1/ PRE-PRINT results on NIH's mix & match COVID vaccines study:


Matched (same) vaccine:
⬆️neutralizing antibody levels 4-20x

Mixed (different) vaccine:
⬆️neutralizing antibody levels 6-76x
3/ Best boosts?

Based on neutralizing antibody titers at day 15 after boost:

After Moderna:
Moderna > Pfizer > J&J

After J&J:
Moderna > Pfizer >>> J&J

After Pfizer:
Moderna > Pfizer > J&J
4/ Note that this study looks only at binding and neutralizing antibody titers out to 15 days after boost.

Data on 29 days after boost are pending for some of these groups, so can't compare out that far yet.
5/ We don't know how much antibody levels will wane (AND THEY WILL) over time for each group.

We also don't know what the impact of these booster doses is on B- and T-cell immunity,

or risk of infection, symptomatic disease, hospitalization, or death.
6/ We also don't know if boosters performed differently by demographic group (e.g. elderly, immunocompromised).

And this only looked at binding and neutralizing antibody titers vs D614G (early variant) not vs the Delta, Beta, or other variants.
7/ Note that the study participants were overwhelmingly white.

All were considered healthy.
(So I assume that means none had underlying co-morbidities–like heart disease, diabetes, or obesity–that would predispose to severe disease if one were infected?)
8/ One more point on neutralizing antibody titers:

These are a reflection of:
Quantity of antibodies
Affinity of antibodies
Breadth of antibodies

It would be interesting to see affinity vs breadth of antibodies by regimen.

• • •

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More from @celinegounder

15 Oct
1/ @CDCgov data on COVID deaths among vaccinated vs unvaccinated:

In August, unvaccinated persons had a 11.3x higher risk of dying from COVID than vaccinated persons.

covid.cdc.gov/covid-data-tra… Image
2/ The risk of dying from COVID among vaccinated persons:
Moderna < Pfizer < J&J

covid.cdc.gov/covid-data-tra… Image
3/ The risk of dying from COVID by vaccination status & age group:

At highest risk of death:
unvaccinated, 65+ years-old

At lowest risk of death:
vaccinated, 18-64 years-old
unvaccinated, 18-29 years-old

covid.cdc.gov/covid-data-tra… Image
Read 6 tweets
15 Oct
1/ Who Needs a COVID Booster Shot?

scientificamerican.com/article/who-ne… Image
2/ Who Needs a COVID Booster Shot? (continued)

scientificamerican.com/article/who-ne… Image
3/ Who Needs a COVID Booster Shot? (continued)

scientificamerican.com/article/who-ne… Image
Read 12 tweets
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

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
11 Oct
1/ Study of ~9M people in NYS

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%

Read 8 tweets
11 Oct

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

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
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… Image
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:
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

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