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Daniel Park Profile picture
@Daniel_E_Park
Feb 26, 2024 • 4 tweets • 3 min read • Read on X
Just released: Pretty remarkable 1-year durability data for Novavax 2-dose primary series. Though there is some expected waning, there was >65% efficacy at 1y (mRNA options typically wane to this level by ~4-5 months). Also fewer waning differences by age.
sciencedirect.com/science/articl…
Image
Refs:
NVX:
BNT:
Waning:
sciencedirect.com/science/articl…
sciencedirect.com/science/articl…
thelancet.com/journals/lanre…
To illustrate age stratified data, I took NVX data from the Japan paper and compared w/ a BNT paper from Norway. For BNT, nAbs & IgG largely back to baseline levels in older individuals by 5m, but remain at protective level at 1y w/ NVX, and more similar to young ages throughout. Image
Long-term durability is challenging to assess due to hybrid immunity, mutations, etc. More long-term durability studies are needed. But this adds to evidence from other observational data and animal models re: NVX durability

jamanetwork.com/journals/jaman…
nature.com/articles/s4146…

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More from @Daniel_E_Park

Daniel Park Profile picture
Apr 24
Large study in children and adolescents shows that SARS-CoV-2 infection is linked with long term cardiovascular complications Image
Study is part of the RECOVER consortium with over 1 million kids.
Link to the paper: nature.com/articles/s4146…
Children and adolescents with SARS-COV-2 infection had higher risk of heart failure, chest pain, myocarditis, cardiac arrest, among others. Nearly double the risk of any outcome with infection. Image
Read 7 tweets
Daniel Park Profile picture
Apr 10
Excited to see our paper out on determinants of SARS-COV-2 infection risk.
Nasal ACE2 and TMPRSS2 levels can predict higher risk of COVID-19.
The nasal microbiome can alter ACE2/TMPRSS2 levels, thus potentially modifying infection risk. Image
Elevated ACE2 and TMPRSS2 levels were higher in individuals who went on to be infected. Higher levels were associated with a four times higher odds of future infection. Cases also had more unstable ACE2 and TMPRSS2 levels over time (i.e. potentially longer windows of risk) Image
Detection of high levels of specific bacteria in the nasal microbiome increased ACE2 and TMPRSS2 levels. One bacteria (dolosigranulum) was linked to lower levels. Dolosigranulum has also shown beneficial characteristics vs severity in other studies Image
Read 5 tweets
Daniel Park Profile picture
Apr 3
Preprint: Higher IgG4 is linked with lower neutralizing Ab & Fc receptor responses. Paper also suggests the Novavax platform may produce higher IgG1/3 and lower IgG4 compared with mRNA COVID vaccines. Image
To illustrate the magnitude:
NVX priming vs. mRNA priming = 49 vs 8,567 ng/mL in IgG4 (the bad one).
Conversely, IgG1 - 3 (the good ones) were similar or higher in the NVX group.

Link: medrxiv.org/content/10.110…
NVX also appears to have beneficial characteristics for protecting against newer variants due to:
1. less immune imprinting
2. enhanced Fc effector functions (that are less impacted by variant changes)
Read 6 tweets
Daniel Park Profile picture
Feb 23
New RCT comparing Moderna bivalent and Novavax (original strain) as a fourth dose. Novavax has:
- lower side effects
- similar cell mediated immunity, lower IgG response
- potentially broader protection vs variants Image
Link to study:

Side effects are a leading cause of vaccine hesitancy. The Novavax reactogenicity shows roughly half the frequency of each symptom, and lower severity. journalofinfection.com/article/S0163-…Image
The IgG responses are lower with the novavax vaccine, as consistent with prior studies. The authors note that these differences may not be meaningful as other RCTs and studies show similar efficacy with these differences in IgG levels. Image
Read 6 tweets
Daniel Park Profile picture
Feb 16
Having worked with many EIS officers, I can confirm they are among the best and brightest. They leave high-paying jobs to serve communities, ready to face danger at a moment’s notice. Now, the entire class has been let go. These heroes won’t be there when we need them.
One particular memory of mine that highlights the character of an EIS officer. We were on call with an EIS grad while he was in the field. Heard screeching tires and the line went dead. Called his cell, and he picked up and said calmly, "Hi, it's [name]".
I said, "oh we were worried you were in a car accident".
He said, "yeah I was. Our car flipped over. Let me call you back, I need to help our driver and check on the other car".
Read 6 tweets
Daniel Park Profile picture
Feb 1
Results from PREVENT-19 Novavax pediatric RCT of >1,000 adolescents.
- Vaccine efficacy was 74% (original Wuhan vax vs Delta variant).
- Nearly all infections after vaccination were asymptomatic or very mild.
- Viral load lower in vaccinated, but not statistically significant Image
Notably, this study used twice-weekly swabs to detect asymptomatic infections. Not directly comparable, but Moderna had 39% efficacy vs. asymptomatic infections in adolescents. Ad.26 was lower at 29%.
nejm.org/doi/10.1056/NE…
nejm.org/doi/10.1056/NE… Image
BNT (Pfizer) had 87% efficacy w/ less freq sampling (weekly), but with an asymptomatic proportion (~38%) suggesting some asymptomatic infections were potentially missed.
Read 5 tweets

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