COVID-19: MMR and Tdap vaccines may reduce severity of COVID-19
For some time now scientists hypothesized that immune memory for other viruses could potentially reduce severity of COVID-19 as well. 🧵1/
Analysis of a large and well-characterized COVID-19 patient cohort revealed that prior MMR (measles-mumps-rubella) and Tdap (tetanus-diphtheria-pertussis) vaccination associates with reduced disease severity and death ( cell.com/med/fulltext/S… ). 2/
How is that possible? A diverse immune T cell response controls viral infections and a major goal of vaccines is to induce a strong and durable T cell memory. Reactivation of memory T cells generated against a different pathogen could enhance immunity to novel pathogens. 3/
Researchers were able to show that pre-existing memory T cells from previously administered MMR and Tdap vaccines are reactivated when infected with COVID-19 or introduction of COVID-19 vaccine spike proteins and have a memory T cell subset implicated in antiviral immunity. 4/
T-cell receptors (TCR) are found on the surface of immune T cells and are responsible for recognizing fragments of a pathogen (antigen). Identical TCRs are shared on COVID-19, MMR, and Tdap generated immune T cells. 5/
The study found the incidence of disease severity was reduced by 32%-38% for those who had received the MMR vaccine and 20%-23% for those who received the Tdap vaccine. 6/
The researchers conclude that Tdap and MMR memory T cells that are reactivated by COVID-19 may provide protection against severe COVID-19. 7/
Not only do the COVID-19 vaccines provide strong protection against severe disease, it seems the MMR and Tdap vaccines your parents got for you may also provide some protection. 8/
Two doses of the MMR vaccine should provide protection for life, while the Tdap vaccine requires boosters every 10 years. 9/
COVID-19 in general is less severe in younger children than older adults. I wonder if part of that comes from the fact that most children more recently had MMR and Tdap vaccines which may provide them with additional protection compared to older adults? 10/
At least this may be for the children that are still getting their standard vaccines these days. Vaccines are not only good for the viruses they were designed for but as you can see in this study, for some new future viruses as well. 11/
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JCVI is now recommending booster shots (3rd dose) be offered to those more at risk of serious disease for the following groups no earlier than 6 months after getting the second dose ( gov.uk/government/new… ). 🧵1/
- those living in residential care homes for older adults
- all adults aged 50 years or over
- frontline health and social care workers
- all those aged 16 to 49 years with underlying health conditions that put them at higher risk of severe COVID-19, and adult carers
2/
- adult household contacts of immunosuppressed individuals
3/
Chief Medical Officers from the UK have recommended COVID-19 vaccines for all those 12-15 ( gov.uk/government/pub… ). This would be 1 dose with a second dose determined later (spring) based on more data accrued internationally. 🧵1/4
The recent advice from the UK's Joint Committee on Vaccination and Immunisation (JCVI) did not take into account any benefits to the community or society despite finding marginally better benefits from vaccinating children 12-15. 2/4
In this case the four CMOs looked at a much wider perspective and when taking into account other details including disruption to education, protection of parents and family members, they came to the conclusion that all 12-15 should be vaccinated. 3/4
In real-world effectiveness studies, the Moderna vaccine seems to outperform Pfizer with higher protection. Since the two vaccines are using the same COVID-19 spike protein design, the two major differences between the vaccines are the dose amount and the time between doses. 2/
Some scientists believe the improved performance is because Moderna's dose is more than 3x higher than Pfizer. Studies have shown increased neutralizing antibody level production with higher doses of mRNA vaccine given to rats ( science.org/doi/10.1126/sc… ). 3/
COVID-19: UK decision not to universally vaccinate children 12-15
The UK's Joint Committee on Vaccination Immunisation (JCVI) recently announced they did not support universal vaccination of 12-15 year olds at this time ( gov.uk/government/new… ). 🧵1/
How did they come to a different conclusion than all the other countries who are already offering vaccines to those 12+ despite actually admitting that the benefits from the vaccine for 12-15 are "marginally greater than the potential known harms"? 2/
As usual, you need to look at the fine print and context they were using. First, they seemed to be using ICU treatment as their baseline and noted that only 2 healthy children per million need ICU care which was too small of a benefit ( washingtontimes.com/news/2021/sep/… ). 3/
COVID-19: Immune antibodies vs T cells in protection
A very interesting study looked at which parts of the immune system are most important for clearing infections from the body ( science.org/doi/10.1126/sc… ). 🧵1/
The immune system has innate and adaptive immune responses ( ncbi.nlm.nih.gov/books/NBK26846/ ). The adaptive immune system remembers previous encounters with specific pathogens and destroys them when exposed again but is slow to develop on a first/primary exposure to a new pathogen. 2/
Specific clones of B and T cells have to become activated and could take a week or more before the immune responses are effective (this is why you are considered fully vaccinated 14 days after you get your dose). 3/
COVID-19: Understanding efficacy when majority of hospitalized are vaccinated
I keep seeing more and more people confused about the raw # of reported COVID-19 cases or hospitalizations of vaccinated people. 🧵1/
The conclusion that some people are drawing is that this must mean the vaccines don't work. Except that they do, and work very well. The problem is with understanding the math, context, and something called Simpson's paradox which I will explain below. 2/
How can the efficacy of the vaccine vs. severe disease be strong when 60% of hospitalized in Israel are vaccinated for example? Jeffrey Morris put together an excellent article explaining all of this, which I will summarize ( covid-datascience.com/post/israeli-d… ). 3/