Starting to get a sense of the public's understanding of, and demand for, the new bivalent Covid booster:

-1/2 of adults have heard little or nothing about the new booster

-4 in 10 fully vaccinated adults not sure if CDC recommends the booster for them

kff.org/coronavirus-co… Results from a new @KFF vaccine monitor release.

On a positive note, 8% of adults 65+ say they got the booster in (approx) 3 weeks since its release, and close to 40% more say they plan to get it as soon as possible.

Wonderful: a malaria vaccine is now recommended for use in high burden areas, and could save tens of thousands of lives a year
who.int/news/item/06-1…

(For sense of the timing: initial Phase 3 trial results for this vaccine were published a decade ago!)
nejm.org/doi/10.1056/NE… WHO and others careful to note the vaccine is best positioned as one component of a comprehensive public health approach to malaria prevention. It is burdensome (4 shots over 18 months) and perhaps 50% effective in preventing severe malaria in kids.

In 2022, protein-based COVID-19 vaccines could be what mRNA vaccines have not been for many lower-income countries: accessible and relatively easy to manage. Slower out of the gate than other vaccines, there are now several candidates on the near horizon. 1/ They are refrigerator stable, have promising safety profiles, and efficacy that in many cases rivals mRNA vaccines. Protein vaccines are also readily scalable, with good prospects for technology transfer 2/
nature.com/articles/d4158…

Over 7 billion Covid-19 vaccine doses have been produced globally to date, with >1.35 billion more doses produced each month now.

Sinovac and Sinopharm produce the greatest number of vaccines monthly, with Pfizer and AstraZeneca not far behind. 1/ By the end of this year the world is likely to produce over 12 billion vaccine doses of all vaccine types.

By June 2022 the number produced could reach double that – 24 billion doses (assuming all goes well, and it usually doesn’t) 2/

Keeping a wary eye on Covid trends in South America. The good: cases/deaths there have come down from devastating peaks a few months back, and there’s progress on vaccinations. The bad: Delta may have only begun to circulate, and questions about vaccine efficacy Most countries in the region have fully vaccinated between 20 and 40% of their populations; Chile and Uruguay stand out, with >70% fully vaccinated. Countries use a mix of vaccines, mostly Chinese inactivated vaccines (Sinovac and Sinopharm), plus some Pfizer & AstraZeneca

Some initial thoughts on full FDA approval of the Pfizer vaccine and what it might mean for vaccine acceptance in the US, based on @KFF polling and policy work A commonly referenced finding from KFF's vaccine monitor is that 3 in 10 unvaccinated people reported they'd be more likely to get the vaccine upon full FDA approval
kff.org/coronavirus-co…

G20 summit today featured many pledges, promises and proposals to address global gaps in COVID19 vaccine access. We'll have to see how many of these become concrete actions in the weeks and months ahead.
reuters.com/world/g20-heal… Pfizer promised to provide 2 billion doses "at cost" for lower income countries over the next 18 months: 1 billion by the end of this year and another billion by the middle of 2022.
reuters.com/business/healt…

Important data on "breakthrough" infections: CDC says 5,800 infections documented so far in the US, of which 396 (7%) needed to be hospitalized. About 77 million people have been fully vaccinated in the US.
cnn.com/2021/04/14/hea… CDC says a "little over 40% of the infections were in people 60 or more years of age" but hard to draw too many conclusions from that given that the preponderance of the vaccinated are in that age group, too.

In light of J&J news, of primary concern with regard to vaccine confidence in the US is the 15-20% of adults still on the fence about getting vaccinated. Could the pause, and the messaging around it, change minds from "wait and see" to "no thanks"?
kff.org/coronavirus-co… The most common concerns about vaccines in the "wait and see" group revolve around safety and side effects, so if a perception takes hold - for whatever reason - that a vaccine is "unsafe" it could have implications for willingness to be vaccinated especially in this group.

30% of Israel's population has received at least 1 dose of Covid-19 vaccine, but no indications yet that case numbers are coming down there (chart).

A few reasons why this might be:

1) Cases reported now were infected 7+ days ago, when vaccinations were lower 2) Less than 500,000 (out of ~2.7 M vaccinated) have so far received a 2nd dose. A single dose is "less effective than we hoped" in providing protection, according to Israeli health leaders.
theguardian.com/world/2021/jan…

Beyond the scientific and epidemiological reasons to doubt the lab escape theory of pandemic origin, let’s not forget that no US or allied intelligence has emerged with even a whiff of evidence that a lab was the origin by accident or intention. To believe the lab escape theory you also have to believe the Chinese have mounted a successful, extended campaign to eliminate incriminating evidence and muzzle officials and scientists who knew or might have suspected it came from a lab.

That the US might adopt a 1 dose regimen or significantly delayed 2nd dose for vaccines already authorized seems more fanciful thought experiment than tractable policy. Pretty much all institutions and incentives are lined up against such a change and not without reason. Current vaccines are authorized via EUAs from FDA, which both clearly state terms of use including a two-dose regimen. Moderna’s EUA says the vaccine is “administered as a series of two doses 1 month apart…”

CDC now provides more data on vaccine distribution and administration by state, agency, etc. Worth a look and a bookmark.

A few things that jumped out to me, in a short thread.

covid.cdc.gov/covid-data-tra… 2.17 million doses distributed through the federal pharmacy partnership prgm for long-term care, but only 167,149, or 7.8%, administered. This is the phase 1a component that needs to make up the most ground.

If this program were a state, it would easily be the worst performer.

Worth noting that Kathleen Hicks, President-elect Biden's pick for the number 2 spot at the Pentagon, would be that unusual senior defense official with some background in global health, as it relates to national security.

https://twitter.com/missy_ryan/status/1344295139771080706

She's co-authored reports on the Department of Defense and global health, such as this one from 2009
csis-website-prod.s3.amazonaws.com/s3fs-public/le…

You may have seen CDC reporting 4.6 million doses of #COVID19 vaccine have been distributed & 614,117 administered. Why the huge gap between doses distributed vs administered numbers? (short thread) Some of the gap is from reporting lag: it can take up to 3 days for providers distributing the vaccine to report to state/local health officials, and additional time for officials to report to CDC
covid.cdc.gov/covid-data-tra…

I realize that without further details made public we're left picking up scraps of info about the White House cluster, but putting together a list of people and their test results and speculating about their exposures is not "contact tracing". Contact tracing is supposed to be a methodical effort by investigators to speak with known cases, ensuring they have support and are taking proper precautions, and also ask them about their close contacts so those people can be told they have been exposed and take proper action.

ICYMI: @KFF released the results of a new poll a few days ago, covering a number of #COVID19 topics.

I'll highlight a few of the findings in a thread.

kff.org/coronavirus-co… Among all registered voters the economy ranks as the most important voting issue, the coronavirus pandemic next. However, there is a stark difference by party, with 36% of Dems saying coronavirus is most important and just 4% of Republicans saying that.

Contact tracing apps have evolved to become "exposure notification apps"; Apple and Google are streamlining the process of participation, allowing push notifications for users to opt-in automatically (Apple) or direct users to state-supported notification apps (Google). The hope is that there will be much greater adoption of these apps because now opt-in will be embedded directly in device operating systems.

Adoption is state-by-state, and about 20 states have, or will soon be, deploying this approach.

I’ve been thinking about the only other time a pandemic vaccine was rolled out during a US Presidential election year: the 1976 “swine flu” campaign. What warnings and lessons might that experience hold? In brief, a new influenza virus was detected in January 1976 in NJ. Public health officials at the time thought the US (and the world) faced an imminent pandemic from this virus, to which no one under 50 had pre-existing immunity.

It is increasingly clear that Chinese government officials- locally in Wuhan and nationally in Beijing- sought to hide information and downplay the seriousness of the coronavirus outbreak in the critical first weeks of the pandemic.
nytimes.com/2020/08/19/wor… Wuhan officials hid information from national authorities. A recent U.S. intelligence community assessment concluded "Officials in Beijing were kept in the dark for weeks about the potential devastation of the virus by local officials in central China."

A few weeks ago @ForeignAffairs asked a group of experts if they agreed or disagreed with the following statement (and level of confidence):

"The daily tally of COVID-19 cases around the world will be higher at the beginning of 2021 than it is today."

foreignaffairs.com/ask-the-expert… Prediction is a fool's game, especially when it comes to pandemics, but even so a number of us responded. Most agreed with the statement, some with fairly high levels of confidence.