There was a ton of new science that came out this week re: vaccine and Delta. This is where we are right now… Efficacy against mild and moderate disease is reduced We have been trying to nail down the “real world” efficacy of mRNA vaccines against Delta. This has proven to be difficult to do. As I
While obviously decreases in severe disease and mortality is significant and a great accomplishment it is still frustrating to have those be the metrics everyone always discusses. Long haul covid19 and damage to multiple systems is a serious issue as well (and in the long run will majorly impact our health care systems). It seems even the mild and asymptomatic cases among vaccinated can result in long covid. I am really worried about this for myself and my unvaccinated kids.
Should we be concerned that unvaccinated individuals are infectious for 16 days? That is much longer than the recommended 10 day quarantine. Thank you for all you do!!!
I contracted COVID in November 2020 and was vaccinated in December/January with Pfizer. Is there data out regarding infection rates with Delta amongst those who have had natural infection plus are fully vaccinated? I am being told colleagues are seeing it, but I have not read anything concrete addressing it.
Doesn't the fact that breakthroughs appear to be starting off with higher viral loads suggest some sort of detection bias? Is there something special about the kinds of people having the breakthrough cases that would cause them to have higher viral loads?
Thank you. 4 of my family members have had breakthrough cases here in Mississippi and many of my friends and family are vaccine hesitant or resistant. I came across an article from the UK that I found helpful even with its limitations. One finding I find particularly interesting is that vaccine resistant participants relied significantly more on social media than any other information source while vaccine accepting participants consumed significantly more information from newspapers, television, radio, doctors, other health professionals, and government agencies.
Resistance has been so strong on social media, but this encourages me to continue sharing reputable information on these platforms. Just wanted to share to encourage others as well.
Are false negative rapid tests less of a problem for Delta than for the original strain because of the increased viral load? It seems reasonable to suspect this would be the case.
If vaccine-resistant strains start spreading, can the vaccines quickly be tweaked to cover the new variants and go straight into arms? Or do Pfizer, Moderna etc need to go through another round of trials before offering the public a shot that protects against new variants?
Great post. I had a question about how the viral load measured really connects to the ability for the vaccinated to infect. Since Rt PCR only measures viral fragments, how do we know it equates to ability to infect? Last year it was shown that people can shed viral RNA for months after they are no longer infectious. Also, the Singapore data is for breakthrough cases, but does the same relationship exist for subclinical and asymptomatic cases? I assume breakthroughs happen because the immune response post-vaccination is sub-optimal to begin with. The reason I ask is that many of us, and the media and scientific sources have been saying that the unvaccinated not only carry the burden of disease but are also responsible for spread. If both groups spread similarly, even in asymptomatic and subclinical cases like they do with breakthroughs, maybe we need to lay off the focus on vaccinations protecting others argument. And what does that mean for herd immunity in general long-term?
I can give a real life example and then I have a question. Colleague of mine , 28 yo male, got delta at a party 2 weeks ago. 10 vaccinated people there and all indoors. J&J person ended up having symptoms. 4 people total infected. Colleague was most symptomatic and it took 4 days from exposure to show up. Loss of taste, smell, cough and shortness of breath. Symptomatic for 3 days and on the mend on day 4 short of taste and smell. My question is now on mandates. Sounds like tons of companies have them with a target of October 1. How much can we disrupt this wave? Challenge to the mandate is demographic it is targeting and also if you don't get it, you are just subject to mandatory testing , so it doesn't solve the vaccine issue.
Are these studies showing viral load just using Ct values of PCR tests. Wouldn’t it be better to be using PCR test with antigen testing? Ct values of PCR just tell us that “pieces” of virus are present, that doesn’t necessarily mean it’s infectious virus that is being found… specifically in the vaccinated.
Thank you so much for this newsletter. Subscribed today.
I have several questions about this.
1) If the effectiveness against asymtopmatic to mild disease is 49-59%, and the effectiveness against severe disease is much higher, what is the overall effectiveness against being able to transmit COVID-19 to others?
2) With these lower effectiveness rates against positive cases, what does it say about the ability to vaccinate our way out of COVID (assuming high uptake of vaccinations)? Is that enough? If not, then what?
3) I remember reading a month or two ago now that one of the vaccine makers, I think Pfizer, was developing a variation of the mRNA vaccine targeted at the COVID variants circulating now. I have seen little about that since. Is that still ongoing? Would it help with Delta?
4) I'm seeing some preliminary news stories about vaccine resistance of lambda or other new variants, based solely on lab studies. Is there anything we can learn about that - perhaps contextualizing it with what the same lab studies said about Delta?
Do you have any other information or know of any data sets that have been collected about vaccine efficacy in pregnant women against the Delta variant? I had COVID in Nov 2020, got fully vaxxed in March/April, but now I'm pregnant and I just feel like none of these data sets really apply to me and I would just love to know how protected I am.
Thank you as always.
While obviously decreases in severe disease and mortality is significant and a great accomplishment it is still frustrating to have those be the metrics everyone always discusses. Long haul covid19 and damage to multiple systems is a serious issue as well (and in the long run will majorly impact our health care systems). It seems even the mild and asymptomatic cases among vaccinated can result in long covid. I am really worried about this for myself and my unvaccinated kids.
Should we be concerned that unvaccinated individuals are infectious for 16 days? That is much longer than the recommended 10 day quarantine. Thank you for all you do!!!
Is there any data yet about whether vaccinated individuals are having asymptomatic transmission with Delta or only when symptomatic?
I contracted COVID in November 2020 and was vaccinated in December/January with Pfizer. Is there data out regarding infection rates with Delta amongst those who have had natural infection plus are fully vaccinated? I am being told colleagues are seeing it, but I have not read anything concrete addressing it.
Doesn't the fact that breakthroughs appear to be starting off with higher viral loads suggest some sort of detection bias? Is there something special about the kinds of people having the breakthrough cases that would cause them to have higher viral loads?
Thank you. 4 of my family members have had breakthrough cases here in Mississippi and many of my friends and family are vaccine hesitant or resistant. I came across an article from the UK that I found helpful even with its limitations. One finding I find particularly interesting is that vaccine resistant participants relied significantly more on social media than any other information source while vaccine accepting participants consumed significantly more information from newspapers, television, radio, doctors, other health professionals, and government agencies.
Resistance has been so strong on social media, but this encourages me to continue sharing reputable information on these platforms. Just wanted to share to encourage others as well.
URL: https://www.nature.com/articles/s41467-020-20226-9
Are false negative rapid tests less of a problem for Delta than for the original strain because of the increased viral load? It seems reasonable to suspect this would be the case.
If vaccine-resistant strains start spreading, can the vaccines quickly be tweaked to cover the new variants and go straight into arms? Or do Pfizer, Moderna etc need to go through another round of trials before offering the public a shot that protects against new variants?
Can you clarify the role of AZ vaccine (not an mRNA vaccine) in the REACT-UK study in your conclusions?
Great post. I had a question about how the viral load measured really connects to the ability for the vaccinated to infect. Since Rt PCR only measures viral fragments, how do we know it equates to ability to infect? Last year it was shown that people can shed viral RNA for months after they are no longer infectious. Also, the Singapore data is for breakthrough cases, but does the same relationship exist for subclinical and asymptomatic cases? I assume breakthroughs happen because the immune response post-vaccination is sub-optimal to begin with. The reason I ask is that many of us, and the media and scientific sources have been saying that the unvaccinated not only carry the burden of disease but are also responsible for spread. If both groups spread similarly, even in asymptomatic and subclinical cases like they do with breakthroughs, maybe we need to lay off the focus on vaccinations protecting others argument. And what does that mean for herd immunity in general long-term?
I can give a real life example and then I have a question. Colleague of mine , 28 yo male, got delta at a party 2 weeks ago. 10 vaccinated people there and all indoors. J&J person ended up having symptoms. 4 people total infected. Colleague was most symptomatic and it took 4 days from exposure to show up. Loss of taste, smell, cough and shortness of breath. Symptomatic for 3 days and on the mend on day 4 short of taste and smell. My question is now on mandates. Sounds like tons of companies have them with a target of October 1. How much can we disrupt this wave? Challenge to the mandate is demographic it is targeting and also if you don't get it, you are just subject to mandatory testing , so it doesn't solve the vaccine issue.
Are these studies showing viral load just using Ct values of PCR tests. Wouldn’t it be better to be using PCR test with antigen testing? Ct values of PCR just tell us that “pieces” of virus are present, that doesn’t necessarily mean it’s infectious virus that is being found… specifically in the vaccinated.
Thank you so much for this newsletter. Subscribed today.
I have several questions about this.
1) If the effectiveness against asymtopmatic to mild disease is 49-59%, and the effectiveness against severe disease is much higher, what is the overall effectiveness against being able to transmit COVID-19 to others?
2) With these lower effectiveness rates against positive cases, what does it say about the ability to vaccinate our way out of COVID (assuming high uptake of vaccinations)? Is that enough? If not, then what?
3) I remember reading a month or two ago now that one of the vaccine makers, I think Pfizer, was developing a variation of the mRNA vaccine targeted at the COVID variants circulating now. I have seen little about that since. Is that still ongoing? Would it help with Delta?
4) I'm seeing some preliminary news stories about vaccine resistance of lambda or other new variants, based solely on lab studies. Is there anything we can learn about that - perhaps contextualizing it with what the same lab studies said about Delta?
Thank you!
A great source of data for Israel's cases is at https://github.com/dancarmoz/israel_moh_covid_dashboard_data
Definitely high viral loads in vaccinated and unvaccinated, but can we really call those Ct values the same? I thought the Ct values are logarithmic not linear, so the Ct values of 22.77 (unvaccinated) and 21.54 (vaccinated) appear close, but they represent viral loads in the unvaccinated group that are more than double that of the vaccinated group. (Each Ct increase of 3.3 typically represents an order of magnitude in scale. See https://www.thermofisher.com/us/en/home/life-science/pcr/real-time-pcr/real-time-pcr-learning-center/real-time-pcr-basics/real-time-pcr-understanding-ct.html).
Looking for your info on this. Thanks
So I've been following info on pregnant women here: https://covid.cdc.gov/covid-data-tracker/#pregnant-population
Do you have any other information or know of any data sets that have been collected about vaccine efficacy in pregnant women against the Delta variant? I had COVID in Nov 2020, got fully vaxxed in March/April, but now I'm pregnant and I just feel like none of these data sets really apply to me and I would just love to know how protected I am.