1. I'm listening to some presentations to #ACIP on myocarditis associated with receipt of Moderna's Covid vaccine or mRNA vaccines in general.
CDC's Tom Shimabukuro was asked about deaths. He said there were 13 deaths reported, but so far none are thought to be vax-related.
2. @CDCgov is doing a study following up on people who reported myocarditis after mRNA vaccination. CDC's Ian Kracalik is presenting on that study now.
3. No surprise by now, most of the people reporting myocarditis after mRNA vaccination were young males.
4. The symptoms for most were mild and did not inhibit their ability to care for themselves or live their normal lives. But a fair proportion of them reported anxiety or depression.
5. Most people who developed myocarditis after vaccination were fully recovered by 38 weeks after the event.
6. The main findings of the study following up people who reported myocarditis following receipt of mRNA vaccine.
7. @tmprowell makes an important point. There are multiple cases of myocarditis; five of the fatal cases in the schematic below were caused not by vaccination, but by other such causes. They include viral infections, such as Covid. #ACIP has broken for a 15 minute lunch break.
8. @CDCgov is now making a presentation on how it is about to update its clinical guidance on Covid vaccine for people who are moderately to severely immunocompromised. It's going to shorten the interval for the 4th dose for people who got an mRNA vaccine to 3 months from 5.
9. And people who are moderately to severely immunocompromised & who got the J&J vaccine initially are now being encouraged to get a 3rd dose, two months or longer after their first booster.
10. For people who are moderately to severely immunocompromised and who initially were vaccinated with the J&J vaccine, the 3rd dose must be one of the mRNA vaccines.
11. @CDCgov is going to recommend revaccination of some people who got vaccinated before or while undergoing treatments that would deplete their B cells (CAR-T, hematopoietic stem cell transplant) should be revaccinated afterwards. This advice was welcomed by clinicians on ACIP.
12. And where previously @CDCgov recommended deferring Covid vaccination after getting passive antibody products (ie monoclonals), it is lifting the recommendation for a deferral.
13. I had to stop listening to #ACIP about mid afternoon — other news got in the way. But ... no surprise ... the committee voted to recommend use of the Moderna #Covid vaccine. And @CDCDirector signed off on that recommendation. cdc.gov/media/releases…
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1. An update on #flu in the US, with data from @CDCgov for the week ending Jan 29.
For the second year in a row the warnings of a "twindemic" of Covid & flu haven't come to pass. There will be winters when we have to deal with both. But this year we may have dodged that bullet.
2. Currently influenza-like activity is "below baseline." That could mean we've passed the peak of flu season for winter 2021-22. That said, #flu B activity often occurs late in the season — sometimes into March & April. So there could be more flu later.
3. @CDCgov estimates that 1,200 people have died from #flu this winter in the US. And it has received reports of 5 deaths of children. In most regular years, there are somewhere between 100 and 200 children who die from flu.
1. Amazing statistic: In the 10 weeks since Omicron was discovered, there have been 90M #Covid cases reported — more than in all of 2020, says @drtedros at today's @WHO press conference.
2. A dangerous narrative on the pandemic has taken root, says @drtedros. With the availability of vaccines & the transmissibility of Omicron, some are assuming the need to fight to reduce transmission is either unnecessary or futile. More infections will lead to more deaths.
3. @drtedros said the #SARSCoV2 virus remains dangerous and continues to evolve. @WHO is monitoring 4 subvariants of Omicron, he said.
1. A short #flu 🧵
Flu activity in the US remains low for this time of year. For the week ending Jan 22, 1.9% of samples tested for flu were positive. To put that in context, in the corresponding week in 2019-20, the positivity rate was nearly 28%.
2. #Flu activity in the week ending Jan. 22 was roughly equal to the previous week, @CDCgov reports. But transmission of other respiratory pathogens has declined, which have brought the epi curve for #influenza-like illnesses (ILIs) for this season almost back down to baseline.
3. It's early in the flu season for this kind of decline; there could be a rebound later.
Is the decline due to precautions people are taking to avoid Covid? Is Covid beating the other ILIs to the punch — it's infecting people before flu or other ILIs can? I'd love to know.
1. A #flu 🧵 based on US data from @cdcgov.
Two children died from flu in the week ending Jan. 15, bringing to 5 the total number of pediatric flu deaths so far this season. It's a such a shame to see this feature of flu season return.
2. #Influenza-like illnesses dropped again last week. The further we get out from the holidays, the more likely it is that's a real thing, not an artifact of reporting delays. Is the Omicron wave crowding out flu? Are measures people are taking to avoid Omicron driving down flu?
3. #Influenza-like illness activity (which is #flu, RSV & a range of other non-Covid respiratory pathogens) is incredibly variable this year. It's unusual to see some areas reporting very little (green) & others lots (deep red). In a regular flu season, it's more homogeneous.
1. A #flu 🧵, based on U.S. data for the week ending Jan. 8.
There has been another pediatric death from flu, the third this season. It occurred in the week leading up to Christmas. Pediatric flu deaths are still at very low levels relative to regular flu years, thankfully.
2. #Flu activity is still at low levels & it actually dropped last week. Is that because of data filing delays over the holidays? Because people are avoiding health care because of Covid? Or is Omicron somehow crowding out flu? Need someone smarter than me to answer that Q.
3. Hospital admissions for flu decreased a little last week. That probably suggests some decline in #flu activity.
Will flu activity pick up again? Most flu seasons don't peak until late January, into February. The size of the Omicron wave, though, could be an influence here.
1. There is a new global flu report out from @WHO, so, a 🧵. #Flu activity is picking up globally after the historic low levels seen in the first year & a half of the #Covid19 pandemic. In some places, WHO says, activity is now at levels see before the pandemic.
2. @WHO didn't stipulate which countries are experiencing as much #flu now as they would have at a corresponding time of the year in the pre-pandemic era. I've asked & will add the info if I get it. It could be in parts of Europe. This from @ECDC_EU.
3. The global positivity rate for the period from Dec. 6 to Dec. 26 was 5.2%, which is above where it was in mid-March, 2020 when #flu activity worldwide collapsed.
The new rate is based on more than a half-million diagnostic tests conducted across 110 countries.