Dr. Angela Rasmussen Profile picture
Excessively direct virologist. PI @VIDOInterVac. Affiliate @georgetown_ghss. Emerging virus host responses. 1X Jeopardy! loser. Rep: @anniescranton. she/her
otaria123 Profile picture Adam Smithee Profile picture Κασσάνδρα Παρί پری Profile picture CRE Profile picture mike norrie Profile picture 39 added to My Authors
14 Jun
I'm very concerned about the delta variant. It's still not clear to me that it's more pathogenic, but it is more transmissible, including among people who are partially vaccinated.

This got me thinking about the J&J vaccine, and how maybe it's time to think about mRNA boosters.
We've known for a while that J&J isn't as effective against infection as mRNA vaccines (probably because it's one dose).

As it stands, J&J does provide great protection against symptomatic COVID-19, and that's important. But we need to think about protecting against infection.
We know 2 doses of mRNA vaccines provide strong protection against the delta variant, but the incidence of severe disease seems high in partially vaccinated people, including with AstraZeneca in the UK. That suggests that it might be an issue for people fully vaccinated with J&J.
Read 10 tweets
2 Jun
There’s a lot of talk about pandemic preparedness and biosecurity so how about a cool paper about how basic virology and immunology helps develop effective antibody-based drugs for Crimean-Congo hemorrhagic fever!
Never heard of CCHFV? You might someday—it’s a tick-borne hemorrhagic fever virus. It’s bad...you don’t want to get it! But if you do it sure is nice to know someone invented a treatment for it even though it’s not common...yet.
There’s a lot of ticks. They carry a lot of different pathogens, including a lot of different viruses. Some of those viruses are pretty bad, like CCHFV. Preparedness means figuring out how to counter pathogens like CCHFV BEFORE they become an out of control problem.
Read 4 tweets
30 May
@KindrachukJason @GidMK @MackayIM @trvrb Lol what Dr. Kindrachuk said. Also this makes no sense at all, and let me just address the big claim that seems to come up more and more: viruses don’t automatically evolve to be more transmissible and less pathogenic. Natural evolution has many possible outcomes.
@KindrachukJason @GidMK @MackayIM @trvrb Plenty of viruses evolve with no changes to either transmissibility or pathogenicity. Ebola? Thankfully hasn’t become more transmissible because it sure as shit isn’t getting less pathogenic.
@KindrachukJason @GidMK @MackayIM @trvrb SARS-CoV-2 is already not that pathogenic, and isn’t likely to evolve much in either direction with regard to pathogenicity. It infects the majority of hosts without killing them. It gets more transmissible because it’s had so many opportunities to acquire adaptive mutations.
Read 4 tweets
15 May
Thinking about the @CDCgov mask guidance a lot...it is based on evidence about vaccine effectiveness & is scientifically sound. It will incentivize some to get vaccinated, but is premature in many places.

But the real problem IMO is the lack of transparency. Why this? Why now?
The CDC has lost the trust of many people, in large part because of actions taken by the previous administration, and the lack of openness about that. Trump administration officials sidelined the CDC and were meddling with comms, guidance, and even data behind the scenes.
Much of this has come to light, including efforts by Michael Caputo and Paul Alexander to manipulate data in support of Trump’s desired policies, which depended on downplaying risks of premature reopening.

It’s no wonder the CDC lost the public’s trust.
Read 7 tweets
12 May
Fantastic thread & piece by @kakape on the peri-mortem analysis of the pandemic, the IPPPR report on COVID-19 led by @HelenClarkNZ & @MaEllenSirleaf.

This report addresses the key question: what went wrong & how can that be avoided next time (because there will be a next time)?
There were a lot of mistakes, most notably not recognizing pandemics as the urgent threats they are.

But here's the breakdown of the most significant missteps:
1. We ignored warnings that we were unprepared for a pandemic
2. Governments failed to adequately prepare
3. WHO was late in declaring a PHEIC (public health emergency of international concern)
Read 9 tweets
5 May
Public health people are often accused of "enjoying" the pandemic. Now some say that anxiety about reopening is actually "fear of normalcy."

Thanks @ChuckWendig for this perfect antidote to the stupid, unsympathetic idea of pandemic "addiction."
The past 15 months have been extremely traumatic to all of us, and not just because of "fear." Of course fear is one part of what's made this so awful, but there's also: loss, grief, isolation, etc. It's entirely cruel and unsympathetic to suggest anyone is "addicted" to trauma.
And many of the people preaching this addiction gospel also position themselves as optimists. One person even created a hashtag #FONO ("fear of returning to normal") to further pathologize a completely normal reaction to trauma and suggest may be a worse epidemic than COVID.
Read 8 tweets
4 May
Seeing a lot of explanations that attribute the horrific surge in India to one thing or another (variants, aerosols, vaccines, etc), all of which betray a facile understanding of how a crisis like this occurs.
"It's because of more transmissible variants!"

This might contribute, but as Dr. @ashishkjha points out, 40% of the population lives in multi-generational households. This is conducive to the spread of any variant, especially to older, higher risk people.
And for their contribution to the overall cases, more transmissible variants are a problem in the surge of severe cases that are overwhelming the inadequately funded health care system. The variants may cause more infection, but more people are dying b/c they can't access care.
Read 25 tweets
3 May
Last week the Sputnik V Twitter account said I was spreading "fake news" in this thread & that I read their statements and as-yet-unreleased correspondence with Anvisa, the Brazilian regulator, as proof.

Anvisa held a press conference. A minor correction is in order.
Let's just get the correction out of the way: Anvisa wasn't responsible for batch testing Sputnik V and didn't find plaques on A549 cells. That was Gamaleya, and they bent over backwards to claim that isn't what their data shows.

BUT IT DOES. Let me explain.
First, let's refresh:

Sputnik V is a viral-vectored vaccine. It uses a type of common cold virus called adenovirus to express the spike protein from SARS-CoV-2. The adenovirus vector is engineered to be replication-defective, meaning these viruses can't reproduce themselves.
Read 32 tweets
30 Apr
There's a lot of myths and misperceptions so I'll try to cover this quickly! See thread below:
1. Vaccines give you COVID. None of the currently authorized vaccines can give you COVID. They only use the SARS-CoV-2 spike protein, and there is no intact virus in any of the vaccines. Flu-like side effects aren't COVID...they are temporary and just show the vaccine is working!
2. mRNA vaccines are gene therapy. mRNA is chemically similar to DNA, but it is not the same thing. mRNA cannot alter DNA and never actually even gets into the part of the cell where DNA is stored (the nucleus). mRNA vaccines make spike protein for a day or two, then degrade.
Read 13 tweets
30 Apr
The vaccines are very safe! We knew this initially because of data from clinical trials, in which thousands of people were vaccinated and studied, as well as from observations of people who have been vaccinated since the vaccines came on the market. Some more detail below:
In the phase 3 trials for Pfizer, Moderna, and J&J there were a handful of severe adverse events reported out of more than 100,000 participants combined in those 3 trials. The most common (but still rare) safety concerns are with allergic reactions. Those are easily treatable.
Nearly 200 million doses of Pfizer and Moderna have been given in the US. There are no "safety signals" reported. "Safety signals" are reports of a severe illness that might be vaccine-related in a database at CDC called VAERS (Vaccine Adverse Event Reporting System).
Read 5 tweets
28 Apr
Они обалдели!

The Sputnik V vaccine Ad5 vector is evidently replication competent. The makers apparently neglected to delete E1, so getting this vaccine means being infected with live adenovirus 5.

Hence Brazil’s regulator correctly rejected it.

Adenovirus-vectored vaccines like J&J, AstraZeneca, and Sputnik V use infection with adenoviruses, common pathogens that usually cause common colds.

But to increase safety and decrease risk of side effects, most vaccine vectors delete the AdV E1 and E3 genes.
E1/E3 deletions are standard in Ad-vectors. Deleting E1 prevents the virus from replicating and deleting E3 prevents it from interacting with the immune system.
Read 19 tweets
26 Apr
Jonas Salk once famously asked if you could patent the sun re: IP rights for the polio vaccine.

That's a far cry from Bill Gates' unilateral decision to place patent protection above global health in terms of priorities.
Gates is right that it's not as easy as just repurposing factories in LMICs, but that is not a good argument against the TRIPS waiver.

Vaccine IP includes the manufacturing process—the recipe, not just the ingredient list. If that were shared, you don't need to "do the trial".
Having proprietary details about the manufacturing process means you could equip facilities to produce these vaccines. Not magically. But safely and in compliance with processes that have already been approved.
Read 6 tweets
20 Apr
Update: I’m grateful to both @erenbali and the support team at @CarbonHealth for escalating our test results being uploaded. We now have them in hand and are going to the border. Many thanks to Mercedes at support for her working to resolve this urgently.
And I also found out what happened: a delay at the lab resulted in delays downstream. I passed along my strong suggestion that in the future, the @CarbonHealth team be as transparent as possible to their clients, especially with time-sensitive medical tests.
I firmly believe that people are empowered by information, especially with regard to their own health. I thank @CarbonHealth for being so responsive and I encourage them to review their support protocols to better inform their patients in the future.
Read 4 tweets
20 Apr
So update on our moving situation: my spouse and I need to have negative COVID tests within 72 h of crossing the Canadian border. We obtained these tests at @CarbonHealth in Seattle on the 18th because we knew it would be hard to get these in eastern Montana where we are crossing
We paid $170 each for our test results to be returned to us yesterday because this is non-negotiable for Canada immigration. But yesterday we got a text from @CarbonHealth informing us the results were delayed. I called and was reassured my results would be posted by this morning
The @CarbonHealth rep I spoke with last night said no problem but in the very unlikely event that the test results still weren’t posted, they are open at 6 am PDT. I just called and waited on hold for 20 minutes, only to be sent to voice mail.
Read 11 tweets
16 Apr
I got the J&J vaccine ten days ago, so the reported blood clotting disorders hits close to home.

Here's why I'm not losing sleep over this, and why the pause to get more data is the smart thing to do. My latest for @nytimes:
*reported blood clotting disorders HIT close to home. Sorry, it's been a long day!
And it's been such a long day that @roby_bhatt just pointed out I made an inadvertent heparin-induced thrombocytopenia pun, so maybe I should expand on that. I had more granular information in my first draft but it got cut in favor of a broader message. Read on if interested:
Read 13 tweets
11 Apr
Before you read headlines along the lines of “the mRNA vaccines don’t work against variants in the real world OMG WE ARE DOOMED!” read this thoughtful thread by an author of the study:
Partial vaccination didn’t protect as well against B.1.1.7 (UK) or B.1.351 (South Africa). In fully vaccinated people, this was enriched for B.1.351, suggesting that full vaccination protects well against B.1.1.7 but less so against B.1.351.
This is consistent with 2 observations that have been made for months:

-1 dose of mRNA vaccine is insufficient. Delayed 2nd dose leaves a longer interval of reduced protection.

-the B.1.351 variant can *partially* evade immunity & is more likely to cause breakthrough infection
Read 7 tweets
8 Apr
Yet another reason why I'm excited to get started at @VIDOInterVac!

Fantastic preprint from my wonderful soon-to-be colleague @akelvinlab (led by @magiefrancis & featuring @KindrachukJason) on the host response in a hamster model of COVID-19 pathogenesis.

What did they find?
Suppression of type I interferons in the lungs, heart, liver, and kidneys? Yes.

Increased proinflammatory cytokines? That too.

Pathological evidence of myocarditis and renal disease? Indeed.
This is consistent with emerging evidence that delayed antiviral responses (interferons) lead to dysregulated inflammation and damage to organs, both in and out of the respiratory tract.

This also gives us insight into how host responses can determine COVID-19 severity.
Read 4 tweets
7 Apr
This is not science-related but we ordered sushi and wanted to watch a travel show so we watched an old No Reservations episode about a famous chef fest in Japan. Anyone want to guess how many non-white male chefs participated?

Well there were 2 East Asian men. Out of like 20.
Not taking anything away from Rene Redzepi, Magnus Nilsson, or Albert Adria but the idea that David Chang is enough to make this diverse is laughable. This show is only 10 years old! How does this manel represent the world’s greatest brain trust in culinary innovation?
The chefs featured are brilliant, as was Bourdain, but the boys club vibe was palpable and unexamined. Lots of bullshit about hunting and how foraging is macho and oh look! Famous “Southern foodways” chef Sean Brock is drinking bourbon and barbecuing a pig.

How innovative.
Read 5 tweets
6 Apr
Great thread. There are 2 problems with much of the variant coverage.

On one side, we have:

On the other, we have:
Nothing to worry about here, because (T cells/herd immunity/scientists are being negative again)

Neither side is 100% wrong or right
Here's what we know:

Yes, variants have emerged. Yes, they are a problem.

Some, like B.1.1.7 are more transmissible and more virulent.

Some, like B.1.351 and P.1, may have *some* capacity to *partially* evade adaptive immunity (B cells/T cells).
But we can address both of these threats:

-Continuing to take precautions (masks, distancing, ventilation, etc) to reduce exposure risk

-Getting vaccinated ASAP. No variant has shown the ability to *completely* evade adaptive immunity. Vaccines still work against the variants.
Read 11 tweets
5 Apr
So I was very privileged to get vaccinated with J&J/Janssen this morning. I was originally supposed to get Pfizer. Let me explain why I switched, even though J&J is slightly less effective overall. A short thread:
Last week when I made the appointment for me and my husband when we became eligible, I was elated to get access right in time for a big life change: moving my family to Canada.
Many of you know I’m moving to Canada later this month to start a lab @VIDOInterVac. I’m so excited about this but I couldn’t help but think: will I be able to get my second dose of Pfizer in Canada?
Read 13 tweets
2 Apr
For all those wondering how variant mutations can screw up antibody responses, have I got the preprint for you!

Buckle up for a long ride down epistasis & biochem road, thanks to this great study by @Dr_MattMcCallum and colleagues in the @veeslerlab & collabs at @Vir_Biotech.
First, some background. All the variants have different constellations of mutations in SARS-CoV-2 spike. This is the protein on the surface of the virus particle (virion) that bind the receptor ACE2 and allow the virus to enter & infect cells.

It looks like this (h/t @profvrr):
As you can see from the above virion, spike is a 3D structure on the surface of the virion. Antibodies bind all over the surface of the spike protein. Some of these bind to important parts of spike that render the virus non-infectious, or neutralize it.
Read 36 tweets