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Céline Gounder, MD, ScM, FIDSA

11 Oct, 8 tweets, 3 min read

1/ Study of ~9M people in NYS
medrxiv.org/content/10.110…

May: NYS adopted CDC guidance for fully-vaxxed
June: end of NYS’ state of emergency (⬇️mask-wearing, distancing etc)
July: CDC recommended mask usage for fully-vaxxed based on transmission levels
July: Delta became dominant

2/ COVID vaccine effectiveness vs HOSPITALIZATION:

Among 18-49 year-olds:

Pfizer/Moderna: >90%
* except June with 87% for Moderna

J&J: >90%
* except June with 54%

* related to behavior? (see #1)

3/ COVID vaccine effectiveness vs HOSPITALIZATION:

Among 50-64 year-olds:
Pfizer/Moderna: >90%
J&J: 87-93%

STABLE OVER TIME.

4/ COVID vaccine effectiveness vs HOSPITALIZATION:

Among ≥65 year-olds:
Pfizer: 93-95% (May)➡️86-90% (August)
Moderna: 96-97% (May)➡️93-94% (August)
J&J: 80-90%

5/ COVID vaccine effectiveness vs lab-confirmed CASES:

Among 18-49 year-olds:
Pfizer: 94%➡️66%➡️69% (May-July)
Moderna: 97%➡️77%➡️78% (May-July)
J&J: 89%➡️52%➡️70% (May-July)

6/ COVID vaccine effectiveness vs lab-confirmed CASES:

Among 50-64 year-olds:
Pfizer: 95%➡️72%➡️76% (May-July)
Moderna: 97%➡️86%➡️83% (May-July)
J&J: 87%➡️73%➡️76% (May-July)

7/ COVID vaccine effectiveness vs lab-confirmed CASES:

Among ≥65 years-olds:
Pfizer: 92%➡️79%➡️78% (May-July)
Moderna: 96%➡️87%➡️84% (May-July)
J&J: 82%➡️79%➡️71% (May-July)

8/ These data support giving additional doses of vaccine to persons 65+ to reduce risk of disease and hospitalization.

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More from @celinegounder

Céline Gounder, MD, ScM, FIDSA

@celinegounder

12 Oct

1/ How can the SARS-CoV-2 virus evolve?

- To become more transmissible (e.g. the Alpha & Delta variants)
- To evade immune responses (e.g. the Beta & Gamma variants)
- To become more virulent

nytimes.com/2021/10/12/hea…

2/ There are limits on how infectious a virus can become. But have we reached that limit with SARS-CoV-2? We don't know.

3/ The SARS-CoV-2 virus can also evolve to escape our immune responses.

Fortunately, we are protected by multiple branches of our immune system.

Read 5 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

11 Oct

@drlucymcbride

1/ Sage COVID advice from @drlucymcbride :
theatlantic.com/ideas/archive/…

2/ WE NEED THE SERENITY TO ACCEPT THE THINGS WE CANNOT CHANGE:

COVID is here to stay.
SARS-CoV-2 cannot be eliminated.
The virus will become endemic (i.e. ongoing community transmission).

3/ ...THE COURAGE TO CHANGE THE THINGS WE CAN:

Maximize use of testing, ventilation, & air filtration.
Tailor based on individual risk.
Masks in some settings.
Support caregivers.
Paid sick leave.
Better treatment/care for long COVID patients as well as disability benefits.

Read 5 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

9 Oct

1/ Black pastors are preaching God's word & public health.
They're working to save the souls & lives of their flock.

nytimes.com/2021/10/09/nyr…

2/ Only 55% of Black New Yorkers have received at least one vaccine dose.

Black & Brown people have good reason to doubt the government & health system:
justhumanproductions.org/podcasts/s1e68…

3/ Vaccination rates are even lower among young Black New Yorkers:
Only 48% between 18 and 44 have gotten at least one dose of COVID vaccine

And only 30% of Black Americans under 40 attend a Black church.

Read 4 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

9 Oct

@FrancesHaugen

1/ Facebook whistleblower @FrancesHaugen joined @WSJPodcasts in Part 6 of the Facebook Files:
wsj.com/podcasts/the-j…

2/ Some highlights:

at 8:30

Vaccine disinformation is being targeted at these groups, too:

justhumanproductions.org/podcasts/s1e72…

justhumanproductions.org/podcasts/s1e74…

3/ at 10:50

Top 10 Facebook threats to democracy AND public health:

hate speech
misinformation
harassment
impersonation
voter suppression

Read 7 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

8 Oct

@NEJM

1/ New @NEJM paper from Qatar on Pfizer vaccine effectiveness vs SARS-CoV-2 infection, severe COVID, or death from COVID.

nejm.org/doi/full/10.10…

2/ The study population included Qatar *residents*.

Note that 90% of people in Qatar are economic migrants from South Asia and other countries.

🤔

3/ Vaccine effectiveness vs INFECTION:
- Peaks at 78% ~1 month after 2nd dose of Pfizer vaccine
- Declines over time

Read 10 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

7 Oct

@NEJM

1/ New @NEJM study from Israel on immunity from Pfizer vaccine out to 6+ months.
nejm.org/doi/full/10.10…

Study participants were healthcare workers at a big hospital.

They provided blood samples before getting vaccinated & then monthly x 6 months.

None had COVID prior to vaxx.

https://twitter.com/celinegounder/status/1417549373987344391?s=20

2/ Antibody responses were measured for 6 months after 2nd dose of the Pfizer vaccine.

Antibody titers were highest days 4-30 after 2nd dose.

Antibody titers dropped over time.

THIS IS TO BE EXPECTED.

https://twitter.com/celinegounder/status/1417549373987344391?s=20

3/ Not surprisingly, antibody titers started lower and dropped down lower among older persons (65+) than younger persons (<45).

Read 15 tweets

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