Eric Topol Profile picture
Aug 11 7 tweets 4 min read
The @CDCgov doubles down on its flawed, not evidence based Covid recommendations with a new guidance document
1. Leaves fully vaccinated = 2 shots, stay "up to date"
2. Leaves isolation at 5 days w/o rapid tests
3. Pushes "community levels" when real info is "transmission levels"
My concerns a month ago, unaddressed
The 4th shot in Americans age 50+
10% age 50-64
25% age 65+
The US now ranks 80th in the world for booster vaccines at 32% of population
ig.ft.com/coronavirus-va…
Our CDC at work. This is embarrassing, to say the least.
Summary of data supporting survival benefit of a 4th shot
The US booster botch for even 3rd shots. All @OECD countries except US >70 boosters/100 residents
Other notable comparators
Peru 71
Cuba 67
Mexico 44
Panama 44
Rwanda 41
Tajikistan 37
Sri Lanka 37
Uzbekistan 36
Iran 34
US 32

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More from @EricTopol

Aug 9
Why are people age 50+ at higher risk of severe Covid?
A new @PNASNews study indicates their significant narrowing of T cell diversity in response to infections may be part of the explanation
pnas.org/doi/10.1073/pn… ImageImage
And what happens if you deplete CD8+ (cytotoxic) T cells with a monoclonal antibody after vaccination + #SARSCoV2 infection?
science.org/doi/epdf/10.11… @SciImmunology (macaque model) ImageImage
End of paper:
"Consistent w/ this perspective, 70 investigators signed a letter to the FDA on April 21, 2022 encouraging the inclusion of T cell responses in addition to antibody titers for the evaluation of SARS-CoV-2 vaccines in humans"
Letter (I signed)
drive.google.com/file/d/1OPfStq… Image
Read 4 tweets
Aug 7
Had the chance the discuss the current status of #LongCovid with @holmescnn last evening
We reviewed the new @TheLancet study, best one so far to establish true incidence (pre-Omicron, with caveats below)
And touched on long term sequelae such as cardiovascular (below), neurologic, metabolic (diabetes), mental health concerns
Read 6 tweets
Jul 27
There are 5 studies that show reduction of mortality for a 2nd booster (vs 1st booster), in people ranging from age 50+ to 80+, as I've tried to summarize here. All during Omicron and subvariants.
Yet less than 10% of people age 50-64, and 24% age 65+ have had a 2nd booster
covid.cdc.gov/covid-data-tra…
Who should get a 4th shot now?
✓ age 50+
✓ immunocompromised
✓ other groups at increased risk (below) if this availability opens up
Read 4 tweets
Jul 21
In today's @SciImmunology, @VirusesImmunity and I call for Operation Nasal Vaccine, the urgent need for a lightened speed initiative, to help block Covid infections and transmission
science.org/doi/10.1126/sc…
It accompanies an elegant study in people & mice. There was little to no lower respiratory mucosal immunity (BAL nAb) vs Omicron after mRNA vaccines, but this was markedly ameliorated w/adding a nasal vaccine in mice
science.org/doi/10.1126/sc… by @ImmunologyTang @Jie_Immunology
That's "lightning speed" not lightened.
There are now 12 nasal vaccines in clinical trials and 4 are far along, in Phase 3.
But no plans for manufacturing at scale, distribution, accelerating. No government support. Yet a major unmet need
Read 6 tweets
Jul 15
New CDC @CDCMMWR on Omicron variants (BA.1, BA.2, BA.2.12.1) Importance of booster to restore vaccine effectiveness improved after significant drop-off (Table), BA.2/BA.2.12.1 variants worse decline
Benefit
3rd shot all ages 18+
4th shot age 50+
cdc.gov/mmwr/volumes/7…
This is quite telling about the slippage of protection of vaccines vs hospitalizations. With BA.2/BA.2.12.1 and 3 shots, in age 50+, vaccine effectiveness was only 55%.
Restored to 80% w/ 4th shot
Too much happy talk about vaccines providing great protection from severe disease
Recall that through the Delta variant w/ a 3rd shot booster, vaccine effectiveness vs hospitalizations was maintained ~95%
Read 4 tweets
Jul 14
Yet another study of improved survival with 4th dose of vaccine compared with 3rd, nationwide Sweden, here for age 80+
thelancet.com/journals/lanep…
Here for improved survival, 4th vs 3rd shot, age 60+
researchsquare.com/article/rs-147…
Here for improved survival, 4th shot vs 3rd, age 60+
nejm.org/doi/full/10.10…
Read 5 tweets

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