Summary Delta breakthrough studies, Ct/viral load, vaccine effectiveness (VE)
Only 1 large study of Ct/viral load, shows some vaccine reduction
VE ranges 39-88%; it's likely ≤ 60% at best for mRNA
More data needed, but points to need for boosters for at least some people
Overall, these findings certainly are concordant w/ increased Delta breakthrough symptomatic infections we're seeing and a major decline in protection (~95% w/ mRNA) compared with previous strains, as reviewed here
Recall that 1-dose mRNA or AZ had little (30%) efficacy (1st study in Table). All of this reflects Delta's immune evasiveness. We're very lucky it's holding up for reduction of hospitalizations/deaths but this🦠is far more formidable for both transmission and our immune response
Other implications for the VE drop vs infections.
For awhile we wondered if the mRNA dosing schedule is Israel (3 weeks) vs UK (8-12 weeks) could account for 39-60% vs 88%, respectively. The new UK study doesn't break down vaccine %, but makes this explanation less likely

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Eric Topol

Eric Topol Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @EricTopol

31 Jul
The 4th wave in Louisiana, the worst spread yet, now 90 cases/100,000 residents and still close to a vertical rise
Now do hospitalizations
For the #casedemics who still don't get it
How sickening to know that so much of this was eminently preventable
Read 4 tweets
29 Jul
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
Read 5 tweets
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
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
Read 4 tweets
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
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

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!

:(