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Céline Gounder, MD, ScM, FIDSA

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15 Oct, 12 tweets, 6 min read

1/ Who Needs a COVID Booster Shot?

scientificamerican.com/article/who-ne…

2/ Who Needs a COVID Booster Shot? (continued)

scientificamerican.com/article/who-ne…

3/ Who Needs a COVID Booster Shot? (continued)

scientificamerican.com/article/who-ne…

4/ Are there any groups of people you think should get a third shot?

scientificamerican.com/article/who-ne…

5/ Are there any groups of people you think should get a third shot? (continued)

scientificamerican.com/article/who-ne…

6/ Do you agree with the CDC’s decision to recommend boosters for people at high risk of exposure through their job, such as health care workers?

scientificamerican.com/article/who-ne…

7/ What is your reaction to the FDA advisory panel’s recommendations on Moderna boosters?

scientificamerican.com/article/who-ne…

8/ What is your reaction to the FDA advisory panel’s recommendations on Moderna boosters? (continued)

scientificamerican.com/article/who-ne…

9/ Is the Moderna vaccine more effective than the other vaccines?

scientificamerican.com/article/who-ne…

10/ Should people mix and match vaccines?

scientificamerican.com/article/who-ne…

11/ Should people mix and match vaccines? (continued)

scientificamerican.com/article/who-ne…

12/ What are you telling your own family and friends about whether they need a booster?

scientificamerican.com/article/who-ne…

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More from @celinegounder

Céline Gounder, MD, ScM, FIDSA

@celinegounder

16 Oct

@MSNBC

1/ The only vaccine for which we give a single dose is the yellow fever vaccine.

We give 2, 3, or 4 doses of all other vaccines.

nytimes.com/2021/08/09/opi…

with @MSNBC's @AliVelshi in for @maddow

https://twitter.com/celinegounder/status/1449069989957406725?s=20

2/ It was a noble effort to try to develop a 1-dose COVID vaccine.

Simpler logistics.

More equitable:
Only have to address barriers (e.g. time off work, childcare, transportation) x1 instead of x2.

https://twitter.com/celinegounder/status/1449069989957406725?s=20

https://twitter.com/celinegounder/status/1449005266268196867?s=20

3/ If you got a single dose of J&J vaccine, what should you get for a second dose?

See:

https://twitter.com/celinegounder/status/1449005266268196867?s=20

https://twitter.com/celinegounder/status/1448356527702675458?s=20

Read 4 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

15 Oct

@DeptVetAffairs

1/ Data from the @DeptVetAffairs VA on vaccine effectiveness to INFECTION (*not* hospitalization/death).

⬇️vaccine effectiveness vs INFECTION over time driven by the rise of the more infectious Delta variant.

2/ Vets under 50 by vaccine:
Blue = J&J
Red = Moderna
Gray = Pfizer
Black = unvaccinated

3/ Vets under 50-64 by vaccine:
Blue = J&J
Red = Moderna
Gray = Pfizer
Black = unvaccinated

Read 5 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

15 Oct

1/ Comparison of immune responses to Pfizer, Moderna, & J&J vaccines over 8 months post-vaxx.

Neutralizing antibodies:
- Pfizer: peaked high, then ⬇️ over time
- Moderna: peaked highest, then ⬇️ over time
- J&J: lower peak, but stable (?⬆️)over time

nejm.org/doi/full/10.10…

2/ Another look at neutralizing antibody responses for Pfizer, Moderna, and J&J vaccines over time:

3/ With all three vaccines, functional antibody responses (antibody-dependent cellular phagocytosis & antibody-dependent complement deposition) were stable over time:

Read 9 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

15 Oct

@CDCgov

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…

2/ The risk of dying from COVID among vaccinated persons:
Moderna < Pfizer < J&J

covid.cdc.gov/covid-data-tra…

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…

Read 6 tweets

Céline Gounder, MD, ScM, FIDSA

@celinegounder

13 Oct

https://twitter.com/celinegounder/status/1442920120909582337?lang=en

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

medrxiv.org/content/10.110…

https://twitter.com/celinegounder/status/1442920120909582337?lang=en

2/
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

Read 8 tweets

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

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Céline Gounder, MD, ScM, FIDSA

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