Thread by @HelenBranswell

1. #ACIP is meeting today & tomorrow. This is one of their 3 scheduled meetings that take place every year.
There will be some discussion of Covid vaccines today, but this meeting will not be primarily about Covid vaccines. Lots of items on this agenda. cdc.gov/vaccines/acip/…

2. I will NOT be live tweeting much in this meeting. When I do tweet, I will do it in this thread.
There are not going to be many votes during these 2 days. Many of the sessions will be about informing #ACIP members on vaccines in development (eg. chikungunya).

3. There'll be a vote about adding Covid vaxes to the Vaccines for Children program. With federal money for Covid all but exhausted, the full cost of future boosters will be paid by individuals or their insurance. This is about ensuring kids without insurance can get vaxed. #ACIP

4. This tweet corrects an earlier version where I said vaccines under EUAs can't be added to @CDCgov vaccine schedules. I'm now told that's untrue.
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There'll also be a vote or votes Thurs. about adding Covid vaccines to @CDCgov's vaccination schedules — adults, teens, kids.

5. Some people seem to be equating adding Covid vaccines to schedules & school vaccine mandates.
@CDCgov doesn't mandate which vaccines kids need to attend schools. That's done at the state & local level. So #ACIP will not be doing anything on that issue.

6. Some state or local authorities could well use the addition of the Covid vaccines to the @CDCgov vaccine schedules to mandate Covid vaccination for school children; some likely will not.
I believe any change on this front would only come into effect for the 2023-24 school yr.

7. This #ACIP meeting is a partially in person one; most of the committee is in the meeting room on
@CDCgov's campus. First meeting like this since ... probably Feb. 2020? Discussion now is about pneumococcal vaccines. Going to be a vote later.

8. #ACIP has a new member today.
@kevinault have finished his term on the committee &
@nirav_mainecdc has joined.

9. #ACIP has been discussing pneumococcal vaccines. I wish I knew more about this, but I haven't been able to listen to this whole session. Plus it's super complex — even committee members are saying this. So I'm not equipped to convey what the discussion has been.

10. #ACIP is now hearing about Covid vaccine safety and effectiveness among pregnant people. This is an information session; no votes.

11. #ACIP member Matt Daley notes that when Covid vaccines first went into use, there weren't data to show if they were safe & effective in pregnancy (it hadn't been studied yet). But more than 1.5 years later, there are data and they are very reassuring.

12. #ACIP, which is significantly behind schedule at this point, is now hearing about Covid vaccine safety and efficacy in children from @CDCgov's Dr. Sara Oliver.

13. How complex is the task of vaccinating people against Covid. This chart just covers the different products/formulations for children and kids.
Eye-crossing. 😵

14. #ACIP is approaching the vote to add Covid vaccines to the Vaccines for Children program, which provides vaccines for kids who don't have medical insurance. This will only kick in when the federal government stops buying Covid vaccines & they are free market products.

15. Former #ACIP chair and now director of @CDCgov's National Center for Immunizations & Respiratory Diseases stressed the VFC vote has nothing to do with mandating Covid vaccination for school children.

16. #ACIP votes unanimously to add Covid vaccines to the Vaccines For Children program. This means that when the federal government stops purchasing Covid vaccines, kids without health insurance can still get them. This is not about school mandates.

17. The #ACIP is not going to vote today on the changes to the #pneumococcal vaccines. There's a ton of confusion over the wording of the first proposed vote & how workable it is. Chair Grace Lee says the language will be worked on overnight and the vote will come tomorrow.

18. #ACIP has started the last session for today, on polio. This is presumably in anticipation that eventually the US may consider approving the new oral polio vaccine, nOPV, which was designed to do what Sabin's oral vaccine did, but without the problems it causes.

19. This session is the start of the conversation at #ACIP. There will be no vote on this at this meeting. @CDCgov's Kathleen Dooling is giving a briefing on polio and the vaccines available to combat it.

20. #ACIP member Oliver Brooks, who is chair of the Polio Work Group, says these are the topics the committee is exploring. To date it has met once.

21. Listening to an #ACIP session on RSV vaccine candidates. Big need for RSV vaccines.
GSK presented on their candidate, which showed impressive results: 82.6% VE.
Several ACIP members expressed disappointment that the study population didn't include more frail elderly.

22. GSK was asked about a report of Guillain-Barré syndrome in one participant in one of GSKs trials.
1 of the more than 15,000 subjects who got the vaccine developed GSB. The investigator thought it could have been vaccine-associated but the company said...

23. ...that it had no information on whether other possible causes of GBS had been investigated, so it concluded that an association between the vaccine and GBS in this case couldn't be ruled in or ruled out.

24. #ACIP member Camille Kotton expressed concern about this GBS case, noting that GSK's shingles vaccine, Shingrix, is associated with an increased risk of GBS, and both vaccines include the same adjuvant.
Pfizer is reporting on its RSV vaccine work now.

24. Pfizer also had 1 case of GBS, out of more than 20,000 participants who received their vaccine.
Their vaccine showed efficacy of nearly 67% against mild disease (2 symptoms) & nearly 86% against more serious disease (3 symptoms). Few cases; confidence intervals are broad.

25. #ACIP member Keipp Talbot also raised concerns with Pfizer about the fact that elderly participants made up too little of their study population. Companies should study vaccines in the populations who need the vaccines, which in the case of RSV means frail elderly, she said.

26. This info, presented just now to #ACIP, confuses me.
The viruses that circulated in Australia's most recent flu season were v/ well matched to those in the vaccine, but vaccine efficacy was at the low end of moderate.
Low end of moderate.