There needs to be truth-telling about the reduced protection of mRNA vaccines vs symptomatic Delta infections.
It was 95% pre-Delta.
Many are claiming it's still ~80%.
It isn't.
50-60% is best estimate from all sources (not US, since we don't have the data)
Why is this important?
Because we need to protect the protected, the fully vaccinated.
Sure we want to get more people vaccinated, but truth engenders trust. And truth helps guide people to be safe, use masks, distance, ventilation and all the other tools we have and know helps.
Look at Israel's Delta case surge, a model country for vaccination, >15 per cent points more of total population vaccinated than the US. That, in itself, tells us about the reduction of protection of mRNA vaccines vs cases/spread
I stand by my estimate, which includes soon to be published preprints with US data even lower than this range.
But the protection vs hospitalization and death is solid, holding up well, and is the reason why everyone should be vaccinated
More data summarized here, and more to come out soon
The Mayo Clinic study of 42% Pfizer vaccine efffectiveness vs Delta infections noted

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More from @EricTopol

12 Aug
The diagnosis and denial of waning immunity from Delta infections (*does not pertain to hospitalizations or deaths*)
In July, @IsraelMOH issued a report that showed a marked decline in mRNA vaccine (@pfizer) protection vs Delta infections, down to 40%. That was met with disbelief Image
There are now 5 mRNA vaccine effectiveness studies for preventing Delta infections, and more on the way. Except for @PHE_uk, all show a marked reduction, particularly for @pfizer, but the @moderna_tx comparison is confounded by its later administration (less chance to see waning) Image
This reduction of protection is quite different from the 6-month follow up of the Pfizer and Moderna pivotal trials which showed modest decline, but were against the original strain, not Delta
medrxiv.org/content/10.110…
nytimes.com/2021/08/05/wor… Image
Read 9 tweets
6 Aug
An update on Delta, vaccination protection and viral loads from the aggregate data available, with new @PHE_uk data
1. Delta infections are characterized by very high viral loads (low Cts). When a breakthrough occurs, the load is similar to unvaccinated, but clears more rapidly
2. Although the new @PHE_uk on effectiveness (VE) remains unchanged vs. Delta, it doesn't break out mRNA and AZ
assets.publishing.service.gov.uk/government/upl…
3. The totality of the data suggests VE for mRNA vaccines vs Delta infections has been substantially reduced, ~95% vs ancestral strain, now 50-60% vs Delta, particularly noting new REACT data
OTOH VE vs hospitalizations & death is holding up well, > 95% (J&J data today 71%)
Read 4 tweets
4 Aug
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
Read 4 tweets
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

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