Daniel Park Profile picture
Nov 8 7 tweets 2 min read Read on X
New study evaluating vascular and inflammatory diseases after COVID-19 infection and vaccination in nearly 14 million children.
Large persistent increase in major cardiovascular risks following infection. A small transient myocarditis risk following vaccination Image
Paper:

"COVID-19 infection in children & young people was associated w/ elevated risks... including venous thromboembolism, thrombocytopenia, myocarditis, & pericarditis particularly in the first month... w/ some risks remaining elevated up to 12 months"thelancet.com/journals/lanch…
"By contrast, COVID-19 vaccination was associated with a short-term increased risk of myocarditis or pericarditis, mainly within the first 4 weeks. However, no increased risk was observed beyond that period, and there was no evidence of long-term myocarditis signal"
The paper nicely demonstrates for children what has been known for years in adults - there is a small risk of mild transient myocarditis following vaccination, but a much larger risk of a host of severe outcomes with infection.
cidrap.umn.edu/covid-19/study…
I continue to see vaccine hesitant influencers harping on the myocarditis risk and ignoring the much larger risks from infection.
Similarly, they stress how "bad" vaccine spike proteins are. But the dose range in mRNA vaccines and fixed dose in the protein novavax vaccine are ~100-1,000 times less than a mild infection.
Like saying 1 minute in the sun is bad, then spending 16 hours unprotected in the sun.
So yes, spike protein is bad. Training your immune system to recognize the virus using a tiny transient dose is good. Letting it infect you and run rampant across your whole body for a multi day infection is much worse. Vaccines help prevent severe illness and long COVID.

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More from @Daniel_E_Park

Nov 2
Excellent study on correlates of protection for nuvaxovid / novavax. Higher IgG and nAb levels are excellent predictors for risk of any and severe infection. Helpful data on durability as well. 🧵 Image
Paper: academic.oup.com/cid/advance-ar…

This study group received the original wuhan vaccine and assessed IgG and nAb levels vs Delta. This phase 2 follows the initial CoP analysis, which had no severe cases. That is great, but precluded analysis for severe COVID: nature.com/articles/s4146…
A key finding was that there were no severe cases above the 33rd percentile of IgG levels at day 35 - i.e. based on initial immune responses, no one with an average immune response had severe illness. Image
Read 8 tweets
Oct 31
Excellent systematic review of COVID, flu, and RSV vaccines. Hundreds of studies, and millions of individuals represented, all demonstrating that these important vaccines help reduce the risk of severe illness and hospitalization. Image
Link to study:

Remember that the COVID vaccine effectiveness of ~50% is comparing up to date vaccination vs a background of infection acquired and prior vaccine immunity.nejm.org/doi/full/10.10…
Protection against long COVID in children and adults was also high (~60%) and lines up nicely with prior large studies
thelancet.com/journals/lanre…
Read 6 tweets
Sep 23
Lost in the recent ACIP meeting: A lack of distinction between non-mRNA Novavax & mRNA. They voted on restrictions largely based on mRNA-specific concerns (many false assertions) when these issues flat-out don't apply to Novavax. A brief overview
The ACIP voted to add language about six additional risks with COVID vaccines. Let's see how those apply to Novavax Image
1. Poor effectiveness & duration?
Effectiveness of COVID vaccines remains strong (around 50%). Importantly, these are population level estimates comparing against a background of infection-acquired immunity (see CDC slide). Image
Image
Read 11 tweets
Aug 24
As anticipated, COVID levels are rising nationally with a late summer wave.
Wastewater detection rising quickly.
Early increases in hospitalization rates (those lag infections and viral detection).
I would expect rates to continue accelerating as kids go back to school. Image
Rates are variable by region. For example Texas is matching the highest levels in the last two years. Some areas remain at low levels. Check your state
cdc.gov/nwss/rv/COVID1…Image
Emergency department rates (early clinical indicator) remain relatively low, but there are substantial increases nationally Image
Image
Read 8 tweets
Aug 19
Great overview of one aspect of how COVID damages our bodies.

Summary:
1) blood vessel inflammation,
2) atherosclerosis (clogged arteries),
3) vascular aging (less flexible and functional blood vessels).

Couple additional thoughts 🧵
The cardiovascular impacts of SARS-CoV-2 infection have been well described since the beginning of the pandemic.
Risk of outcomes like heart attack are higher for months or years after infection.
nih.gov/news-events/ne…
nature.com/articles/s4159…
Vaccination halves the risk of cardiovascular outcomes when infected. Vaccines are even more protective if you include prevention of infection (roughly halves the risk of infection vs reference population of mostly infection acquired immunity)
jamanetwork.com/journals/jama/…
Read 6 tweets
Aug 7
Excellent durability up to one year following Novavax booster doses shown in a new study from Japan.

Correlates of protection estimate 66% throughout the first year following first booster, and 88% throughout second year after 2nd booster. Image
Link to study:

Slight limitation that antibody patterns suggest some people likely had asymptomatic infections that were not captured. However, I'll note that the asymptomatic infection scenario (avoiding moderate/severe disease) is also a good outcome.sciencedirect.com/science/articl…
Lastly, correlates of protection have a degree of uncertainty. However, the data for NVX are quite good on this front
nature.com/articles/s4146…
Read 4 tweets

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