The overwhelming evidence for 3rd shot boosters *before* Omicron, reinforced by new data for benefit vs Omicron
1. The randomized trial of 3 shots vs 2 shots + placebo, 95% efficacy for preventing symptomatic infections across all age 16+ groups (N=10,125)
cdc.gov/vaccines/acip/…
2. Reduction in death by 90% for age 50+, 3 shots vs 2, among >840,000 people
nejm.org/doi/full/10.10… @NEJM
3. Marked reduction of hospitalizations and deaths in over 728,321 people with 3 shots vs matched 728,321 people with 2 shots, across all age groups
thelancet.com/action/showPdf…
4. Now vs Omicron, the variant with substantial immune escape, the 3rd shot induced a 25-fold increase in neutralizing antibody titer pfizer.com/news/press-rel…
Clinical correlation with effectiveness data and duration of impact pending
PS I am getting very tired of people ("experts," CDC, journalists) negating the incontrovertible evidence for 3rd shots that existed prior to Omicron, which is one of the reasons why less than 1 in 4 US adults have had boosters

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More from @EricTopol

10 Dec
First data on booster vaccine effectiveness vs Omicron (581 cases): drop in protection vs symptomatic infection by 2 doses (AZ ->0, Pfizer-> <40%) restored to ~75% with 3rd shot Pfizer
assets.publishing.service.gov.uk/government/upl… @UKHSA

khub.net/documents/1359…
The 95% CI presented here with relatively small number of Omicron cases overlap vs Delta, but certainly suggest less protection after 3rd dose.
For Omicron, essentially no protective effect of 2 AZ doses, 3rd goes to 71% (42,86); 2 Pfizer doses to 34%, 3rd doses to 76% (56,83)
Much more new beyond 1st look at Omicron vaccine effectiveness, summarized in a terrific thread by @kallmemeg
— ~7% cases Omicron reinfections (0.4% Delta)
— 3.2X adjusted odds of household transmission (vs Delta)
— big growth advantage👇
Read 4 tweets
7 Dec
Great credit to this team for quickly getting us Omicron lab neutralization data. The bright side is that there is incomplete immune escape from vaccination👍
For people who had Prior Covid plus vaccination, the preserved Omicron neutralization level (FRNT) likely reflects solid protection. Not seen with 2 doses of Pfizer vaccine, but would expect that a 3rd shot, with its marked effect on raising nAbs, would simulate that
Here are some relevant data for the small sample. The 6 vaccinated individuals range from 10-39 days post-vaxx.

Take home point is how powerful hybrid immunity (vaccine + prior Covid) vs all variants that we've seen now, including Omicron
Read 4 tweets
7 Dec
Does Omicron lead to less severe illness than prior variants ? We don't yet but let's review what is the basis for the hope /1
nytimes.com/2021/12/06/wor…
In South Africa, among those hospitalized, less requirement for ICU for those admitted compared with Delta /2
ft.com/content/d315be…
And the same, much less ICU need among those testing positive /3
Read 9 tweets
29 Nov
This is actually a BIG deal and fully warranted, evidence based. Great to see!
Thanks @CDCgov @CDCDirector Image
Revised: Image
People are asking why not 3rd shots for age <18, i.e. teens?
There is no application yet from a vaccine manufacturer to FDA for age <18, so it can't be recommended yet. That will change soon......
Read 4 tweets
28 Nov
The US markedly lags many countries with boosters, in part because of poor messaging, and lack of priority to get *all* adults with fully restored vaccine effectiveness.
Would help vs Omicron, too. Boosters induce a striking increase in level & breadth of neutralizing antibodies.
Today's @washingtonpost editorial
"The [waning] phenomenon should compel all adults to get a booster shot."
Our editorial on boosters, @mtosterholm @PostOpinions
"Each day in the United States, the number of people with waning immunity greatly exceeds those who are getting newly vaccinated"
washingtonpost.com/opinions/2021/…
Read 4 tweets
26 Nov
The @WHO has named B.1.1.529 Omicron, a Variant of Concern [O, not Nu)
Here's their full statement, summary of data
who.int/news/item/26-1…
This is only the 5th Variant of Concern since the pandemic began: Alpha, Beta, Gamma, Delta, and now Omicron.
That it was not named as a Variant of Interest is interesting and raises concern ;-)
There have been thousands of uninteresting #SARSCoV2 variants
Read 5 tweets

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