The ‘leaked’ CDC presentation summarizes a lot of key Delta variant data, but it takes an unusually dark interpretation. Overall, the report basically restates what we have known for a month from England:
🔵 RNA vaccines still work ~88% against Delta cases (and even better against hospitalizations).
🔵 Delta is much more infectious (i.e., transmits faster)
🔵 Delta has faster 🔝 viral loads.

Yes, Delta variant is trouble! And it is really trouble for unvaccinated people
“Although it’s rare, we believe that at an individual level, vaccinated people may spread the virus, which is why we updated our recommendation,” according to the federal health official, who spoke on the condition of anonymity because they were not authorized to speak publicly.”
As noted above, the presentation took an unusually dark interpretation of the data. e.g., highlighting some of the worst numbers, and, for example, highlighting total infections in vaccinated people (PCR+) instead of symptomatic infections (COVID).
The most unexpected part was unpublished data of a Massachusetts outbreak where viral loads were equal in vaccinated and unvaccinated people. That would be surprising.
Ct and viral load interpretations have been notoriously inaccurate in reports for variants over the past 8 months. Lots of experiment controls have to be in place, so I currently put more weight on other data. It’s 1 unpublished report.
And, of course, since most vaccinated people are protected from infection, the majority of transmissions are by unvaccinated cases. And that’s really what we’ve seen in America this summer.
So, again: yes, Delta variant is trouble! And it is really trouble for unvaccinated people
🔵 RNA vaccines still work ~88% against Delta cases (and even better against hospitalizations).
🔵 Delta is much more infectious (i.e., transmits faster)
🔵 Delta has faster 🔝 viral loads

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More from @profshanecrotty

24 Jun
Immunity in people who have had COVID-19 and get a vaccine is a fascinating topic. There are really impressive immune responses! I discuss this in Science today, particularly highlighting recent discoveries. 🧵
science.sciencemag.org/content/372/65…
Hybrid vigor can occur when different plant lines are bred together. Something similar happens when natural immunity is combined with vaccine-generated immunity, resulting in 25 to 100 times higher antibody responses, driven by memory B and CD4 T cells. Image
Conceptualized above as trees of different sizes.
And here's another visualization, a bit more to scale. 😁 Image
Read 24 tweets
14 Jun
Novavax COVID-19 vaccine 90% effective in USA Phase 3 trial! 🧵

This is a protein subunit vaccine

🔵 90% effective against COVID-19 cases
🔵 ~100% effective against "Moderate to severe" COVID-19 (14 cases total in the trial, all in placebo group)
🔵 Very good safety profile
Vaccine efficacy: 90.4% against any COVID-19. Very good!
No moderate or severe cases in the vaccinated group. Very good!
14 moderate to severe in the placebo group.
So, "100%" protection, for 14 events measured.
(The trial was done with a 2 to 1 ratio of vaccinated to placebo people, so the math takes that into account)
Read 11 tweets
11 Jun
Ed Yong won a Pulitzer! My favorite @edyong209 quote is:

“An immunology board game would have a rulebook that's 600 pages long and is written only in acronyms; there's a cupboard's worth of tokens; and every so often, the board spontaneously catches fire.”

@PulitzerPrizes
Immortalized on a coffee mug in my household
😂

Read 4 tweets
4 Jun
Data from the UK are convincing that B.1.617.2 (including NTD deletion)(1st seen in India) is the variant of the future.

1-dose RNA vaccine does NOT sufficiently protect against that virus, so please get your 2nd vaccine dose! 🧵
Sadly, the data are now clear enough that B.1.617.2 is:
🔵 Substantially more transmissible than B117 (~50%)
🔵 Exhibits partial antibody escape, almost = B.1.351
🔵 Can infect most people who only received 1-dose of RNA or AZ vaccine
So, this new variant will probably outcompete other variants in most populations.

The positive is that 2-doses of RNA vaccines work very well still against B.1.617.2 (~90% prevention of cases. UK data).
Read 7 tweets
1 Jun
A thread on current understanding of natural immunity to SARS-CoV-2 🧵
Immunity to SARS-CoV-2 is a key issue for global society. Natural immunity to SARS-CoV-2 (obtained by infection) and vaccine-generated immunity to SARS-CoV-2 are two different paths to immunity.
Based on our team’s SARS2 immune memory measurements (memory T and B cells & antibodies) we predicted natural immunity against serious cases of SARS2 reinfection would last multiple years in most people, against the original SARS2 strain. Back in Nov-Jan.

science.sciencemag.org/content/371/65…
Read 18 tweets
26 May
I gave a short talk today at a WHO symposium on COVID-19 vaccine correlates of immunity. It was an excellent conference. My role was to highlight and discuss potential roles of T cells in vaccine mechanisms or correlates of protection. 🧵
I decided to record a copy of the presentation, posted above.
The conference was organized by Stanley Plotkin
As part of the talk I show this model. The concept here is that as variant divergence increases, the amount of the protective immunity provided by neutralizing antibodies decreases, but the amount of protective immunity provided by memory T cells and B cells is preserved.
Read 7 tweets

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