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Vincent Rajkumar Profile picture
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14 Oct, 4 tweets, 2 min read
If you see tweets that Waterford, Ireland is having the highest number of COVID cases in Ireland, even though >90% of adults are vaccinated.

1) Vaccination has kept the disease mild.
2) 70% in ICU are not fully vaccinated. irishtimes.com/news/health/no…
More here. irishtimes.com/news/health/co…
Lesson for all of us: There is waning immunity after two doses of vaccination, especially in the elderly. This is why boosters are recommended. The risk of transmission is still there which is why for now masks and other preventive measures are recommended.
Here is Dr. McNamara saying what we should all take to heart. Wherever we live. irishtimes.com/news/health/no… Image

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Vincent Rajkumar Profile picture
15 Oct
IQVIA report: Good news is drug spending as % of healthcare spending is stable at ~15%.

Worrisome: While $ spent on cholesterol, antibiotics, & ulcer meds is lower, the ones rising are ones that will continue go up: oncology, immunology, diabetes. iqvia.com/Insights/The-I… Image
That's because cholesterol drugs and peptic ulcer drugs work chronically. Not just a few months and stop. So when you have a lot of generics, prices go down due to competition.

In contrast, oncology, immunology drugs are either ones that don't work for very long or are biologics
So there will continue to be newer and more expensive drugs each year and we are not seeing that effect yet. Every new cancer drug sold since 2017 has been >$100,000 per year. And that opening price has kept going up. These drugs also work only for a few months on average.
Read 5 tweets
Vincent Rajkumar Profile picture
12 Oct
What about natural immunity? A thread.

I'm not a virologist or vaccinologist. I'm addressing this issue as someone whose career has been focused on plasma cells, the cells that make antibodies, for over 20 years. 👇
1) When first exposed to an antigen, virus or vaccine, the immune system produces a primary immune response. On exposure to same antigen again, it produces a better, bigger, and more durable secondary response. Basic immunology. microbiologynotes.com/differences-be…
Sometimes the first infection gives a long enough exposure to the antigen to stimulate the secondary response. Sometimes it's not. Depends on the virus and duration of infection.
Read 11 tweets
Vincent Rajkumar Profile picture
12 Oct
I hope that the fourth time is the charm.
This time around a lot more people have immunity than in previous waves. So there is more reason to hope.

>215 million have received one dose of vaccine. >400 million doses administered. Probably a third to half the country has had COVID.
Worries that threaten hope: First worry is that 60-80 million are still very susceptible. A second worry is duration of immunity; but this should be quite good and long lived at least in terms of protection against severe disease. A third worry is potential rise of a new mutant.
Read 4 tweets
Vincent Rajkumar Profile picture
11 Oct
The US had crossed over 400 million doses of COVID vaccine administered.
We have get the rate higher. But this is a great accomplishment. Under 10 months. ourworldindata.org/covid-vaccinat…
This has been accomplished even though I think the extent of anti vaccine misinformation has been the highest in the US. Public health leaders have tried their best to convince the hesitant.

We have 70 million eligible people left to reach.
Read 4 tweets
Vincent Rajkumar Profile picture
9 Oct
What proportion of the US has some immunity to COVID— where the immune system is not totally caught by surprise?

215 million have received at least 1 dose of vaccine.

40-60 million of the rest likely have had COVID.

That still leaves 60-80 million who are very susceptible.
The true number at risk of severe COVID is hard to estimate because some people who have been vaccinated or have had COVID may not have adequate protective immunity due to underlying comorbidities like cancer or other immunosuppressive disorder.
The unvaccinated include 50 million not yet eligible for vaccination. If a vaccine approval comes, this number will come down.
Read 4 tweets
Vincent Rajkumar Profile picture
4 Oct
Study of 3.4 million people @aboutKP @TheLancet

Vaccine efficacy against infections:
- First month post: 88%
- 5 months post: 47%

But vaccine efficacy against hospitalization (Figure):
- First month post: 87%
- 5 months post: 88 %

thelancet.com/journals/lance…
No significant difference in rate of decline in vaccine effectiveness between delta and other variants.

Vaccine efficacy against hospitalizations 93% for delta and 95% for other variants.

thelancet.com/journals/lance…
Bottomline is that some drop in efficacy against infections is seen over time, but protection against severe illness remains constant. Vaccines are working great in this study as in multiple others which have demonstrated the same thing.

#GetVaccinated
Read 7 tweets

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