1/ On mixing & matching COVID shots, by @KatherineJWu in @TheAtlantic:
theatlantic.com/health/archive…

If you're eligible for an additional dose of COVID vaccine, you can get whichever you want (Pfizer, Moderna, or J&J).
2/ There were only ~50 people in each 9-arm of the NIH mix & match study for a total of less than 500.

Moderna was given full-dose (100 mcg) in the NIH mix & match study, not half-dose (50 mcg) as approved for boosters.
Higher dose➡️more side-effects

4/ FWIW, I got my 1st dose of Pfizer in December and my 2nd dose in January.

I am a healthcare worker. I am under 65 and don't have chronic medical conditions.

I have not gotten a booster because my risk of severe disease, hospitalization, & death has not increased.
5/ If there's evidence that immunity to vaccination in people like me is waning and that I'm at increased risk of severe disease, hospitalization, or death, I will seek out a 3rd dose of vaccine, and that will likely be a Pfizer shot because that's what I would be offered.

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More from @celinegounder

24 Oct
1/ Why can't we just test people to see if they have immunity to SARS-CoV-2 and decide whether they need to be vaccinated based on that test result?

jamanetwork.com/journals/jama/…
2/ Commercially available tests (what you'd get through your doc's office / urgent care clinic) measure binding, not neutralizing antibodies.

While there is a correlation, it's an imperfect one.

We don't know what level of neutralizing antibodies are necessary for protection.
3/ Some tests only pick up antibodies after infection (e.g. antibodies to nucleocapside protein).

Others pick up antibodies after infection or vaccination (e.g. antibodies to spike protein).
Read 7 tweets
22 Oct
1/ Important reporting by @snolen for @nytimes today:
nytimes.com/interactive/20…

We keep being told: "Yes, we know. It's not right. It's a really hard problem. We're doing everything we can."

No, that's not Facebook on disinformation (well, that too).

That's the USG & Moderna.
2/ It makes no sense when you want to maintain control over the technology.

You could TRAIN people how to make mRNA vaccines.
3/ Thanks to @DrTomFrieden, @Public_Citizen, @PrEP4AllNow, & @MSF_USA for beating the drum on this:
Read 25 tweets
21 Oct
1/ Some interesting slides from today's @CDCgov ACIP meeting:
cdc.gov/vaccines/acip/…

Waning immunity?
Or the Delta factor (more infectious, somewhat more immune-evading)?

Some of both.
But in 65+, it's the Delta factor.
2/ Also, those 65+ have a weaker immune response up front.

I'd expect to see the same among immunocompromised persons.

Immunosenescence is a form of immunocompromise.
3/ Why is there ⬇️VE vs hospitalization over time among those among 18-44 yo with 1+ non-immunocompromising chronic conditions?

Confounding by behavior?

If real, this would justify different eligibility criteria by race based on "weathering" argument:
washingtonpost.com/opinions/black…
Read 9 tweets
21 Oct
1/ @TheAtlantic's @KatherineJWu expands on B-cell immunology & antibodies:
theatlantic.com/science/archiv…

I've been trying, but I'm not sure it's getting through:
theatlantic.com/ideas/archive/…
newyorker.com/news/q-and-a/w…
2/
3/
Read 7 tweets
21 Oct
1/ Colin Powell warned that HIV/AIDS posed “a clear and present danger to the world," that it was a global security issue.

Today the White House, Pentagon & intelligence agencies warn that climate change is a global security threat.

washingtonpost.com/national-secur…
2/
- China & others could take advantage of rising seas & melting glaciers
- drought & other extreme weather can spark conflicts and forced displacement—countries like China & Russia are poised to take advantage
3/ 11 countries in that category of acute risk: Afghanistan, Colombia*, Guatemala*, Haiti*, Honduras*, India, Iraq, Myanmar, North Korea, Nicaragua* & Pakistan.

* half in our backyard
Read 12 tweets

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