Tweet

Shamez Ladhani

7 Aug, 10 tweets, 4 min read

1/ It’s actually headline-grabbing news articles such as this that fuel conspiracy theories

The JCVI did not make a U-turn on vaccinating teens. The JCVI path to vaccinating teens has remained the same & their message has been consistent. Here’s why 🧵

👉thetimes.co.uk/article/when-v…

2/ On 19 July 2021, JCVI issued advice on COVID-19 vaccination for teenagers

JCVI advised that those aged 12+ years with specific underlying health conditions that put them at risk of serious COVID-19 should be offered COVID-19 vaccination

👉 gov.uk/government/pub…

3/ For healthy teens, however, JCVI *deferred* the decision, specifically stating “Data on the incidence of these events [myocarditis in teens & young adults] are currently limited, & the longer-term health effects from the myocarditis events reported are not yet well understood”

4/ JCVI has never been against vaccinating kids but raises caution because of rare reports of myocarditis & pericarditis. To reiterate, it was never as much about the low risk of myocarditis that was in question here, but the more about the outcomes of myocarditis in young adults

5/ Myocarditis is no joke. Inflammation of heart muscle can have serious consequences, including permanent scarring. Even if the initial illness is reported as mild, the inflammation can take weeks to heal & we *have* to wait to be certain that there are no long-term problems

6/ As new data continue to emerge, it is becoming clear that most of the myocarditis risk is after the 2nd mRNA vaccine dose and mainly in younger male adolescents & young adults, with very low risk reported in males or females after the 1st dose dose of vaccine.

7/ In the UK, we have limited data on myocarditis risk after 2nd #COVID19 vaccine dose in young adults (18-30 year-olds) because this group is only now going to be eligible for their second dose of #COVID19 vaccine. This information will help guide risk-benefit in younger teens

8/ Therefore, the most logical next step would be to offer 1st vaccine dose to 16 & 17 year-olds, whilst we assess options for 2nd #COVID19 vaccine dose: better data on myocarditis outcomes, lower mRNA vaccine doses, boosting with newer vaccine, etc 👉gov.uk/government/pub…

9/ In conclusion, if it’s not obvious, JCVI is slowly extending #COVID19 vaccination from young adults to 16 & 17 year-olds, using real-time data to monitor vaccine safety, before considering extending vaccination to younger teens with increasingly ⬇️ risk of severe #COVID19

10/ For what it’s worth, my personal opinion is that older adults & healthcare workers across the world deserve to be vaccinated 1st before we consider extending vaccination to younger kids in rich countries ... and yes, it IS taking vaccine doses away from poorer countries

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More from @ShamezLadhani

Shamez Ladhani

@ShamezLadhani

31 Jul

1/ Our preprint on #SARSCoV2 infection & transmission in secondary schools following the emergence of the Alpha variant in England is now online

We took multiple blood samples from ~2,000 students/staff for #SARSCoV2 antibodies. Here’s what we found 🧵

👉medrxiv.org/content/10.110…

2/ In England, #Covid19 cases due to the Alpha variant increased rapidly from late Nov 2020, leading to national lockdown in Dec 2020, including school closures. When schools reopened fully in Mar 2021, we took blood samples from 1,895 students & staff in our sKIDsPLUS study

3/ Between December 2020 & March 2021, 5.6% (61/1094) students & 4.4% (35/792) staff had laboratory-confirmed SARS-CoV-2 infection.

Most of these infections were acquired during community peaks in infections rates in December 2020, with a trickle of cases throughout lockdown

Read 8 tweets

Shamez Ladhani

@ShamezLadhani

29 Jul

1/ It was the JCVI that used basic immunological principles of vaccination to recommend a 12-week interval between #COVID19 vaccines to save more lives during the Alpha wave in the UK

Our paper (preprint) here shows why that was the right decision…🧵

👉medrxiv.org/content/10.110…

2/ We tested #SARSCoV2 antibodies in adults aged 50-89 years and found that, for both Pfizer & AZ vaccines, 95% had seroconverted (developed antibodies) by 35-55 days after the first #COVID19 dose, and 100% by 7+ days after the second dose

👉 medrxiv.org/content/10.110…

3/ BUT, when the vaccines were given 9-11 weeks apart, antibody levels at 2-5 weeks after 2nd dose were 6x ⬆️ for Pfizer (6703; 95%CI, 5887-7633) than AZ (1093; 806-1483), which in turn were higher than Pfizer given 3-4 weeks apart (694; 540 - 893) 👉medrxiv.org/content/10.110…

Read 6 tweets

Shamez Ladhani

@ShamezLadhani

27 Jul

1/ On 19 July 2021, JCVI published their statement on #Covid19 vaccination for 12-17 yr-olds

If you only heard that JVCI did not recommend vaccine for teens then you missed out on a wealth of information & recommendations in the report

Here’s why 🧵

👉 gov.uk/government/pub…

2/ First, the MHRA & JCVI have very different functions. The MHRA authorises medicines, including vaccines, & monitors their safety but does not make vaccine recommendations. The JCVI makes recommendations on vaccines for the national immunisation programme & for risk groups

3/ JCVI took rather long to release their statement on vaccinating 12-17 yr-olds because risk-benefits of vaccinating this age-gp
were finely balanced between risk of severe #Covid19 & risk of rare but severe side-effects for the only vaccine licensed for 12-15 yr-olds (Pfizer)

Read 19 tweets

Shamez Ladhani

@ShamezLadhani

21 Jul

1. Most of us do not really appreciate how resilient children and their immune systems are when they encounter #sarscov2. Most kids don’t even realize they have been exposed, which leads to ⬆️⬆️⬆️ over-estimation of the long-term effects of #COVID19 in children

Here’s why … 🧵

2/ when asked, most parents don’t even realize when they child was exposed to #SARS_CoV_2 because most kids either remain asymptomatic or have such a mild and transient illness that parents don’t even associate the illness with #COVID19

3/ In our primary schools study, although small numbers, parents reported no symptoms in 85% of kids who didn’t have #SARS_CoV_2 antibodies at start of the study & then developed antibodies during the study (ie. got infected) compared to 47% of staff
👉 thelancet.com/journals/lanch…

Read 7 tweets

Shamez Ladhani

@ShamezLadhani

16 Jul

1/ We studied the quality,
quantity and persistence of #SARSCoV2 antibodies in primary school students (6-11 year-olds) compared to staff (adults) over 6 months (until ~7-8 months after their #SARSCoV2 infection)

Here’s what we found (pre-print) 🧵

👉 medrxiv.org/content/10.110…

2/ The proportion of students & staff who had #SARSCoV2 antibodies in back June 2020 was similar:

👉 11.5% (95%CI, 9.4-13.9) & 11.3% (95%CI, 9.2-13.6; p=0.88) students had nucleoprotein & RBD antibodies vs 15.6% (95%CI, 13.7-17.6) & 15.3% (95%CI, 13.4-17.3; p=0.83) staff

3/ Live virus neutralising activity (ability of antibody to kill #SARSCoV2) was detected in 79.8% (71/89) of N antibody & 85.5% (71/83) of RBD antibody positive kids. RBD correlated more strongly with neutralising activity (rs=0.75; p<0.0001) than N antibodies (rs=0.37; p<0.0001)

Read 7 tweets

Shamez Ladhani

@ShamezLadhani

16 Jul

1/ We developed & validated an oral fluid assay to measure #SARSCoV2 antibodies. Basically it’s a lollipop stick with a sponge that collects oral fluid (saliva) from around cheeks/gums. Kids can do the test themselves & sample can be posted to the lab 🧵👉 medrxiv.org/content/10.110…

2/ Here’s the technical stuff: We used contemporaneous blood & oral fluid samples from ~2,000 kids & adults taking part in our school studies and developed 3 different oral fluid assays for testing & validating: N-antibody, Spike-antibody & RBD-antibody 👉 medrxiv.org/content/10.110…

3/ The N-protein capture assay was the best candidate, sensitivity 75% (95%CI, 71–79%) specificity 99% (95% CI: 78–99%) when compared with paired serum antibodies, but higher sensitivity in kids (80%, 95% CI: 71–88%) than adults (67%, CI: 60%-74%) 👉 medrxiv.org/content/10.110…

Read 5 tweets

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