Thread by @doctorow

The covid vaccine picture is awfully confusing. The current vaccines are doing a great job of preventing serious illness (at least, for people who are boosted), but they're not nearly so effective at preventing infection and transmission. 1/

What's more, the new variants are more contagious and less likely to cause severe infection, but they also appear to confer less immunity against re-infection:

bloomberg.com/news/articles/… 2/

At the same time, #VaccineApartheid continues to reign supreme: the WTO's vaccine waiver initiative stalled in the face of opposition from Big Pharma and the Gates Foundation, and the world's poorest people are forced to serve as reservoirs and incubators for new variants. 3/

But there's promising news that addresses both of these issues: new vaccines that are royalty free, that offer superior protection and don't require the extreme cold-chain or even the skilled needlework of the mRNA vaccines. 4/

Writing today in her @substack, @dr_kkjetelina writes about two vaccines she describes as "game-changers": #CORBEVAX and NVX-CoV2373 (AKA #Novavax):

yourlocalepidemiologist.substack.com/p/two-underdog… 5/

Novavax uses techniques that have been proven out in some flu and HPV vaccines, and can be made rapidly and in bulk in moth cells. It combines a spike protein with "an immune-boosting compound from the soapbark tree," and it had some *very* promising Phase III trials. 6/

How promising? "An efficacy of 100% against moderate-to-severe disease with the original variant and 90% efficacy overall...highly effective against other variants of concern, like Delta, Beta, and Omicron."

nejm.org/doi/full/10.10… 7/

Novavax has already been approved for use in parts of the global south, including India and South Africa; it's close to approval in the US, too (a production snag held up FDA approval). 8/

Then there's CORBEVAX, which was produced by Drs Maria Elena Bottazzi and Peter Hotez without pharma company backing. It's a project that started 20 years ago, during the first SARS epidemic. 9/

Neither the Trump administration nor Biden's have given them real financial support, so they've relied on the philanthropic arm of Tito's Vodka (seriously) and other donors. 10/

CORBEVAX is made in yeast cultures, like the Hepatatis B vaccine - a decades-old technique that's cheap and highly reliable. CORBEVAX's Stage III trials had 50% fewer adverse events than other vaccines, and yielded ">90% vaccine effectiveness and 80% effective against Delta." 11/

Best of all: it's available without royalties - it's "the world's vaccine." It's already been licensed for manufacture in Indonesia, Bangladesh, South Africa and Botswana. 12/

All of that is promising, but the most promising vaccine news I've found involves nasal vaccines, which "put protection exactly where it is needed to fend off the virus: the mucosal linings of the airways, where the coronavirus first lands."

nytimes.com/2022/02/02/hea… 13/

India's Bharat Biotech (makers of Covaxin) have a promising nasal-spray vaccine that can be administered without injection. It's just one of dozens of nasal vaccines in development around the world. 14/

The immunologists quoted in @apoorva_nyc's @nytimes story are bullish on them as a booster for primary vaccines.

According to the article, introducing vaccines directly to the airway induces "immune memory cells and antibodies in the nose and throat." 15/

That's important because the antibodies created by intramuscular injections don't propagate well to those parts of the body, which may be why vaccines prevent illness, but not infection. 16/

Nasal sprays (and nebulizers, which can deliver vaccines to the entire airway, down to the bronchioles) induce IgA antibodies "that thrive on mucosal surfaces like the nose and throat [and] may wane more slowly." 17/

And here's where it all comes together: Cuba is a biotech powerhouse with five vaccines under development, including a nasal spray. These vaccines are crushing it in Stage III tests. 18/

Cuba is ramping up production, on the island and overseas, and supplying vaccines to the whole Global South.

pluralistic.net/2021/11/28/som… 19/

It's a powerful curative to the racist lie - peddled by Big Pharma and its apologists like Howard Dean - that brown people in poor countries are too primitive to make vaccines.

pluralistic.net/2021/04/08/how… 20/

Therefore we should let Big Pharma harvest all the gains from publicly funded mRNA research and dribble out vaccines to the 2.6 billion poorest people in the world: 21/

Image:
Jeremy Sutcliffe (modified)
flickr.com/photos/jmts/15…
flickr.com/photos/jmts/16…

CC BY:
creativecommons.org/licenses/by/2.…

MathieuMD (modified)
commons.wikimedia.org/wiki/File:Poly…

CC BY-SA 3.0:
creativecommons.org/licenses/by-sa… 22/

ETA - If you'd like an unrolled version of this thread to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

pluralistic.net/2022/02/04/up-…