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:
4/
5/ Yes, they can produce mRNA vaccines.

If we share the recipes and manufacturing know-how.
6/ Where?
7/
8/
9/
10/
11/
12/
13/ So why, again, can't Moderna share their manufacturing know-how?
14/
15/ mRNA vaccines are highly profitable.

There are even BIGGER profits to be made on using mRNA vaccine technology for cancer and other diseases.

Of course, Moderna doesn't want to share.
16/ Meanwhile, the USG is afraid China & Russia will get their hands on lucrative mRNA technology.

Something the WSJ acknowledges here:
wsj.com/articles/biden…
17/ And yes, the USG has the right:

healthaffairs.org/do/10.1377/hbl…
18/ The USG owns the '070 patent on Spike protein stabilization technology that's used by the Moderna & J&J vaccines.

We should be using that lever to pressure Moderna to supply low- & middle-income countries with COVID vaccine.

justhumanproductions.org/podcasts/s1e75…
19/ It's HIV all over again.

It's racist.

They said Indian, African, & Latin American pharmaceutical companies couldn't make antiretrovirals.

But then they did.
20/ COVID is HIV part deux.
21/ And how long will this take?
22/
23/ 6 months
24/ You can't fight scarcity with scarcity.

justhumanproductions.org/podcasts/s1e76…
25/ When you put shareholders over stakeholders,

and profits over people,

people die.

• • •

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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/ 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

Read 5 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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