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29 Jul, 5 tweets, 4 min read
T cells were supposed to be the "on-demand" reserves to kick in after the normal decline of neutralizing antibody (nAb) levels, providing protracted protection. But several new reports point to nAbs as key.
1. @NEJM report on breakthroughs w/ low nAbs
2. @ScienceMagazine report on giving vaccine -induced nAbs to protect in animal model model
3. The Israeli data on diminished protection for age >60 several months out from vaccination, due to Delta
T cells were especially supposed to be helpful, relatively unaffected by variants, as this study and others support (pre-Delta)
cell.com/action/showPdf… @CellRepMed
These observations should lead to acceleration of the universal coronavirus vaccine, based upon broad nAbs, that is eminently doable, but we're not giving it the priority.
More on nAbs @Nature
nature.com/articles/d4158…

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More from @EricTopol

Eric Topol Profile picture
31 Jul
The 4th wave in Louisiana, the worst spread yet, now 90 cases/100,000 residents and still close to a vertical rise Image
Now do hospitalizations
For the #casedemics who still don't get it Image
How sickening to know that so much of this was eminently preventable
Read 4 tweets
Eric Topol Profile picture
29 Jul
The data from Israel, for fully mRNA vaccinated reduced protection vs severe illness from Delta, in age > 60, down from 97% to 81%, is yet unpublished, but has led to a change in policy to offer booster shots for this age group
ft.com/content/b6a804… by @MehulAtLarge @FT
If this holds up, it's the first sign of a significant dropdown of protection against hospitalizations and death for these vaccines. I hope all of the data will be shared ASAP as the implications are big.
When this first surfaced last night, I asked my friend @segal_eran about the lack of concordance with the UK @PHE_uk data. Here is our back and forth, with his key points
Read 4 tweets
Eric Topol Profile picture
29 Jul
Why is Canada at 1.4 cases/100,000 people and the US at 20/100,000, heading towards its 4th wave?
Remarkably, Delta prevalence for new infections is 10% vs 93%, respectively.
And yes, there is also an ever-growing gap in vaccination coverage, favoring Canada's ability to defend against Delta as it inevitably rises
Delta prevalence data cov-spectrum.ethz.ch/explore/Canada…
Read 4 tweets
Eric Topol Profile picture
28 Jul
Very important @NEJM paper today on breakthrough infections (BTI) post-vaccination in Israeli health care workers.
5 key points:
1. Of ~1500 people, 0.4% had BIs, sequenced to be Alpha 85% (this was pre-Delta)
nejm.org/?query=feature…
2. All these BTIs were mild (67%) or without symptoms (33%), done due to routine testing. No hospitalizations.
3. 7 of 36 (19% ) of BTIs had "persistent symptoms" > 6 weeks. Table below
An indicator for the potential of #LongCovid in BTIs in a few of these people at > 6 weeks, but that's a very limited and early time for assessment.
Read 6 tweets
Eric Topol Profile picture
23 Jul
Why is "I'm vaccinated, I'm fully protected" wrong?
The pivotal clinical trials, such as with mRNA vaccines, showed a 95% reduction of symptomatic infections, the primary endpoint. Not 100%
That was pre-Delta
nytimes.com/2021/07/22/hea… @apoorva_nyc /1
Now we have conflicting data for protection vs symptomatic infection post-mRNA vaccination for Delta
UK @NEJM 88% protection

Israel 40% protection (unpublished)
bloomberg.com/news/articles/… /2
We don't have an explanation for this glaring contradiction, which could include demographics, sample size, time from vax, all sorts of things. The delayed 2nd UK dose (8 wk) has been suggested by raising level of immunity. But we don't know yet /3
bbc.com/news/health-57…
Read 6 tweets
Eric Topol Profile picture
22 Jul
One of the most important advances in the history of life science today combines deep learning #AI, the human proteome, #openscience: accurately determining 3D structure of human proteins and organisms via amino acid sequence nature.com/articles/s4158… @Nature
This work by @DeepMind @embl @emblebi is made fully available to the biomedical community and sets the foundation for accurately predicting virtually all protein structures, >100 million
Essential for understanding biology, drug discovery, and many life science disciplines
Fixed link nature.com/articles/s4158…
Read 5 tweets

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