The Pfizer booster trial is pretty spectacular.

10k previously 2x dosed (median 11 months from dose 2).

Randomised 1:1 placebo and 30ug.

95.6% relative risk reduction in symptomatic infection in intervention arm vs control (2dose only).

5 v 109 events 7+ days from boost.
To repeat: 95.6% RR reduction in symptomatic infection was for 3 vs 2 DOSES

UK data has 2dose Pfizer at ~80% VE vs symptomatic infection in Delta era. But follow up time <11 months in Pfizer trial.

If boost anywhere near 90% RR⬇️ we're looking at ~98% VE vs immunonaive.
They found no statistical difference for age, sex, race, ethnicity, or co-morbidities within the limitation of study size.

The primary course in the trial would have been with a 3-4 week dose interval between dose1 and dose2. (cf 10 week typical in UK).

pfizer.com/news/press-rel…
Phase2 neutralisation data that complements this RCT👇

We should just call Pfizer a 3 dose primary vaccine regimen (others similarly).

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Devan Sinha

Devan Sinha Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @DevanSinha

9 Aug
80% [78,82] of England's Total population have now been vaccinated or infected

Wall of immunity:

10% Infected only
19% Both infxn+vax
51% Vaccinated 1or2 doses

Usual caveats: time lag after vax, not 100% protective, assumes random vaxing probability of previously infected etc
Remaining 11.5m unexposed/unvaxxed susceptible population is heavily skewed to younger age groups.

80% under 25yo
47% in school age kids 5-14yo

Outbreaks and cases will expectedly be concentrated in these groups now and increasingly <15 after current vax roll out plan completed
Quick check of the model against ONS serosurvey and PHE blood donor antibody surveillance, in 16yo+:

Model 95.8% (up to 8 August)
ONS 93.6% (12 - 19 July)
PHE 96.2% (28 June - 23 July)

Looks okay.
Read 7 tweets
26 May
70% [68,72] of England's Total population have now been infected or vaccinated.

Wall of immunity:

13% Infected
44% Vaccinated 1+
13% Both

Usual caveats: time lag after vax, not 100% protective, assumes random vaxxing probability of previously infected etc.

1/
Estimated numbers of people:

7.0m Infected only
24.7m Vaccinated only
7.5m Infected & vaccinated

17.1m unexposed and susceptible

2/
The remaining 17.1m unexposed/susceptible population is heavily skewed to younger age groups.

2/3 under 25
1/3 in school age kids 5-14yo

Outbreaks and cases will expectedly be concentrated in these groups now and increasingly <18 after current vax roll out plan completed.

3/
Read 5 tweets
23 May
Grateful for the hard work of dedicated public health scientists at @PHE_uk like @kallmemeg and unsung others who work overtime to produce excellent reports on the variant of concern B1.617.2 🇮🇳

🧵analysis of vax effectiveness, and why interpretation of reduced VE limited.

1/
PHE did a 'test negative case control study' w/ logistic regression as I outlined yday.

From test and vax databases they retrospectively created a control cohort of 99k who tested negative and compared to 6.4k test positive for B117 & 1k for B1.617.2

2/

PHE found a statistically significant dip in symptomatic protection after 1 vax dose.

51% ➡️ 33% against B1.617.2 variant (yellow).
For both Pfizer and Ox/AZ (21 days after 1st dose).

No statistically significant change after 2 vax doses (14 days after 2nd dose).

3/
Read 21 tweets
22 May
This is good news.

The longer it takes to statistically tell difference between vax effectiveness against variants the smaller the actual dip (if any) in protection will be.

1/
In randomised control trials we can be confident in vax effect after only 100+ infections because selection bias and confounding variables between the vaxxed and unvaxxed comparison populations are (e)limited by the randomisation process.

2/
This is not the case when we do retrospective observational studies - like vax effectiveness against variants in the field.

The statistical analysis is more challenging. There are biases in who is vaxxed or infected, living, working, mixing patterns, medical health/immunity.

3/
Read 7 tweets
16 May
JCVI extension of vax dosing interval to 12 weeks is a great public health decision.

3.5X higher peak antibody levels w/ Pfizer if delayed boost vs 3 week.

Really important for protection against variants and duration esp in vulnerable🧵

1/

nature.com/articles/d4158…
We kept seeing 1 dose vax after prior infxn boosting Ab tires 3X higher than 2 doses at the standard 3 week interval. Some of us wondered if this was from optimised prime-boost interval at the time...

It now looks like a probable explanation.

2/

3 weeks on short side of intervals, where immune response hasn't completely matured after prime stimulus.

Delay may selectively expand population of long lived plasma cells (B cell derivatives) too.

Delayed boost shown to have better Ab response across prev vax types👇

3/
Read 15 tweets
29 Apr
Fantasy commentary letter in Lancet (not a peer reviewed study)!

It's an unreasonable proposition for most countries like the UK to achieve elimination + constraints of reality negates claimed economic and liberty benefits if attempted...

1/

thelancet.com/journals/lance…
Despite pre-flight screening and quarantine Australia and New Zealand have failure rate of 4.8 per 100k travellers. SARS-COV-2 cases slip through!

2/

medrxiv.org/content/10.110…
Those cases slipping through results in necessary lockdown (regional or state wise) to eliminate community transmission.

Up to January 31, 2021:
Australia 7 failures, with 1 causing 800 deaths
New Zealand 9 failures, 1 causing an outbreak of 3 deaths

more since

3/
Read 18 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!

:(