Michael Lin, MD PhD 🧬 Profile picture
Feb 2, 2022 11 tweets 5 min read Read on X
This study flew under the radar (only 1 news article): Omicron antibodies in participants of the NIH mix and match trial

Results: 3xRNA ~ 2xRNA+JJ ≥ JJ+RNA >> JJ+JJ

JJ+JJ ends up 10x worse than 3xRNA

medrxiv.org/content/10.110… @PaulSaxMD Image
Also confirms JJ is a poor booster for JJ, for either "original" D614G or Omicron. Image
Above, the JJ+Pfizer looked about 2x worse than 3xPfizer. Confidence intervals are wide, but another underreported Omicron study found JJ+Pfizer was ~3x worse than Mod+Mod+Pfizer. So this effect size seems consistent.

Great graphics BTW

medrxiv.org/content/10.110… Image
The difference between JJ+RNA and 3xRNA was bigger in the @BalazsLab study. I believe those patient samples may have been more heterogeneous. Regardless JJ+RNA is consistently lower than 3xRNA.

cell.com/cell/fulltext/… Image
Returning to the second paper by the de Vries lab, they also looked at B and T cell responses to original spike, over time after "full vax" (1xJJ or 2xAZ or 2xRNA)

No surprises: we see again that the 2-dose vaccines have higher Ab levels at 1mo than at 6mo.

Peak Mod>Pfiz>AZ>JJ Image
For those who might have just read press releases or news articles that reiterate press releases, yes JJ (Ad26COV2S) Ab levels go up and then stabilize between 2mo and 6mo. But the whole time it is below the levels of 2xRNA (mRNA or BNT), so there's no net advantage of 1xJJ.
How about T cells, which some people thought would be an advantage of adenovirus (Ad, vectored) vaccines? As measured by IFNgamma release, they're worse for 2xAZ (ChAdOx) or 1xJJ (Ad26COV2s) vs 2xRNA (mRNA1273).

White circles = selected for in-depth analysis Image
They also looked at unboosted Ab levels against Omicron. This is a measure of breadth of the response. You can see convalescent sera and Moderna had the most Omicron neutralization (look at #'s above), everything else similarly poor. Image
And they also looked at T cell responses across strains. Again Moderna much better than everything else. Little differences across strains (because T cell epitopes are from anywhere in the protein, and not subject to the same selective pressure) Image
So the de Vries study is remarkably consistent in showing Moderna to have the broadest B cell responses, and the strongest B and T cell responses. It does seem like the most protective of the vaccines, and Modernites also get to enjoy a 3rd shot of their choice (4 if they are IC)
And finally the de Vries study, like the Balazs study, is a joy to read because of the excellent graphics. Everything is consistently labelled, well organized, and color-coded, and there's a cartoon of the experimental process. You hardly ever have to look at the legend. 🙏👏👏

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More from @michaelzlin

Jul 18
Basically Pelosi figured out Donilon was the one feeding Biden hopium-spiked poll results, and leaked it out.

Once it was proven that there really was bad info in the inner circle, that gave everyone else confidence in their own eyes. The emperor really was naked.
“Put Donilon on the phone,” Ms. Pelosi told the president, referring to Mike Donilon, the president’s longtime aide, according to people familiar with the exchange, which was reported earlier by CNN. “Show me what polls.”

Go Nancy!

nytimes.com/2024/07/18/us/…
Real Donilon's claims for why Biden would win (before the debate), and concerns raised by other Democrats, and see who was more correct:

axios.com/2024/06/19/bid…
Read 11 tweets
Jul 17
Biden has COVID-19 again. He had first symptoms today, positive test today, and first Paxlovid dose today.

As the early Paxlovid will limit immunostimulation by virus, I predict he will suffer rebound again, unless he gets 10-day course, or he is given a strain-matched vaccine. Image
Biden's DO does not seem to follow the science. The rate of rebound is 26% if started within the first 2 days of symptoms or positive test.

Sure, FDA and CDC and Pfizer still claim it's less than 3% and no different than no-Paxlovid, but it fools nobody
I predicted his first rebound on immunological principles alone and on understanding Paxlovid mechanism of action. It was a real prediction, made before it happened, and sticking my neck out in public to make it.
Read 12 tweets
Jul 17
The question is when Biden's inner circle (all 4 of them) will tell him the truths:

That he's dropping in most polls.

That 2/3 of Democrats prefer a different nominee.

That he looks low-energy and confused in recent appearances, and the contrast with Trump keeps getting wider.
Citations. Dropping in most polls: "New Democratic-funded polling shows Biden losing ground to Trump in key states"
cnn.com/politics/live-…
"Nearly two-thirds of Democrats want Biden to withdraw"

pbs.org/newshour/polit…
Read 4 tweets
Jul 9
I intuited that early start of Paxlovid blunts immunity, allowing viral rebound once drug ended. I thus predicted both Joe and Jill Biden's rebounds (before they occurred), as they started Pax on day of symptoms.

A math model now supports the intuition:
nature.com/articles/s4146…
"The model identifies that earlier initiation and shorter treatment duration are key predictors of post-treatment rebound."

The model shows that early therapy reduces the number of infected cells secreting innate immune signals (IFNs) that then activate antibody production.
"If the virus is not eliminated by an early acquired response along with antiviral pressure, it rebounds to a peak level that is sometimes comparable to the initial peak."

We have seen this with many people, e.g. Fauci reported the rebound was worse than the initial infection
Read 15 tweets
Jun 30
"Short- and long-term neuropsychiatric outcomes in long COVID in South Korea and Japan"

Higher recorded rates of cognitive deficit (2.7x), insomnia (2.4x), anxiety (2.2x), mood disorder (1.9x), and stroke (2.0x) in the year after COVID-19 infection.

nature.com/articles/s4156…
Image
Big caveat: Retrospective association study, so major possibility of reporting bias. People who recently got COVID may be more likely to seek care and diagnosis for any new health problem. The study tries to control for this but there's no way really to eliminate it entirely.
Arguing for adequate adjusting is that there are a few conditions that would be prone to reporting bias for which an association was *not* seen: parkinsonism, muscle disease, psychosis.
Read 10 tweets
Jun 3
Documents for the June 5 FDA VRBPAC meeting are out.

Advisors will be asked to answer the question "For the 2024-2025 Formula of COVID-19 vaccines in the U.S., does the committee recommend a monovalent JN.1-lineage vaccine composition?"

fda.gov/advisory-commi…
Documents now include company presentations. Meeting has started and love video link is below

youtube.com/live/weaKQiFk_…
Useful antigen cartography overview. At the big level the JN.1 subvariants including KP.3 are closely clustered together Image
Read 17 tweets

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