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Eric Topol Profile picture
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20 Sep, 4 tweets, 2 min read
Delta can be daunting to contain.
The situation in Singapore with over 1,000 new cases today and yesterday, 80% of total population fully vaccinated, 1 of top 3 countries in the world, is an important indicator of the challenge.
Singapore’s booster campaign for people over the age of 60 began Tuesday, 14 September
The primary schools shifted to online reuters.com/business/healt…
Unlike Israel, Singapore was not a 1st mover, less proportion has waned, attained ~20 per cent points higher fully vaccinated population. Far less natural infection immunity
Israel: 100% Pfizer
Singapore: Pfizer/Moderna, AFAIK spacing by protocol
https:// ig.ft.com/coronavirus-va…

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More from @EricTopol

Eric Topol Profile picture
22 Sep
New large dataset of US Medicare (age 65+) population subgroup: 2.7 million Pfizer; 2.9 million Moderna vaccinated, w/ ~30,000 breakthrough hospitalizations, via claims 🧵main findings
@Humetrix humetrix.com/powerpoint-vac…
1. Definite waning of protection vs hospitalization for those 5-6 months out from vaccination (odd ratio 2.5X at 6 months) Image
2. No significant difference of waning for Pfizer vs Moderna for protection from breakthrough infections Image
Read 6 tweets
Eric Topol Profile picture
18 Sep
A @CellCellPress commentary yesterday entitled "Keeping Pace with the #SARSCoV2 Variants" states
"The evidence so far suggests that effectiveness against hospitalizations and symptomatic illness is highly preserved against Delta" cell.com/cell/fulltext/…
I'm calling it out. /1
For several weeks dating back to July, we have seen protection of vaccination for symptomatic infections drop down from >90% to <40% in Israel which was refuted, attributed to poor analysis, Simpson's paradox, and many other objections to @IsraelMOH reports /2
Those reports were since corroborated by others including @KPSCalResearch, @PHE_uk. Qatar and many other. But they were ignored and denied. /3
Read 8 tweets
Eric Topol Profile picture
15 Sep
3 new @NEJM papers today on @Pfizer/@BioNTech_Group vaccine
1. 3rd shot (Booster) in over 1.1 million Israelis, age ≥ 60, > 12 days later
19.5-fold reduction in severe illness
nejm.org/doi/full/10.10…
2. 6-month follow-up of the original placebo-controlled trials (adult + teens; > 44,000 participants) showed gradual reduction in efficacy vs symptomatic infections from 96% (fully vaxxed) to 83% (> 4 months)
nejm.org/doi/full/10.10…
3. Small 3rd shot-> Neutralizing antibody study vs Wild-type and Delta by age group, showing significant increase immune response not much affected by variant or age
Read 4 tweets
Eric Topol Profile picture
15 Sep
The @Pfizer @US_FDA booster documents fda.gov/media/152161/d…
reviews all data on effectiveness (VE) vs infection
—waning immunity not related to Delta, just a matter of time, 6% reduction of VE every 2 months
—restoration to 95% VE by 3rd shot
—recommends booster for all age 16+
The (Pfizer) bottom line, w/ antibody % safety data in this 53 page report.
Their case is not made sufficiently for all age groups, predominantly relying on infections, not protection from severe illness, which exists now for age ≥ 60
That may change with ongoing follow-up data.
Little evidence of difference in booster effect by age or variant (WT/Wuhan vs Delta/DA)) difference for neutralization assays. Substantial increase on this log-scale NT50 plot across the board.
Read 4 tweets
Eric Topol Profile picture
14 Sep
Let me be clear about the evidence on 3rd shots. It is unequivocal for Pfizer's vaccine, given w/ 3 week spacing. In people over age 60, there is significant reduction of effectiveness (VE) vs hospitalizations and symptomatic infections at 5+ months after primary vaccination. /1
And that Israel's data shows that VE vs severe illness is restored by a 3rd shot for those age ≥ 60.
The duration of the restored VE can be debated, but likely several months, at minimum. /2
It's not the "general population" but there are over 70 million Americans age ≥ 60. They should not be sitting vulnerable while infighting takes place /3
nytimes.com/2021/09/13/hea…
Read 8 tweets
Eric Topol Profile picture
13 Sep
A new @TheLancet viewpoint by an international panel on boosters: "To date, none of these studies has provided evidence of substantially declining protection against severe disease." …s-jbs-prod-cdn.jbs.elsevierhealth.com/pb-assets/Lanc… But that'll change w/ this week's @NEJM Israel report, Pfizer💉, age >60
This is where I disagree w/ the panel. Many studies on reduced efficacy have been published in the media & preprints. Waiting for "robust data" that is adjudicated by the eminent authorities is not how it works. The public wants to know, has a right to know, and that builds trust
Read 4 tweets

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