Nice coverage from Vox on some of the benefits of the Novavax COVID vaccine: similar effectiveness, fewer side effects, and potentially longer lasting protection. Since concerns about the mRNA platform and side effects are leading causes of vaccine hesitancy, increasing awareness will increase uptake and have societal benefits.
Link to article: vox.com/even-better/39…

Epidemiologists did remarkable work in the early days of COVID-19. Within months, they:
- Accurately predicted the timing of every major wave for the next 3 years.
- Warned SARS-CoV-2 would likely become endemic.
- Identified risk of aerosol transmission.

https://x.com/Daniel_E_Park/status/1865510627965374932?t=ZfA38-edK5Oiwm6hmJ5sJg&s=19

We knew from day 1 that airborne transmission was likely (like SARS-CoV-1).
As confusion w/ masks grew, we saw the urgent need to provide clarity on ventilation (e g. Excerpt from Drs. Prather @kprather88 and Milton, Oct 2020)
science.org/doi/10.1126/sc…
nejm.org/doi/full/10.10…

New RCT study shows the "conventional" Novavax COVID vaccine has a similar side effect profile to the routine meningococcal vaccine, and fewer side effects than the mRNA options.
Side effects are a leading cause of COVID vaccine hesitancy. This can help. Both concerns about the mRNA platform and vaccine side effects are leading causes of hesitancy.
Being able to say the NVX vaccine has similar side effects to routine vaccines that most people are familiar with could be a useful tool.
Paper:
sciencedirect.com/science/articl…

"Trust the experts" is generally a wise approach in many facets of life.
But in an era of Internet "experts" and Monday morning quarterbacks, sometimes we forget what expertise actually looks like.
Lessons from chess, pilots, and epidemiologists and applications to COVID, a 🧵 Chess: Do you know chess? Imagine being shown a chess board, with pieces placed as they were mid-game from a tournament 20 years ago, and being asked to recognize the game. Now imagine doing that with all the pieces replaced with identical discs.

Preprint: comparison of mRNA & protein vaccines and neurodegenerative and neuroinflammatory responses to SARS-CoV-2.
Infection causes neurological damage.
Both vaccines generally protective, but among higher-risk mice, only the protein-based vaccine was protective. Caveat that this is a small mouse study, and is a preprint. Link to the paper: biorxiv.org/content/10.110…

More evidence showing the updated JN.1 vaccines are protective against currently dominant strains (KP.3.1.1 and XEC).
Just in case you needed extra motivation to stay up to date on your COVID boosters.
Paper is here: thelancet.com/journals/lanin…
And my earlier thoughts on the preprint:
x.com/Daniel_E_Park/…

People often ask me what the optimal timing of boosters is. That's an incredibly complex question that varies by individual, including location, anticipated future exposure, family or contacts who are at higher risk, and variants. This paper covers a few of these nuances. Link to paper: academic.oup.com/cid/advance-ar…

Another paper from the PICOBOO randomized trial, evaluating second boosters after mRNA priming.
1) novavax is more durable
2) mRNA vaccines have higher antibody responses
3) novavax has fewer side effects
More nuances in this thread
journalofinfection.com/article/S0163-… 1) Durability: Pfizer antibody levels drop around 40% between 1 month to 3 months post vax.
Moderna is less, w/ a 14% drop in younger adults, 26% decline in older adults.
Novavax had only a 3% decline in younger adults and 17% in older adults.

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.

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… 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.

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 The current dominant strains are KP.3.1.1 and XEC (which is gaining steam quickly)
covid.cdc.gov/covid-data-tra…

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

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

https://x.com/Daniel_E_Park/status/1847257999305273465

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.

https://twitter.com/Yash25571056/status/1847139677775732972

Just a reminder that COVID damages the brain, along with other organ systems.
nejm.org/doi/full/10.10…
thelancet.com/journals/eclin…

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/…

Just out: mRNA COVID-19 vax do not establish in long-lived plasma cells; could account for faster waning vs. infection. Other mechanisms still protect durably vs. severe illness, but improving durability is important. Adjuvants (like in Novavax) may help.
nature.com/articles/s4159… My previous thoughts on the preprint here.

h/t @atranscendedman

https://x.com/Daniel_E_Park/status/1766079718854455681

Vaccines likely lower transmission, in addition to reducing infection and severe illness. New study shows Novavax and Moderna significantly reduce viral load (amount of virus) in the upper respiratory tract.

academic.oup.com/jid/advance-ar…
Novavax reduces viral load by 2.78 log10, while the Moderna vaccine was 2.12. The log10 scale is 10x for each step, indicating Moderna reduces viral load by just over 100x, and Novavax reduces viral load by over 600x. No significant reductions seen for others.

There is a common and dangerous misconception that the JN.1 vaccines are inferior to KP.2 vaccines. In reality, JN.1 and KP.2 vaccines will both provide excellent protection, with each being slightly better in different aspects. But the experts were right to pick JN.1. First, a bit of background. The FDA vaccine expert committee, consisting of 14 highly experienced and accomplished vaccine experts, supported selecting JN.1, with many suggesting it would be a safer and potentially better strain to select compared w/ KP.2.
fda.gov/advisory-commi…

Preprint: Interesting study from Korea comparing homologous NVX (Novavax) and BNT (Pfizer) COVID vax. One of the few places where there are enough NVX doses to do this analysis. Slightly better effectiveness (16% better) with NVX after primary series

medrxiv.org/content/10.110…
More interestingly (to me at least), NVX effectiveness is 35% higher than BNT comparing after the 1st homologous booster. There have been suggestions that homologous NVX boosts can uniquely improve antibody avidity, affinity maturation, & epitope spreading
nejm.org/doi/full/10.10…

Excellent broad cross neutralization to variants with the upcoming JN.1 Novavax COVID vaccine, including some of the best responses to variants that are likely to be dominant this late fall and early winter
novavax.widen.net/s/zg79lxwknx/2…
The latest CDC nowcast shows a rapid rise in KP3.1.1, which is the variant with best response to the NVX JN.1 vaccine. Others variants to keep an eye on include LB.1 (a direct JN.1 descendant) and LP.1 (KP1.1 descendant)
covid.cdc.gov/covid-data-tra…

How our family stayed COVID-negative when my 2-year old was infected. An epidemiologists’ perspective. In late February, our toddler woke up with a runny nose. Anyone with a toddler will know runny noses are very typical. However, thanks to ongoing local surveillance (which I monitor ~weekly), I knew case rates were slightly elevated in our area, and that led me to test.