1. The preprint from the @NIH mix-&-match #Covid vaccine trial is out. Interesting though not surprising findings. It is too bad the study was conducted using a full dose of Moderna's vaccine, given the fact the company's booster is a half dose. medrxiv.org/content/10.110…
2. The fact that the study used 2x as much vaccine in the Moderna arm than Moderna is proposing to give people with its booster shot means the Moderna findings have to be taken with a big grain of salt. It's a huge shame.
3. The study found all boosters did what the name implied — they boosted antibody levels. But mRNA boosters did it more than the J&J vaccine did.
Caveat: These findings are based on antibodies in blood not vaccine effectiveness trials. Don't know how long the boost will last.
4. The list of limitations on the mix-&-match study are sobering. These data point in a direction. But to paraphrase @matthewherper, they aren't a lot to make policy on.

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More from @HelenBranswell

1 Oct
1. If you're a fan of #VRBPAC — and seriously, who isn't a fan of VRBPAC? — October is going to be a banner month.
3 upcoming meetings. More boosters! Mix-&-match! #Covid vaccine for kids!
fda.gov/news-events/pr…
2. @US_FDA announced this afternoon it will convene its vaccines advisory committee, #VRBPAC, on Oct. 14 & 15 to discuss booster shots for both the Moderna (Oct. 14) & J&J (Oct. 15) vaccines.
That will be especially welcome news for J&J recipients, I think.
3. As a bonus, the Oct. 15 meeting will include discussion of data from the NIH's mix-&-match study, where they've been looking at whether boosting with a different vaccine works as well or better, aka a heterologous boost. This is critical info for the best use of Covid vaccines
Read 4 tweets
29 Sep
1. As we look to the coming winter in the Northern Hemisphere, 2 big Qs loom. What's going to happen with Covid? & Will #flu return in a significant way this winter?
@WHO's biweekly flu update suggests transmission remains at low levels globally.
All data below are from @WHO.
2. There are smatterings of #flu here and there around the globe. Some flu B in the Caribbean & Central America. Some flu A in parts of Africa and Asia.
3. How much #flu is out there? Of nearly 276K flu tests run in 88 countries from 8/30-9/12, 1,884 were positive for flu — 0.68%.
During the same 2-week period in 2019 (ie before Covid) 7.4% of tests globally were positive for influenza. In 2020, it was 0.04%, ie almost none.
Read 8 tweets
26 Sep
1. Belatedly looked at this week's FluView from @CDCgov. There's something to watch here.
A child or teen in Ohio contracted a swine flu virus — an H1N2. Public health investigations can find no link between the person & pigs, ie didn't live on a farm, didn't attend a state fair.
2. Public health has concluded it is possible this person was infected by another person. According to @CDCgov, they can see no evidence of ongoing person-to-person spread. But this bears watching. The 2009 flu pandemic was caused by a swine #flu virus.
3. There are a number of cases every year of people contracting a swine #flu virus in the US. Ten reported so far this year. Typically they occur in people who live or work on a farm with pigs, live with someone who works with pigs or has had contact with pigs at a fair.
Read 4 tweets
23 Sep
1. Good day. #ACIP is meeting today to vote on recommendations about who should receive a booster shot of the Pfizer #Covid vaccine. The meeting starts at noon ET. I will be live tweeting.
@US_FDA's EUA for the Pfizer booster is veeeeeery broad. statnews.com/2021/09/22/fda…
2. The meeting is underway. Doran Fink of @US_FDA is now explaining FDA's EUA for the Pfizer booster, which was issued last night.
My observation: The group of people eligible for a booster under this EAU is very broad. 16-17 yos are excluded but many over 18 will be eligible.
3. @CDCDirector is addressing #ACIP. She acknowledges that the committee has to make decisions, sometimes with a huge amount of data, sometimes with "a paucity."
She mentions pregnant people.
My observation: Oddly, there was no mention of them in the FDA EUA.
Read 50 tweets
22 Sep
1. Good morning. #ACIP is meeting today and tomorrow. Today, at least, I will be live tweeting.
@US_FDA has not yet indicated what it is going to do with Pfizer's application for a booster license. So it's really completely up in the air at this point how this turns out.
2. You'll recall FDA's advisory committee, #VRBPAC, voted that there wasn't enough data to approve the Pfizer application to give a booster to everyone 16 & older. VRBPAC did agree there was enough data to authorize boosters for people 65 & older & people at high risk.
3. But as I mentioned, FDA hasn't indicated what it's going to do. It is not bound to follow #VRBPAC's advice, but it will cause a real stir if it does not. If it doesn't follow VRBPAC's advice, it may set up a situation where a second advisory committee #ACIP disagrees with FDA.
Read 46 tweets
13 Sep
1. Some unsettling #rabies exposure stories in a post from the invaluable @ProMED_mail tonight.
Some people in RI were feeding a raccoon that later testing showed was infected with rabies.
People: Do not feed raccoons. They do not need your help. local21news.com/newsletter-dai…
2. A grey cat that was hanging around a campground in Frederick County, Md, tested positive for #rabies. There were reports the cat was biting & scratching people between Aug 24 & Sept 3. People exposed or people whose pets were exposed to the cat should contact their MD or vet.
3. A link to the cat story here.
Important to know: #Rabies is fatal without quick post-exposure treatment. wfmd.com/2021/09/08/cat…
Read 4 tweets

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