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Mar 21 • 7 tweets • 5 min read
The 4th shot is already underway in the UK. Meanwhile, millions of Americans of advanced age are well past 6 months from getting their 3rd shot, with substantial waning of protection, with no plan yet. /1
Reduction in neutralizing antibodies after mRNA vaccines at 5 months /2
nejm.org/doi/full/10.10…
Waning in vaccine effectiveness vs Omicron symptomatic infections and hospitalizations after 3rd dose, all ages @UKHSA /3
assets.publishing.service.gov.uk/government/upl…
In older adults, waning of neutralizing antibodies faster after Omicron than Delta
"In the absence of omicron variant-specific vaccines, booster immunizations are crucial to restore
vaccine effectiveness against severe outcomes." /4
thelancet.com/journals/lanin…
"The [neutralizing antibody] response against Omicron declined 6.3-fold over the same 6-month time frame after the boost." @NatureMedicine /5
nature.com/articles/s4159…
CDC report on waning of 3rd dose vaccine effectiveness vs emergency department and urgent care encounters, age 18+, from 87% < 2 months to 31% > 5 months /6
cdc.gov/mmwr/volumes/7…
Israel started giving a 4th dose to people age 60+ in December and reported short-term benefit of 4-fold protection vs Omicron severe illness /7 medrxiv.org/content/10.110…
More data on durability of protection will be available soon

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More from @EricTopol

Eric Topol Profile picture
Mar 20
Israel's findings of protection for the 3rd and 4th dose are quite different, both in people age 60+, early read out at just 12+ days
3rd shot (Delta wave): ~15-fold protection vs severe illness
4th shot (Omicron wave): ~4-fold protection vs severe illness
Whereas the 3rd shot had durable protection vs severe illness for 4+ months, the 4th (vs Omicron, w/ far more immune evasion), may be limited
They've worked remarkably well vs severe disease, with a 3rd shot that restored effectiveness at ~95% vs hospitalization and death.
But the virus has continued to evolve, the antigenic distance between Omicron BA.1 and BA.2 is as far as Beta to Gamma.
Read 4 tweets
Eric Topol Profile picture
Mar 19
Europe's BA.2 variant ascent continues
Hospitalizations on the rise in several countries
“We’ve been wearing rose-colored glasses instead of correcting our vision.”--@arimoin
nytimes.com/2022/03/19/hea…
Read 6 tweets
Eric Topol Profile picture
Mar 16
When South Korea, a model country for the pandemic, has >400,000 new cases in a day, leading the world per capita, you take notice. Tests 4X the US with <1/6th the population. BA.2 is 26% as of this week's report.
Very high 2-shot vaxx 87%, 3-shot 63%. The pandemic isn't over.
Relative to Hong Kong, it's death rate is very low. Boosters more than double. Great coverage of age 60+ No Sinovac vaccines.
BTW Hong Kong's booster 30% rate now exceeds the US (29%)
Relative to European countries with a BA.2-related hospitalization increase, South Korea's (BA.1) is more pronounced
Read 4 tweets
Eric Topol Profile picture
Mar 12
A review of the latest @UKHSA report
assets.publishing.service.gov.uk/government/upl…
1. Booster shots have prevented about 160,000 hospitalizations in England during the Omicron wave
2. The falloff of effectiveness vs Omicron over time is striking. Here VE for age 50+ against mortality
3. Also seen vs hospitalizations by 10+ weeks
Read 6 tweets
Eric Topol Profile picture
Mar 10
This represents phenomenal progress, folks.
The immunity wall in England has now led to Covid carrying (slightly) *less* fatality risk than seasonal flu
ft.com/content/e26c93… @FT @jburnmurdoch @mroliverbarnes
That's even the case for people of advanced age
Consider that Covid started with a ~18-fold increased mortality compared with influenza for people age 60+
Read 4 tweets
Eric Topol Profile picture
Mar 10
US Covid hospitalizations descend to their lowest level in over 8 months, and below all but 1 of its pandemic waves👍
It doesn't mean we're out of the woods.
Keep in mind that in England hospital admissions have started to rise again
ft.com/content/e26c93…
Possible explanations and implication, @chrischirp
Read 4 tweets

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