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Michael Lin, PhD-MD 🧬 Profile picture
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23 Nov, 4 tweets, 1 min read
Speaking of motivated reasoning, last clause in pink box is a scientifically dubious interpretation.

Sisonke2 is a trial to give Sisonke1 participants (single-dosed J&J) another J&J dose as booster.
Gets worse after you click through. Really, no safety support? Trial organizers would actually withhold medical treatment if you have issues? I'm sure that's not what they meant, as it would be extremely unethical. So why use threatening words that imply it? Image
It's in reality a bit of a nonissue for safety, as there is *more* data in support of the safety of a Pfizer boost for J&J than of a J&J boost for J&J. So bringing it up is not scientifically valid either, and it seems to brought up only as a way to scare people away from Pfizer.
It's important that a trial of J&J booster would of course actually only dispense J&J booster, but the coercive language here does not seem like best practices for any clinical trial whatsoever.

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More from @michaelzlin

Michael Lin, PhD-MD 🧬 Profile picture
24 Nov
I'd like to wrap up tweeting about vaccine boosters, because I prefer to provide scientific analysis in on controversial or misunderstood issues, not to repeat what's already known.

And now it's clear that boosters were/are needed and were/are useful.

A mini-thread
There were disparate reasons for anti-booster arguments, making for an odd hodgepodge of forces denying booster efficacy or need across the political spectrum. These included:

1. Denial of booster need/efficacy in the US to signal dediction to health outside the US (sadly...
...in the way it was communicated, some similarities to the playing it down by the former guy)

2. Reluctance by certain political or media favorites (not using the E word here) to be the bearer of inconvenient news, or to change a position formulated before Delta
Read 18 tweets
Michael Lin, PhD-MD 🧬 Profile picture
23 Nov
One could say the ability to adapt one's beliefs in response to new evidence is 1 of 2 essential characteristics of a scientific mindset. The other one is the ability to use theory to formulate new hypotheses.
arstechnica.com/science/2021/1…
If you then think experts should have a scientific mindset (and I'd suggest you should, or you'd just have someone who's only right when they're lucky, and wrong other times), then you'd want your experts to change their position when presented with evidence that contradicts it.
Interestingly using theory to back a hypothesis and adapting beliefs to data are in tension: if you hold on to an incomplete/outdated theory too strongly, you can fail to accept new data. This is indeed a major contributing factor to scientific debate.
Read 6 tweets
Michael Lin, PhD-MD 🧬 Profile picture
5 Nov
Pfizer revealed great results for their COVID19 drug: prevention of 89% of hospitalizations if taken within 3 days of symptoms (85% if 5 days). I think you've all heard by now.

The drug blocks the coronavirus protease. As some of you know, my lab works on the same thing...
and in fact we have been testing the Pfizer drug (PF-07321332) in the lab, because it differs from our own previously revealed SARSCoV2 protease inhibitor (from September 2000) by only a few atoms, so we synthesized PF-07321332 as well.

Knowing Pfizer's compound (now called Paxlovid) works so well and was zipping through clinical trials (helps when you have $billions), we have been working on making even better protease inhibitors, hence our silence since September 2000.
Read 61 tweets
Michael Lin, PhD-MD 🧬 Profile picture
25 Oct
We can compare the UK experience to other similar countries to understand the role of public health rules in limiting disease.

Here I choose the Netherlands for comparison since it is close geographically, has similar vaccine rates, and had an initial Delta surge of similar size
As apparent from the graph above, UK doesn't come out too well. But first let's establish the conditions. Vaccination rates are similar between UK and Netherlands
Age structure is similar with the Netherlands having slightly more people in age segments >50yo
Read 22 tweets
Michael Lin, PhD-MD 🧬 Profile picture
23 Oct
Pfizer's application for the vaccine for 5-11yo is progressing well.

FDA analysis identifies no red flags.

cnbc.com/2021/10/23/fda…
VRBPAC meeting Tuesday to discuss risk/benefit ratio. Much will depend on the value of case suppression which I think should be considered in context of schools and families. Meeting materials at link below

fda.gov/advisory-commi…
Trial was too small (n ~ 1500 in vaccine group) to see myocarditis. FDA estimated benefits vs risks assuming MC rate similar to 12-17yo getting 30ug (maybe overestimate; 5-11yo get 10ug).
Read 6 tweets
Michael Lin, PhD-MD 🧬 Profile picture
23 Oct
Another study just posted comparing Abs & T cells in #JnJers after J&J, Moderna100, or Pfizer boost

Confirms NIH and Singapore studies: Both Abs and T cells are boosted by Moderna100 > Pfizer > J&J

#JnJers should boost accordingly

h/t @ChildrenNeedUs_

medrxiv.org/content/10.110…
Booster happened at 3mo after J&J vaccination.

Fig 2A: Antibody levels after boost go as Moderna100 > Pfizer > J&J

Moderna50 would be in between Moderna100 and Pfizer, most likely Image
Fig 2B: p values were not done for differences in post-boost antibody levels by booster group, but for diffs in fold change within individuals by booster group. Subtle distinction, but the latter is more variable (boxes and whiskers are taller). Anyway all diffs significant. Image
Read 12 tweets

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