This thread explains how @Novavax is different from the #Moderna and #Pfizer #mRNA #vaccines and describes some of the benefits such as broadened #variant recognition, more durable #immunity, and fewer side effects. 🧵1/
An unrolled one-page web view for this long thread that may be easier to read or share can be found here ( ). 2/
Novavax is a protein based vaccine (similar designs have also been used for many years for tetanus, diphtheria and hepatitis B). Novavax presents the full COVID-19 Spike protein in nanoparticles designed to mimic the structure of the virus itself ( ). 3/ novavax.com/science-techno…
mRNA vaccines on the other hand get your immune cells to produce copies of the full Spike protein as single Spikes on their own which may interact differently with the immune system than Novavax's multi-Spike arrangement around a core. 4/
This video shows you how the mRNA Spikes are produced in your body ( ). 5/
Another big difference between Novavax and the mRNA vaccines is that Novavax uses an adjuvant called Matrix-M made from the soapbark tree to enhance the immune response to the vaccine. 6/
This adjuvant induces early activation of innate immune cells at the injection site and in the draining lymph nodes ( ). H/T: @paulseaman31 7/ tandfonline.com/doi/full/10.10…
You can read the study to to get much more details about the mechanisms of action with Matrix-M, including interesting facts such as within 24 hours both the Spike antigens and adjuvant are undetectable at the injection site... 8/
...since they have already been processed and transported to the draining lymph nodes by immune cells. I wonder if that is one of the reasons why many people feel much less pain in their arms after injection compared to mRNA shots? 9/
Using Matrix-M translates into an improved magnitude and quality of the antibody response to the Spike protein (antigen) and importantly broadened recognition of locations on the Spike (epitopes). 10/
This improvement was actually seen in the real world with the BA.1 and BA.5 variants and the original Novavax vaccine formula. 11/
Both Pfizer and Moderna released bivalent BA.1/BA.5 vaccines in fall 2022 since the antibodies generated from their original mRNA vaccines could no longer neutralize these newer Omicron variants. 12/
Novavax however did not release a bivalent vaccine because their original vaccine formula with Matrix-M still worked with the BA.1 and BA.5 variants. 13/
The Matrix-M adjuvant elicited antibodies from a broader set of locations on the Spike protein (epitopes) so even when some of the locations mutated with BA.1 and BA.5, the conserved locations could still be recognized by the immune system. ( ). 14/ medrxiv.org/content/10.110…
There have also been suggestions to improve mRNA vaccine potency, durability, safety and T-cell response by using adjuvants ( ). 15/nature.com/articles/s4155…
In mice they found the adjuvant in mRNA vaccines increased antibody levels 10x and produced Fc-binding antibodies which showed better control over viral replication and help predict resolution of severed COVID-19 ( ). 16/
Many people have anecdotally discovered and reported that Novavax doses had much lower side effects than when they received an mRNA shot. 17/
Multiple studies have now shown this to be the case as well. One preprint study (supported by Novavax) that compares the reactogenicity (frequency of side effects) of Novavax and mRNA vaccines ( ). H/T: @michaelzlin 18/medrxiv.org/content/10.110…
They found a notable difference in the percentage of reported side effect symptoms with Novavax being lower in each category:
* 30.8% lower muscle pain
* 30.4% lower injection site pain
* 25.7% lower fatigue
* 25.4% lower injection site tenderness
* 24.9% lower malaise
What about people who had mRNA doses previously but want to consider Novavax? There have been several studies now that found mixing the two, getting mRNA and then Novavax actually gave better results than just mRNA on its own. 21/
One study found that getting Novavax as a booster after mRNA "may enhance the persistence and durability of vaccine-mediated immunity compared to mRNA options"... 22/
...with slower decay rate compared to an mRNA booster dose and less side effects than mRNA boosters ( ). H/T: @Daniel_E_Park 23/tandfonline.com/doi/full/10.10…
A randomized controlled trial found that getting a Novavax dose after Pfizer mRNA elicited the highest humoral and peak cellular immune responses ( ). H/T: @michaelzlin 24/journalofinfection.com/article/S0163-…
The mRNA + Novavax combination also had the lowest rate of breakthrough infections and the study also found fewer moderate and severe systemic adverse effects for Novavax than Pfizer mRNA. 25/
Neutralising antibodies against Omicron BA.1 and BA.2 were higher with Novavax after mRNA compared to two mRNA doses. 26/
Now you have more details as to how Novavax is different and some of the nice benefits including for people who had mRNA shots previously. 27/
I'm hoping that the Matrix-M adjuvant will again show its ability to broaden the immune system's ability to choose epitopes so that it might continue to work better for upcoming variants as it did when BA.1 and BA.5 emerged. 28/
FYI, I do not work for Novavax or have any investments or make any money from Novavax selling products. 29/
I am a little confused as to why @Novavax just recently filed their regulatory approval paperwork with Health Canada as many people are waiting for the fall boosters so it would be a shame if they were not available soon like the mRNA fall boosters are expected to be. 30/
While vaccines are important, they should be the last layer of protection to rely on in case all the other layers fail and you get exposed. Vaccines should not be the one and only layer governments all seem to be currently relying on. 31/ Click "Show replies" 👇 to continue.
ASHRAE Standard 241, Control of Infectious Aerosols ( ) was released in July 2023 so this should now be adopted and required in air quality standards for buildings like governments already require clean drinking water standards for these same buildings.32/ashrae.org/technical-reso…
It is important to have good indoor air quality, not just from viruses but also for cognitive function and from other air pollutants (like wildfire smoke) which have been linked to various health problems ( ). 33/
Aerosol and particulate matter (PM) particles can also be filtered and removed from the air using HVAC filters like MERV-13 or better, HEPA filters, build yourself CR-boxes with traditional fans or super quiet versions with PC fans. 34/
You can find guides and useful information on my website ( ). 35/covid.gilchrist.ca
Since you don't have control over the air quality in most public spaces you can also use personal filters (aka masks) with a good seal designed to protect from airborne pathogens like N95 respirators. 36/
To find out how well your mask seals, you can see my thread on fit testing ( ) and some of the test results I got comparing masks ( ). 37/
Some people misunderstand and think filters such as HEPA and mask material work like a sieve or chain link fence which allow smaller objects like flies to pass through. 38/
This thread explains how the laws of physics are used to allow the filtering material to stop such tiny smoke and aerosol particles ( ). 39/
People are rightfully concerned about the high case fatality rate (CFR) of the H5N1 influenza virus but did you know fatalities from COVID infection (which already spreads easily between humans) with the elderly are as high as 40% ( )? 🧵1/
Virus infection can damage the body, we have seen this with Long COVID and this can happen with other viruses as well such as Influenza causing increased risk of cardiovascular events among other things. 2/
This study tries to indirectly measure the impact of influenza infection by looking at cardiovascular events and then measuring the risk people had if they received the influenza vaccine or not( … ). 3/ H/T: @JaninePaynterncbi.nlm.nih.gov/pmc/articles/P…
#Variant update for #Ontario, #Canada (to Apr. 17, 2024)
The JN.1.* +FLiRT variants now make up 20% of sequences and XDK.* which is recombinant of JN.1.1.1 and XBB.1.16.11 has made an appearance at 5%. Graph tools by @Mike_Honey_ 🧵1/
FLiRT is a nickname for variants with F456L & R356T mutations which seem to provide an advantage over the JN.1 Pirola variants without them. You can see the current FLiRT variants here from @dfocosi. 2/
JN.1 #Pirola has dropped to around 20% frequency and JN.1.4 is hovering at 14% while the FLiRTs are gaining: KS.1 at 10%, KP.1.1 at 4%, KP.2 at 3% and XDK.1 at 4%. 3/
#Variant update for #Ontario, #Canada (to Apr. 9, 2024)
The regular BA.2.86.*/JN.1.* #Pirola clan of variants as you know them are starting to go down in Ontario. This is because descendants are picking up two very useful FLiRT mutations. Graph tools by @Mike_Honey_ 🧵1/
FLiRT is a nickname for variants with F456L & R356T mutations which seem to provide an advantage over the JN.1 Pirola variants without them. You can see the current FLiRT variants here from @dfocosi. 2/
Now that most variants with FLiRT have designations, you can see that JN.1 has dropped to 20% frequency while the new KP.3 FLiRT has jumped to 17.5%. The KS.1 FLiRT variant has also increased to 11% and KP.2 FLiRT is in the mix as well. 3/
PHO is reminding HCWs, even those who have been vaccinated, to wear an N95 while providing care to people with confirmed or suspected cases because they know N95s can prevent infection from infectious aerosols. Works for other airborne viruses as well and non-HCW too.
Respirators protect individuals who are healthy and help reduce the chance of individuals who are sick from infecting others even in well ventilated places where short-range transmission is a concern. 2/
Yes, respirators actually work, read this thread to learn how ( ). 3/
COVID-19 #Wastewater levels in #Ottawa have finally declined significantly but lower does not mean gone as PCR test positivity rates are still at 7.6% ( ). 🧵1/ covid.gilchrist.ca/Ottawa.html
RSV WW levels are 7.7x lower than the peak which was much lower than last year. Influenza had much higher peaks this year than last year and while Flu A levels are low, Flu B hit its peak at the beginning of March and is now declining but still above the peak from last year. 2/
Ottawa Public Health (OPH) stopped updating its COVID dashboard and now produces new stats on their updated respiratory virus dashboard ( ). 3/ottawapublichealth.ca/en/reports-res…
#Variant update for #Ontario, #Canada (to Mar. 14, 2024)
The BA.2.86.* #Pirola clan of variants has made most other lineages extinct in Ontario. The SanKey shows the situation is now much simpler and almost exclusively JN.1 and descendants. Graph tools by @Mike_Honey_ 🧵1/
Right now the JN.1 and JN.1.4 Pirola variant are still the most prevalent. The JN.1.11.1 variant, its descendants (KP.*) and other FLiRT variants will be the ones to watch as they start growing in Ontario and may be able to escape immunity from JN.1 infections. 2/
The % positivity from viral tests is quite a mixture now, the original Coronavirus in lead at 8.2% with COVID-19 in 2nd (6.3%) then Entero/Rhinovirus (5%), Human metapneumovirus (4.6%), Influenza A (4%), Influenza B (3.8%), Parainfluenza (3.4%) ( ). 3/ publichealthontario.ca/en/Data-and-An…