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Vincent Rajkumar Profile picture
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22 Sep, 4 tweets, 2 min read
Somewhere in the last few days Mississippi became only the second state (after Florida) to average more daily deaths from COVID than all previous waves.

Only 43% are fully vaccinated in Mississippi.
It's pretty hard to exceed peaks set prior to arrival of vaccines. It's a cause for concern. Louisiana and Georgia are nearing this level and I hope rates in those states goes down soon.
Vaccinate rates are low in Georgia and Louisiana, 44% and 45% respectively. nytimes.com/interactive/20…
Thanks to @CharlesRenPara1 for this figure which plots COVID ICU hospitalization per million versus % fully vaccinated by state/province in USA (blue) and Canada (red). You may have to zoom in to see the details.

Vaccines work really well.

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More from @VincentRK

Vincent Rajkumar Profile picture
23 Sep
The FDA seems to have been more lenient on who should get the booster dose than the CDC panel. How's is that going to play out?
Unlike the FDA, the CDC panel has not recommended a booster for those at high risk of occupational exposure. Something that an FDA advisory panel unanimously voted to recommend to the FDA. And the FDA obliged.
So we have an FDA approved EUA indication that is not recommended by the CDC panel.

Unless CDC director revises it, I think it will be interesting how this plays out for healthcare workers and teachers.
Read 6 tweets
Vincent Rajkumar Profile picture
23 Sep
Please don't think of it as natural immunity vs vaccine induced immunity. Think of it as a risky versus safe way of getting immunity.

Both present antigen to the immune system which responds in the natural way it was designed to. #COVID19
The whole virus which is capable of dividing presents the immune system with a bigger challenge & can overpower some people. Even previously healthy.

It also can cause serious damage before the immune system can react.

A vaccine provides the immune system a safer target & time
The word "natural" makes it sound like the virus is some kind of healthy fruit growing on a tree. It's not.
Read 4 tweets
Vincent Rajkumar Profile picture
23 Sep
Eta, Iota, & Kappa are no longer variants of interest. Well that's good! Maybe there is an end in sight; the rain of serious variants has slowed.

All 4 variants of concern were documented last year. None new this year.

Of the 2 variants of interest, none new since Jan 2021. Image
Variants of concern. See below.
HT @MenonBioPhysics Image
More details here @WHO who.int/en/activities/…
Read 4 tweets
Vincent Rajkumar Profile picture
22 Sep
CASSIOPEIA trial maintenance results in myeloma: Main takeaway is that daratumumab maintenance provided ZERO benefit if daratumumab was given as induction/consolidation

This PFS curve (blue versus yellow line) should have been in the main paper, not the Appendix. @TheLancetOncol
Key points

1) When this trial was designed we were already using lenalidomide maintenance as standard. This trial had a no treatment control arm. So the question is how good is Dara maintenance against Len. Not Dara maintenance against nothing.
2) If 6 cycles of Dara given upfront provides the same as many years of Dara maintenance, it is preferable to give the Dara at induction. Not as maintenance.

The myeloma field is moving in this direction giving Dara upfront.
Read 12 tweets
Vincent Rajkumar Profile picture
21 Sep
Two doses of J&J vaccine provide outstanding protection against COVID. Wish J&J vaccine had always been a two dose approach from the outset , from when they designed the phase III trial. cnn.com/2021/09/21/hea…
From 3 different studies we see now that 2 doses offer outstanding protection comparable to mRNA vaccines.

cnn.com/2021/09/21/hea…
Of course to defend the single dose approach there is the obligatory "our one dose approach is excellent statement"

But that's hardly the question. In terms of efficacy and durability there was no reason to think 2 doses won't be better than one. Basic immunology.
Read 7 tweets
Vincent Rajkumar Profile picture
20 Sep
Canada is almost 70% fully vaccinated. Only 5 states are close to that level in the US. Why?

% Fully vaccinated disparity:
12 states 60-70%
19 states 50-60%
19 states 40-50%
nytimes.com/interactive/20…
How it looks for COVID related deaths since vaccinations started.
Too 12 states. Note only few are at the level of Canada.
Read 8 tweets

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