Shamez Ladhani Profile picture
Paediatric infectious diseases specialist @StGeorgesHospital, Epidemiologist @UKHSA #vaccines #meningitis #covid #childhoodinfections tweets personal
Κασσάνδρα Παρί پری Profile picture Hope Heliotrope Profile picture 🆔 Richard Nathan || Vaccinated 💉 🦠🐶🐕☕⚾😷🐾 Profile picture Myrne Stol Profile picture Kim Profile picture 7 added to My Authors
Aug 3 8 tweets 4 min read
1/ Our preprint on immune responses of kids to #SARSCoV2 #Omicron is online

Top line: Primary Omicron infection induces poor antibody responses in unvaccinated kids, but robust T cell responses which will protect against severe #COVID19 in the future🧵

👉… 2/ We determined the variant-specific antibody and cellular immune response following Omicron infection in children aged 6-14 years and related this to prior SARS-CoV-2 infection and vaccination status.
Jul 5 12 tweets 6 min read
1/ Many parents are still concerned about long covid in kids:

If you want to know where we really are with long covid in kids then take a few mins to read this short, honest, down-to-earth editorial by a Danish paediatrician in @LancetChildAdol …🧵

👉… 2/ Early in the pandemic, following long covid reports in adults, studies focused on asking parents & their kids about symptoms experienced after #COVID19. Most kids had common, non-specific symptoms that commonly come and go over time, often nothing to do with covid
Jul 2 13 tweets 8 min read
1/ I was asked by @TheLancet to write an editorial on #COVID19 vaccines for 5-11 year-olds: 6 months on, what have we learnt?

Importantly, what is the endgame?
Preventing infections? Severe disease? Long covid? And at what cost?

My tuppence worth …🧵

👉… 2/ My editorial was based on an Italian study on #COVID19 vaccines for 5-11y during Jan-Apr 2022:

VE ⬇️ from 65% (95% CI 62–68) in the 2 weeks after 2 doses to 12% (8–16) by 28-34 days

VE against hospitalisation was 41·1% (22·2–55·4) after 2 doses

Jun 8 8 tweets 5 min read
1/ Our preprint on #COVID19 & childhood deaths during the first 2 pandemic years in England 👉…

Top line: Among ~12 million <20 year-olds, there were 81 #covid deaths (infection fatality rate, 0.70/100,000 infections) - that’s less than 1 in 100,000 …🧵 2/ We followed up all deaths within 100 days of confirmed #SARSCoV2 infection in children & young people (CYP) aged <20 years in England during 2021 & 2022, using national databases, surveillance questionnaires, post-mortem reports and clinician interviews
Apr 7 8 tweets 5 min read
1/ Unlike adults, the majority of kids hospitalised with #SARSCoV2 do *not* have severe #Covid

In London we found only 10% of kids hospitalised with a +ve #sarscov2 PCR-test had severe #COVID19, mainly during the alpha wave

Here’s our preprint…🧵

👉… 2/ We reviewed medical records of 0-18 year-old admitted to a large London teaching hospital over 14 months, covering alpha, delta & omicron waves. PIMS-TS excluded because diagnosis does not require positive virus test. There were 150 kids hospitalised between 01Dec20 & 31Jan22
Mar 30 5 tweets 3 min read
1/ Back when #SARSCoV2 Delta variant emerged & there were reports of increased severity in adults & then in US kids, we tried to reassure parents with indirect data that delta was not more severe than alpha in kids. Here finally is our evidence …🧵

👉… 2/ We compared hospitalizations in kids with alpha or delta variant in England. Between Nov 1 2020 & Sept 13, 2021 (before COVID-19 vaccine for 12–15y in the UK), there were 759 307 SARS-CoV-2 infections in kids; 156 031 were sequenced/genotyped: 31 182 were alpha & 115 795 delta
Mar 25 7 tweets 4 min read
1/ Please BEWARE this pre-print from Hong Kong claiming that the Omicron BA.2 variant is not mild in kids. Basic epidemiology will tell you that the methodology is flawed & the conclusions go against everything we know about the Omicron variants

👉… 2/ This preprints compares 1,147 kids (0-11y) who were hospitalized with BA.2 in Feb 2022 (at the peak of their latest pandemic wave) with 737 kids hospitalised with any of the past #SARSCoV2 variants since the start of the pandemic (over 20 months) - but here’s the problem…
Mar 24 5 tweets 3 min read
1/ Our latest analysis from the UK School Infection Survey (SIS2) is now online @UKHSA @ONS @LSHTM

Here are some interesting findings from the autumn term (Sep-Dec 2021) in primary and secondary schools … 🧵

👉… 2/ Unlike autumn 2020, the highest infection rates in autumn 2021 were in kids in least deprived areas (20.1% primary & 27.9% secondary pupils in least deprived vs 9.4% primary & 15.3% secondary pupils in most deprived) - likely because they had avoided infection previously
Feb 28 8 tweets 4 min read
1/ In England, ONS recruited nationally representative schools in Nov 2021 & found only 1.0% of kids in primary (4-11y) & 2.7% in secondary (11-17y) schools fulfilled Long COVID criteria *since March 2020* - only loss of taste/smell was significant…🧵

👉… 2/ The survey used Delphi criteria developed from the CLoCk study to define long COVID, which included:
1. Positive viral test
2. Symptoms for 12 weeks or more
3. Everyday life affected by these symptoms

Feb 27 5 tweets 3 min read
1/ In other news, England is seeing an ⬆️ in invasive pneumococcal disease in young kids this winter, higher than pre-pandemic years, likely because of immunity debt from earlier lockdowns. Fortunately, total cases still 50% ⬇️ @MartaBertran9 @acciochoc 👉… 2/ We recently also reported a small ⬆️ in meningococcal group B infections (meningitis, septicaemia) in university-aged students (the main age group that carries meningococcal bacteria at the back of their nose/throat) - higher than pre-pandemic numbers 👉…
Feb 26 6 tweets 4 min read
1/ We have updated our #COVID19 vaccine effectiveness (VE) results to include data on Omicron for teenagers in England (pre-print)

VE against symptomatic disease waned after doses 1 & 2; higher VE for Delta but fell to 20% by 10 weeks for Omicron…🧵

👉… 2/ A rapid initial uptake of #COVID19 vaccine soon plateaued doe both 16-17 year-olds (60-70%) and 12-15 year-olds (50-60%). Second doses are underway and uptake rates are increasing slowly. Those who had #covid in then Omicron wave sigh have their dose delayed Image
Feb 22 5 tweets 3 min read
1/ Two years into the pandemic, we continue to include kids with adults in #COVID19 surveillance - yes, kids always fare better than adults, but that doesn’t tell the whole story and just gives zero-coviders ammunition to propagate fear among concerned parents …🧵 2/ E.g. Take this #COVID19 mortality surveillance report from @UKHSA. Fatalities are so rare in kids that most numbers are suppressed below 10 but, unlike adults, fatalities up to 60 days after #SARSCoV2 are highly unlikely to be due to #COVID19 in kids 👉…
Feb 20 10 tweets 5 min read
1/ The UK JCVI has recommended a non-urgent offer of 2 lower doses of Pfizer vaccine (10 mcg) for 5-11 year olds given 12 weeks apart “to protect against future #COVID19 waves”. This is as close to “you can have it if you want it” as you will get … 🧵

👉… 2/ The Pfizer #covid vaccine is already being offered to high-risk 5-11 year-olds in the UK. This group should take up the offer of vaccination, even if previously infected, to protect against severe #COVID19 & hospitalization from any variant 👉…
Feb 18 7 tweets 3 min read
1/ Our latest preprint is now online. We assessed #SARSCoV2 antibody levels in vaccinated adults aged 50+ years & show that antibody levels are higher after 3 vs 2 doses & in previously-infected vs infection-naive adults but rate of waning is similar

👉… Image 2/ We @UKHSA have been monitoring #SARSCoV2 antibodies in adults aged 50+ years who were vaccinated against #COVID19 as part of the national programme and agreed to provide blood samples at regular intervals since January 2021, including after their booster with Pfizer vaccine
Feb 4 5 tweets 4 min read
I feel sorry for @BinitaKane’s daughter because some kids do suffer long term effects of #COVID19 just like any other virus, but this information about the risk of severe covid, deaths & long covid in kids is blatantly incorrect (ht @R_Hughes1) …/1 Firstly, it’s 1 in a 100 children with a positive #SARSCoV2 test that are hospitalised BUT not *for* #COVID19. More than half the kids do not even develop symptoms - the hospitalizations are for other medical conditions. It’s just that we test every kid who comes to hospital …/2
Jan 24 10 tweets 6 min read
1/ For parents, the decision to vaccinate their child against #COVID19 is personal & voluntary, but many are uncertain because of mixed messaging out there. I can’t tell you what to do, but here are some things to consider when making your decision …🧵 2/ If your child has a medical condition that increases their risk of severe #COVID19, then it’s a no-brainer because the benefits far outweigh any potential risks of vaccination. In the UK, the list of high-risk conditions can be found in the Green Book 👉…
Jan 19 7 tweets 4 min read
1/ In England, we have recently seen a small increase in meningococcal disease, mainly in university-aged students. We are working hard to raise awareness of the symptoms and signs of meningitis & septicaemia because early treatment saves lives …🧵

👉… 2/ Meningococcal disease typically manifests as meningitis, septicaemia or a combination of the two. Infants & toddlers have the highest risk, followed by teens & young adults but any age can be affected. More information here @M_R_F @MeningitisNow 👉
Jan 9 9 tweets 4 min read
1/ The CLoCk study is the largest study on long covid in teens. This study *DOES NOT* show that 1 in 7 teens (14%) get long covid & neither do the ONS surveys. Here is a short summary. The real gem in the data, however, is hidden in the Supplement …🧵

👉… 2/ CLoCk is a case-control study comparing acute and persistent symptoms in PCR+ and PCR- teens in England. More than 200,000 teens were contacted & 13% agreed to complete regular online questionnaires
Dec 27, 2021 7 tweets 3 min read
1/ Kids rarely get severe #COVID19. While hospitalization in adults often reflects severe disease, this is not true for kids. In England, we found very low rates of #covid19 hospitalisations in kids during the 1st pandemic year & most were short-stay without complications ...🧵 2/ We assessed hospitalisations in kids (0-17y) from Feb 2020 to Jan 2021 in England. There were ~500,000 hospitalizations, including 6,338 recorded to have COVID & 712 with PIMS-TS. This compares with 6,968 for influenza in the previous year (2019/20)

Dec 23, 2021 22 tweets 11 min read
1/ A lot of questions about natural immunity following #SARSCoV2 infection in children

After nearly 2 years, what have we learnt about kids, antibodies, cellular immunity, variants, reinfections and vaccines so far?

Our 3 recent studies help answer many of these questions… 🧵 2/ Back in June 2020, a small team of doctors, nurses & scientists realized that #SARSCoV2 would have major impact on kids despite a low risk of severe #COVID19. We started #COVID19 surveillance in schools & took blood samples +++ from staff & students 👉…
Dec 21, 2021 4 tweets 3 min read
1/ If anyone still has any doubt as to whether a longer interval of 8-12 weeks between #COVID19 vaccine doses provides better protection than the shorter 3-4 week interval, here is our paper with definitive evidence now published in @NatureComms …🧵

👉… 2/ We assessed #SARSCoV2 antibody responses in 750 adults aged 50–89 years receiving either Pfizer or AZ vaccine with varying intervals between the 2 doses, and evaluated responses against real-world national vaccine effectiveness (VE) estimates against COVID-19 in England