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Jonathan Cedernaes Profile picture
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9 Dec, 6 tweets, 3 min read
Viktigt att beakta nedanstående när man utvärderar Sydafrikas fallrapporter mm.

1/
2/ Reinfektioner är som regel - ej alltid - mildare.

"Reinfections had 90% lower odds of resulting in hospitalization or death than primary infections"

- Omicrons effekter ännu oklar, men ⬆️ reinfektionsrisken
-Vaccinering därmed viktigt för denna grupp
nejm.org/doi/full/10.10…
3/ Att reinfektioner (~2a exponering) ger mildare förlopp är jämförbart med hur vaccinen - fast via säker 1:a exponering för virusprotein - sänker risken för allvarlig COVID-19.

Oklart: Vissa tror att 2, särskilt 3 vaccindoser, kan ge hyfsat skydd mot allvarlig C19 av Omicron
->
4/ Hur vaccinen fortsatt skydda väl mot allvarlig sjukdom under Deltavariantens dominans:

Försök till beräkning (preliminärt & givetvis osäkert, men ett försök) till hur vaccinen ev. skyddar mot olika former av COVID-19 av Omicron:
5/ Mer om hur inåget av nya varianter - liksom Omicron - ev. kan verka mildare, men att detta kan vara en bieffekt av vilka som nu har någon grad av immunitet (t.ex. enbart infektion eller vaccination)



6/ Läs gärna hela excellenta ursprungstråden som förklarar hur Omicronvarianten kan verka mildare än den faktiskt kanske är (behöver dock inte betyda att den är mer allvarlig per fall, men varianten tycks ha hög smittspridning pga. ex mkt immune evasion):

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More from @JCedernaes

Jonathan Cedernaes Profile picture
11 Dec
Bra & dåliga nyheter gällande #Omicron:

God nyhet:

⦿ Preliminärt ger 3 vaccindoser ~70-75% skydd mot symptomatisk #COVID19 orsakad av Omicron
- åtminstone ~2 veckor efter dos 3 & hos yngre

Därmed antas vaccinskyddet mot svår C19 vara än högre

Trista nyheter-> 🧵 ImageImage
2/ Trista nyheter:

I jämförelse med smittsamma Delta tycks Omicron, *preliminärt*:

⬆️ Reinfektionsrisken 5x (3.4-7.8x) för de med tidigare COVID-19
⬆️ ~2 ggr oddsratio att föra smittan vidare till nära kontakter
⬆️ ~3 ggr oddsratio att föra smittan vidare till hushållskontakter
3/ Trista nyheter:
*preliminära*

⦿ ~22% kontra tidigare 11% risk att en hushållskontakt smittas (secondary attack rate; SAR)
⦿ Smittan växer nu med dubblering var 2.5:e dag i Storbritannien – beräknas kunna ta över (dvs. majoritet av fallen) om någon vecka i Storbritannien. Image
Read 14 tweets
Jonathan Cedernaes Profile picture
2 Aug
Pulmonary #embolism (lung blood clot) was >10 times more common after #SARSCoV2 infection (COVID19; ~15x over background rate), vs after getting #Pfizer's or #AstraZeneca's vaccine (~1.2x> background)

Similar greater risks with COVID-19 for #DVT & #VTE
🧵
medrxiv.org/content/10.110…
2) First of all – as the authors note – in those #vaccinated against COVID-19, "thrombosis, thrombocytopenia, and thrombosis with thrombocytopenia were very rare events."
3) Data from 1.9 Million (M) recipients of AstraZeneca, ~1.7 M of Pfizer, and ~300k COVID-19 cases (few old) – compared with ~2.3 M in the general population.

These cohorts were used to calculate the observed incidence vs. background (SIR) or observed vs. expected # of cases.
Read 8 tweets
Jonathan Cedernaes Profile picture
2 Aug
Alla (>18 år) som vill ha en dos [dvs dos 1 eller 2] #Moderna kan nu boka tid för vaccination i region Uppsala, fr.o.m. idag.

”Bakgrunden till beslutet är att vi har gott om Moderna-vaccin"

Moderna är ett mycket effektivt mRNA-vaccin mot COVID-19
🧵->
svd.se/uppsala-erbjud…
2) Tycks finnas många lediga tider, här från bokningen på 1177:

1177.se/Uppsala-lan/sj…
3) Liksom Pfizer tycks effekten för Moderna mot sjukhuskrävande COVID-19 orsakad av SARS-CoV-2-varianten Delta mycket god (punkt 3 nedan)

Dock tycks mRNA-vaccinens/AZs skydd mot övriga former (symptomatisk & asymptomatisk) av COVID-19 av delta sämre
drcedernaes.com/2021/07/covid-…
Read 5 tweets
Jonathan Cedernaes Profile picture
19 Mar
Not possible to review yet, so very preliminary:

German researchers seem to claim that in some individuals - that is, in very few as reported elsewhere - the Astrazeneca vaccine may activate platelets (which regulate clotting)
ndr.de/nachrichten/me…
The upside is that they seem to think they know how to treat these rare complications:

"The discovery means that targeted treatment can be offered to those who suffer similar clotting, using a very common medication."

m.dw.com/en/astrazeneca…
3) Some more details regarding the possibility of the rare clotting/bleeding complications following the Astrazeneca vaccine, and how to possibly treat the more serious type of them:

explica.co/german-scienti…
Read 8 tweets
Jonathan Cedernaes Profile picture
18 Mar
"“Our scientific position is that this vaccine is a safe and effective option to protect citizens against COVID-19,” said the head of the EMA, Emer Cooke.

She added: “If it were me, I would be vaccinated tomorrow.”"

abcnews.go.com/Technology/wir…
2) However, the EMA “cannot rule out definitively a link” between the rare types of blood clots and the vaccine.

They are therefore recommending to add a description that such cases have been reported, to the vaccine leaflets, to make health workers and patients aware of this.
3) Note however that this would be a very rare event, 37 or slightly more out of 17 M recipients, bringing the reported ratio to ~ the reported rate of anaphylaxis for Pfizer & Moderna (2.5-4.7 per 1 million doses) - just from a numbers comparison.
jamanetwork.com/journals/jama/…
Read 5 tweets
Jonathan Cedernaes Profile picture
18 Mar
1) A Danish study @TheLancet has followed over 520 000 people, from the 1st to 2nd surge.

Similar to some other studies, they find that those with a prior #SARSCoV2 infection had ~80% lower risk of #reinfection, but only ~47% reduced in those ≥65 yrs
🧵
thelancet.com/journals/lance… Image
2) The @TheLancet article describes how Denmark during tested ~0.5 M people for #SARSCoV2 during wave 1.

At the end of 2020, ~10% of the population tested every week.

In all of 2020, Denmark tested ~4 million people (68% of their pop.) and 64% of those had been tested >1 time.
3) In their analysis, they also included an alternative cohort, that looked at individuals throughout the pandemic (& not only those testing positive in the 1st & 2nd wave), thus examining reinfection risk in a group of 2.4 M people, of which 28 875 had been previously infected.
Read 12 tweets

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