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Daniel Park Profile picture
@Daniel_E_Park
Nov 16 • 9 tweets • 4 min read • Read on X
A trio of Novavax preprints, showing 1) remarkable durability >6 months, 2) cross protection against newer variants, and 3) low reactogenicity (side effects), supporting NVX as an excellent booster platform.
medrxiv.org/content/10.110…
medrxiv.org/content/10.110…
medrxiv.org/content/10.110…
1) Antibody levels remained high over 6 months after the first booster, with pre-boost levels before Dose 4 being similar to post-primary antibody levels. This is quite remarkable durability. Image
2) The original strain vaccine showed good responses with BA and XBB strains, and even had some cross protection to JN.1. in other words, the original NVX vaccine had at least some cross-protection against 3 years worth of variants. Image
In 2022 the FDA had preferential language for bivalent mRNA, despite NVX showing cross protection vs BA.5 using the original vaccine. We now know bivalent mRNA vaccines had skewed responses to the original strain and not BA.5 (i.e. original antigenic sin)
academic.oup.com/jid/article/22…
Variant cross protection with heterologous boosting has long been shown across many large RCTs. This new study adds further support to NVX following an array of mRNA or other priming schedules.
nature.com/articles/s4159…
journalofinfection.com/article/S0163-…
It's probably worth a quick note that the updated mRNA and Novavax vaccines for this season have excellent cross protection against the currently dominant KP.3.1.1 and XEC variants
Image
Back to the preprint, 3) the authors note that reactogenicity does not seem to increase with further booster doses. Based on limited data, the second priming dose likely has the highest reactivity, but still generally lower than mRNA options. Image
The authors correctly note in the discussion that side effects are a leading reason for low booster uptake. Lower side effects w/ NVX makes it a good option for this relatively large group that may otherwise not be vaccinated.
academic.oup.com/jid/article/23…
The excellent discussion section summarizes the 3 main factors making NVX an excellent booster option: 1) durable protection beyond at least 6 months, 2) good cross protection vs new variants, 3) fewer side effects

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More from @Daniel_E_Park

Daniel Park Profile picture
Nov 12
Comparison of NVX (Novavax) and BNT (Pfizer) after primary or booster from South Korea through 180 days. NVX primary series offered slight "added protection" against infection (~10%) and severe disease (~35%), while homologous boost findings were mixed.
sciencedirect.com/science/articl…Image
Again, this is one of the few populations that have the adequate sample size to explore this comparison. The 180 day window is helpful at assessing longer term patterns. Image
The NVX primary series is more protective for infection and severe illness compared w/ Pfizer, whereas Pfizer homologous boost is slightly better for infection (~15% w/ barely significant confidence interval), but w/ NVX booster having 61% lower risk of severe illness
Read 5 tweets
Daniel Park Profile picture
Nov 9
Preprint: Pfizer preprint supporting that JN.1 and KP.2 vaccines are similarly effective against currently circulating strains, including KP.3.1.1 and XEC.
And some very interesting info supporting earlier suggestions about conformation of JN.1, KP.2, and KP.3.1.1 Image
The current dominant strains are KP.3.1.1 and XEC (which is gaining steam quickly)
covid.cdc.gov/covid-data-tra…Image
The authors compare neutralization titers (a correlate of protection) for both vaccine naive and vaccine primed mice across these variants. Both show much improved protection across all variants of concern compared w/ the older XBB vaccine.
Vaccine naive here (relevant for kids) Image
Read 12 tweets
Daniel Park Profile picture
Nov 7
I closed my Public Health lecture today with this quick thought.

We can't control everything around us, but we can control our actions, we can impact those around us, and we can save and help millions around the world with our work, which is now more important than ever.
There are reports a certain vaccine conspiracy theorist may have a role in the next administration. Vaccines have saved 154 million lives over the last 50 years - six lives every minute. Many more live full healthy lives thanks to prevention of chronic/debilitating illness https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00850-X/fulltext
It is challenging enough to get these life saving vaccines distributed to where they are needed. Misinformation has had real a impact on increases in preventable illness. Regression on our progress will cost lives and cause unnecessary suffering.
ecdc.europa.eu/en/news-events…
Read 5 tweets
Daniel Park Profile picture
Oct 27
Large study provides support for many long COVID (LC) findings:
1 Fatigue & neurological symptoms most common
2 Women more likely to have LC
3 Reinfection has milder acute symptoms but more severe LC
4 Vaccination reduces LC risk
5 ⬆️post-COVID infections
thelancet.com/journals/lanwp…
For #1, memory loss was a leading LC symptom along with fatigue, and brain fog was in ~15% of respondents.
Brain damage and neurological symptoms following even mild cases of COVID are becoming better understood and characterized
For #2, women were shown to have more frequent and more severe LC.
Prior studies have shown nearly double the prevalence of LC in women.
Read 7 tweets
Daniel Park Profile picture
Oct 18
I do quick cognitive tests as part of my daily work routines to adjust my tasks based on my current state. My very "mild" case of COVID resulted in a ~20% slowdown and 10% reduction in overall cognition, which only gradually resolved over a year.
Just a reminder that COVID damages the brain, along with other organ systems.
nejm.org/doi/full/10.10…
thelancet.com/journals/eclin…
Recent studies demonstrate that in addition to structural brain changes, many effects may be immune meditated
nature.com/articles/s4159…
Read 5 tweets
Daniel Park Profile picture
Oct 12
I've recently discussed sudden behavioral issues in school aged children w/ parents and teachers. In most cases, this followed the kids being sick.
Reminder: COVID can cause increased anxiety, aggression, and defiance in children.
mecp.springeropen.com/articles/10.11…
ncbi.nlm.nih.gov/pmc/articles/P…
These symptoms can last months after the initial infection.
Long COVID in children also manifests differently by specific age group
jamanetwork.com/journals/jama/…
The mechanisms of impact on mental health continue to be better understood, mostly from adult studies. This includes significant loss of grey matter (even w/ mild infection)
ncbi.nlm.nih.gov/pmc/articles/P….

nature.com/articles/s4158…
Read 5 tweets

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