The United States is not taking its 5th major wave seriously.
In November, new cases have increased 30% starting from the high level of 70,000/day. With that hospitalizations and deaths are increasing again.
We haven't taken heed from Europe 4 times… /1
Our vaccination rate is dangerously low, putting >100 million Americans (40% of 331 M) who are not vaccinated vulnerable. Then there's another 40% who were highly 💉💉protected, but are now out 6 months out and that protection has waned /2
Instead of @CDCgov urging all people who've waned to get a 3rd shot, they deemed them "eligible." Only age 50+ "should" according to their recommendation. That is *not* what the data show and will further diminish our immunity wall /3
Let me review the data showing all adults 18+ benefit from a 3rd (booster) shot
There's the only randomized trial, data presented yesterday for the 1st time, of >10,000 people with 95% efficacy for 3 vs 2 shots /4
That trial enrolled adults of all ages. The efficacy vs symptomatic infections in the young s was just as high (numerically higher) as in people 55+ (96% and 93%, respectively) /5
Then there's the @TheLancet study of >728,000 people with 3 shots matched with 720,000 with 2 shots, across all ages, showing significant reduction of deaths, hospitalizations, and severe disease (not reviewed @CDCgov yesterday)… /6
By not promoting boosters among the fully vaccinated for all adults, the US is actually going into further attrition of protection. The net number of newly vaccinated people each day is markedly exceeded by those who have waned and not boosted. /7
Obviously vaccinations (both primary and 3rd shots) are not the only strategy. There's lack of almost any mitigation, and multiple tactics that could be used as reviewed in the @Guardian piece link, top of thread. /8

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More from @EricTopol

19 Nov
First look at the only randomized trial of a booster vaccine data (Pfizer) today…
95% efficacy vs symptomatic infections, consistent across all age, sex, race, ethnicity and comorbid condition subgroups
Benefit seen very early
Primary efficacy endpoint: 6 (booster) vs 123 events (placebo)
Solid safety profile
Side by side event curves for the original Pfizer vaccine trial vs the Booster trial
You can see the curves diverge about a week earlier with a booster, ~14 vs 7 days, which aligns with much faster induction of neutralizing antibodies
Read 6 tweets
16 Nov
The problem with vaccine waning 4-6 months later was 1st recognized in Israel in July, confirmed by more than 10 reports, and occurs with all vaccines. Protection is fully restored (or even exceeded) by 3rd (booster) shots.
The >95% vaccine efficacy vs hospitalizations and deaths for mRNA vaccines in the Phase 3 randomized trials also waned. Protection is fully restored to this high level by 3rd (booster) shots.
How long will it last?
Nobody knows for sure yet.
But let's hope Israel is right again:
"By analyzing the antibody levels, researchers have concluded that the third shot could be effective for 9 – 10 months, or even longer."…
Read 5 tweets
14 Nov
Addressing the anti-vaxxer BS about vaccines not preventing transmission. It's not 0|1.
1. Recent Dutch study during Delta
"Effectiveness of full vaccination of the index against transmission to unvaccinated household contacts was 63% (95%CI 46-75%)."…
2. UK study with Delta by genome sequencing, household transmission reduced from 38% (via unvaxxed) to 25% (vaxxed), a 35% reduction…
3. A 2nd UK study with sequencing of Delta showed a 27% reduction of transmission for vaccinated vs unvaccinated…
Read 4 tweets
13 Nov
Why should every adult get a 3rd shot (booster) when eligible (6 months after 1°💉)?
1. A randomized, placebo-controlled trial, the gold standard for assessing efficacy, showed restoration of efficacy to 95.6%, in >10,000 participants across all age groups
2. Prevention of hospitalizations and deaths in a study of >728,000 people w/ 3-shots vs >728,000 matched controls (2-shots)… @TheLancet ImageImage
3. We have no US National data by vaxx status but hospitalizations are starting to increase again and several states are reporting an increasing proportion of breakthroughs accounting for them Image
Read 8 tweets
11 Nov
The @nytimes published "What We Know So Far About
Waning Vaccine Effectiveness" today
It is misleading and missing key reports from New York State, Veterans Affairs, Puerto Rico, Israel, Qatar, the UK, and several others…
Exemplifies bad messaging, skewed, incomplete data.
No, it's not true that "vaccines still offer strong protection against severe Covid-19" which is why the majority of at-risk US people (such as age 60+, past 6 months from 💉💉) have not gotten boosters yet
For months the media & many experts insisted the vaccines were fully protective vs severe disease while the evidence was pointing against that assertion. Still today @nytimes! No wonder the public is confused and booster uptake is low. Only 32% in the highest risk age group, 65+
Read 4 tweets
9 Nov
Important new study on immunity (anti-spike Ab) waning and breakthrough infections after AZ & Pfizer vaccines in >5500 people
1. AZ far more pronounced and earlier waning than Pfizer & more breakthroughs
2.Anti-S correlated w/ risk of breakthroughs… ImageImage
"Our data demonstrate the importance of booster doses to maintain protection in the elderly and clinically vulnerable and suggest that these should be prioritized to those who received ChAdOx1 [AZ vaccine] as their primary course."
About timing:
"Our results show waning to levels associated with breakthrough infections before this 6 month period for those vaccinated with ChAdOx1 but not for BNT162b2."
Read 4 tweets

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