Share this page!

Monica Gandhi MD, MPH Profile picture
Twitter logo
27 Oct, 9 tweets, 3 min read
WHY DID THAT ISRAELI STUDY SHOW BETTER PROTECTION FROM NATURAL IMMUNITY THAN VAX? Because complicated as everything is in COVID. Ignore tweets at top of this thread as re-infection with delta way more common now - summarized some studies of natural vs vax
Okay, so the rate of natural infection in Israel was 3.8% in September & vax rolled out early (we don't have good seroprevalence data in winter, sorry). CA had 38% seroprevalence when vax rolled out to general population here
twitter.com/i/web/status/1…
That Israeli preprint does not tell us breakdown of severe infections versus mild but data compelling that more durable responses in severe infections. Ok, then you give ONLY Pfizer in a country with low natural immunity at strict 3 week intervals
So, you give a vax in a way that provides the lowest effectiveness (every 3 weeks) in a country that recognizes severe disease (even when not in hospital) -maybe those with natural immunity had stronger immunity than the Pfizer 3 weekers. Systematic review
medrxiv.org/content/10.110…
And Kentucky case control study from US had problems too (see my first thread) that showed vax better than natural infection so we need clean data (coming from Johns Hopkins) on this comparison in US. Think hybrid immunity providing most durable control
So, would look at California (38%) and Italy (30%) natural immunity with high rates of vax (80% >12) to provide more durable ANTIBODY (not T cells- seem to be holding up really well against severe disease!) immunity which prevents delta in nose cases (VT, Singapore <3%; UK 9.8%)
Here is data showing 9.8% seroprevalence in UK prior to roll-out of vaccine. Recent cases (remember fully open since July) as didn't vax young people 12-15 until recently; think to "get there" we need more & more vax'd even young
bmj.com/content/372/bm…
Seroprevalence in Vermont before vax 1.7% (reference). VT cases rising now in colder weather but NOT hospitalizations/severe disease to date. So, in CA, is it the 38% seroprevalence prior to vax which leads to more diverse antibodies, less delta in nose?
covid19serohub.nih.gov
"New daily infections in Vermont, with 71% population fully immunized, trending upward...state, home to about 620,000 people, never averaged more than 2 daily deaths since January, however". Protection against severe disease (like in Denmark) maintained
washingtonpost.com/nation/2021/10…

• • •

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

Keep Current with Monica Gandhi MD, MPH

Monica Gandhi MD, MPH 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 @MonicaGandhi9

Monica Gandhi MD, MPH Profile picture
28 Oct
MISTAKEN MESSAGES: Think these 2 messages continue to decrease confidence in the vaccines: 1) Vaccines don't reduce transmission: Untrue. CDC data shows 6x less likely to get infected if vax'd to begin with; 2) Boosters needed so didn't work but 2-dose vax holding up really well
Mistaken message #1: Here is thread on why you are less likely to transmit if vaccinated (which is compelling reason that vaccines protect you and others)
Mistaken message #2: Nice article today about how well the original vax holding up to protect against severe disease. Yes, after President Biden made announcement re: boosters, FDA/CDC had to address so said boost J&J & >65 but look how well working
abcnews.go.com/Health/booster…
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
28 Oct
Right, with 2/3 of parents either on the fence or seeing no reason to vaccinate their child, I would not try to motivate in any way but with optimism. I am very depressed by our approach.
There is nothing COVID minimizing to say that children are much less at risk of severe disease than adults, especially older. This is a blessing. However, since the risk is not zero, I recommend adults vaccinate their children if not naturally infected to 1) make it as close
to zero as possible (I would do this if I had a magic wand to ensure nothing ill befalls my child); 2) protect others (yes, our society is less vaccinated than others); 3) of course have normalcy. We have asked young people (college students) to protect older this whole pandemic
Read 5 tweets
Monica Gandhi MD, MPH Profile picture
26 Oct
Good summary: "FDA scientists concluded that benefits outweigh risks in most scenarios when Covid widespread. Only when Covid cases were very low in the community — as was the case in June — that it did not appear beneficial to vaccinate children."
nbcnews.com/health/health-…
Would advise CDC ACIP to discuss only 1 dose after natural immunity and spacing strategy as below.
Original FDA document, Pfizer presented to advisory committee: 3 reasons listed: 1) rare severe disease in kids; 2) prevent transmission; 3) return children to normal life- will ask my local DPH if kids will unmask in school when adults do in public here (8 weeks post child vax)
Read 7 tweets
Monica Gandhi MD, MPH Profile picture
26 Oct
COVID cases keep falling across US; in states with low vax with delta, hospitalizations at 1st increased (no T cells). But many areas didn't increase vax rate nor put back masks-still falling cases: highly transmissible variant causes lots of immunity
nytimes.com/2021/10/26/bri…
@ZDoggMD, I know there are those who hoped masks, distancing, ventilation, testing, contact tracing could get countries through a pandemic but (like in 1918), immunity seems to be the only real way to get to other side (so much more needed with delta)
and we will post our seroprevalence comparison soon - but simple example here. CA has lots of natural immunity (38% in general population before rolling out vax); Vermont had 1.7% before vax. Both 80% vax rate >=12. Cases staying low in CA but increasing in VT but both have high
Read 4 tweets
Monica Gandhi MD, MPH Profile picture
26 Oct
CAN YOU TRANSMIT IF ASYMPTOMATIC AND VACCINATED? (delta) Will put into context later, contact tracing studies; briefly, difficult to transmit if asymptomatic/vax'd. Health workers swabbed- if no symptoms, test turned negative fast: don't isolate 10-14 days
acpjournals.org/doi/10.7326/M2…
Annals of Internal Medicine study may make CDC rethink quarantine after exposures when vax'd and isolation after testing positive if no symptoms and vax'd (or masking everyone vax'd/asymptomatic) - see below for microbiology: immunity works to kill virus
Please remember CDC does not actually recommend testing asymptomatic individuals who are vaccinated without an exposure but this is being done in many settings. This is important data from the Annals of Internal Medicine (a very high impact journal)
Read 6 tweets
Monica Gandhi MD, MPH Profile picture
25 Oct
DELTA NOT MORE VIRULENT IN US STUDY: In viral evolution, variants like to become more transmissible to create more copies of themselves, but good to see the most transmissible variant of all in the US (still massively dominating) not more virulent; haven't seen this yet
But with increased transmissibility comes increased cases; those cases will turn into hospitalizations (or there will be less "uncoupling" of cases & hospitalizations like in places of high vax) in places of low vax. So delta hard in US in low vax states
sfchronicle.com/health/article…
We had written this in the WSJ early on after delta (with @LeslieBienen and @citizen_oregon) that delta doesn't cause more severe disease per case; it will cause more cases and therefore hospitalizations in areas of low vax (that did happen)
wsj.com/articles/delta…
Read 4 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!

Like this author's thread?

Get emails when @MonicaGandhi9 has new unrolls!

Check out other threads from @MonicaGandhi9!

Read all threads by @MonicaGandhi9

:(