 2:

This does not suggest the population is so distrustful that it warrants dismantling the process by which vaccines have been recommended. ACIP standard procedures have minimized the risk of alleged conflicts of interest and biases. For decades, members of ACIP have undergone a thorough application and review process to participate. Proposed members submitted letters of support from other known experts and peers, completed an interview process, underwent a background check, and disclosed financial interests that might be considered a conflict, including any professional or financial relationships of immediate family members. Historically, it has taken up to 2 years for nominees to be approved to join ACIP.
Once part of the committee, ACIP members spent significant time preparing for meetings, reviewing the scientific evidence, and chairing work groups that, along with many CDC public health officials, led to the final recommendations that were determined during public meetings, which also included opportunities for public comment. Recordings of these meetings, agendas, and presentations were publicly available. Additionally, members agreed to ongoing monitoring and disclosure throughout their tenure. For example, potential conflicts of interest were reviewed throughout their time on the committee. Statements about potential conflicts were required during each meeting and before each vote, and members recused themselves from voting if any conflicts were identified. These disclosures have also recently been posted on the CDC website for public scrutiny. ACIP was among the most stringent and transparent of the federal committees, and we hope those criteria will apply to any new members joining the committee.
The abrupt dismissal of the entire membership of the ACIP, along with its executive secretary, on June 9, 2025, the appointment of 8 new ACIP members just 2 days later, and the recent reduction of CDC staff dedicated to immunizations have left the US vaccine program critically weakened.5,6 These actions have stripped the program of the institutional knowledge and continuity that have been essential to its success over decades. Notably, the ACIP charter specifies that committee members serve overlapping terms to ensure continuity and avoid precisely the disruption that will now ensue. The termination of all members and its leadership in a single action undermines the committee’s capacity to operate effectively and efficiently, aside from raising questions about competence.
Compounding these concerns, recent changes to COVID-19 vaccine policy, made directly by the HHS secretary and released on social media, appear to have bypassed the standard, transparent, and evidence-based review process.7 Such actions reflect a troubling disregard for the scientific integrity that has historically guided US immunization strategy. The newly stated strategy to replace ACIP members with individuals who will “exercise independent judgment, refuse to serve as a rubber stamp, and foster a culture of critical inquiry” is already leading to warnings by academic and scientific institutions, professional organizations, and the public who for decades have known well that these sought-after qualities precisely characterized the now-dismissed members of the ACIP.5
3) Part 3:

As former ACIP members, we are deeply concerned that these destabilizing decisions, made without clear rationale, may roll back the achievements of US immunization policy, impact people’s access to lifesaving vaccines, and ultimately put US families at risk of dangerous and preventable illnesses. Vaccines and the anti-RSV monoclonal antibodies are lifesaving, and people in the US deserve to have recommendations and broad access to use them to prevent serious diseases. In this age of government efficiency, the US public needs to know that the routine vaccination of approximately 117 million children from 1994-2023 likely prevented around 508 million lifetime cases of illness, 32 million hospitalizations, and 1 129 000 deaths, at a net savings of $540 billion in direct costs and $2.7 trillion in societal costs.8Finally, as individuals, we remain committed to evidence-based vaccine policy, both through our ongoing work in immunization science, public health, and medical education, and by supporting future efforts to keep America healthy that uphold scientific rigor and the public’s trust.
Read 4 tweets
Eric Feigl-Ding Profile picture
May 8
⚠️Tariffs On Medications Will Make America Sick

We might soon see the Trump WH impose tariffs on pharmaceuticals—patients will suffer and die.

During the past few weeks, President Trump’s on-again, off-again tariff wars have rattled the stock market, decimated many Americans’ retirement funds, and promised to send grocery prices soaring—and his administration hasn’t even gotten to critical pharmaceutical tariffs yet. But that will likely be the next shoe to drop.
Trump exempted pharmaceuticals from his first round of tariffs in early April, but recently declared that he intends to impose “a major tariff” on imported medicines “very shortly.” These tariffs, he claims, will prompt pharmaceutical companies to leave countries including China and India and begin “opening up their plants all over the place.”
Commerce Secretary Howard Lutnick said in a television interview in mid-April that these tariffs are coming in the “next month or two.”

What will this mean? 

Read on:
progressive.org/op-eds/tariffs…Image
2) The majority of brand name drugs used in the United States are imported. Even generic drugs often rely on ingredients and direct imports from China, including pain relievers and cardiovascular drugs used by millions.
3) The United States was already facing a drug shortage crisis before Trump’s tariff announcement. Now, his policies will drive upnot only the cost of medicines, but also other health care items such as X-ray machines and medical instruments.
Read 8 tweets
Eric Feigl-Ding Profile picture
Apr 10
It’s a trap: CATCH 22—if you register, ICE will deport you. If you don’t register, you’ve now committed a crime for the first time, and ICE will deport you. Trump doesn’t care if you’ve paid all taxes and followed all laws—ICE will deport you.

apnews.com/article/illega…Image
2) The Department of Homeland Security announced that it was mandating that all people in the United States illegally register with the federal government, and said those who didn’t self-report could face fines or prosecution. ***Failure to register is considered a crime***
3) Registration will be mandatory for everyone 14 and older without legal status. People registering have to provide their fingerprints and address, and parents and guardians of anyone under age 14 must ensure they registered. The registration process also applies to Canadians who are in the U.S. for more than 30 days, such as so-called snowbirds who spend winter months in places like Florida.
Read 4 tweets
Eric Feigl-Ding Profile picture
Apr 3
Now economists know how scientists felt back when he pushed “hydroxychloroquine”
2) HCQ preventing COVID deaths has been debunked— and it’s now been linked with deaths.

@JoshuaPCohen1
forbes.com/sites/joshuaco…Image
@JoshuaPCohen1 3) JPMorgan on Trump Tariffs: “The largest tax increase since 1968” Image
Read 6 tweets
Eric Feigl-Ding Profile picture
Mar 28
My god—Earthquake (a Richter ~7.7) causes a skyscraper to collapse in Bangkok. Hope all the construction workers made it out.
2) this skyscraper collapse was captured from a distant car’s dashcam while on a highway

3) another view of the collapse. For those who lived through 9/11, this collapse is a bit triggering.
Read 5 tweets
Eric Feigl-Ding Profile picture
Mar 27
Welp—kiss public health & medical research infrastructure in America goodbye for the next 4 years. RFK Jr plans to cut 10,000 jobs from Trump HHS. Image
2) this will not make America healthy again… not by a long shot. So dangerous and irresponsible.
3) “Kennedy is set to announce Thursday the planned changes, which include axing 10,000 full-time employees spread across departments tasked with responding to disease outbreaks, approving new drugs, providing insurance for the poorest Americans and more”.
Read 5 tweets

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