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AaronRichterman's profile
Aaron Richterman, MD
Aaron Richterman, MD
Aaron Richterman, MD
@AaronRichterman

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Aaron Richterman, MD

@AaronRichterman

infectious diseases, health equity @PennMedicine. prev @BrighamWomens @GlobalHealthMGH. “His horoscopes were especially popular because they were often right”

Philadelphia, PA
scholar.google.com/citations?hl=e…
Joined July 2010

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    1. Aaron Richterman, MD‏ @AaronRichterman 12 Jan 2021

      Aaron Richterman, MD Retweeted Aaron Richterman, MD

      4. Even if we assume vaccines ONLY prevent symptomatic disease, turning all into asymptomatic infections, there is a solid body of evidence 👇 (inc systematic reviews from @mugecevik and @nicolamlow) that this alone would substantially reduce transmissionhttps://twitter.com/AaronRichterman/status/1340285330428182529?s=20 …

      Aaron Richterman, MD added,

      Aaron Richterman, MD @AaronRichterman
      Thankful to Singapore for surveillance systems that allow for the detailed studies required to truly assess the relative transmission risk of asymptomatic vs symptomatic cov-2 👇, which they find to be much higher in those who develop symptoms /1 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32651-9/fulltext … pic.twitter.com/hLbKPhHOVB
      Show this thread
      4 replies 1 retweet 24 likes
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    2. Aaron Richterman, MD‏ @AaronRichterman 12 Jan 2021

      5. Based on this, I think the possibility that these vaccines don't meaningfully reduce transmission (to the point that populations can move back towards normal life in due course) is low enough that we should treat this as a mostly theoretical concern at this point.

      1 reply 9 retweets 33 likes
      Show this thread
    3. Aaron Richterman, MD‏ @AaronRichterman 12 Jan 2021

      Aaron Richterman, MD Retweeted Aaron Richterman, MD

      6. An enduring lesson of this pandemic (& others) is the need to communicate uncertainty honestly (in both directions). Of course its reasonable to be careful, but lets not forget that this theoretical concern is being cited as a reason not to get the vaxhttps://twitter.com/AaronRichterman/status/1348494121019826178?s=20 …

      Aaron Richterman, MD added,

      Aaron Richterman, MD @AaronRichterman
      Returning to normal activities is one important motivator for public to get vaccinated. Emphasizing that vaccines are unlikely to facilitate this because lots of transmission might happen anyway undermines this, especially when that seems unlikely based on what we know now 👇🏻 https://twitter.com/MonicaGandhi9/status/1347988651179798530 …
      Show this thread
      2 replies 6 retweets 31 likes
      Show this thread
    4. Aaron Richterman, MD‏ @AaronRichterman 3 Feb 2021

      Aaron Richterman, MD Retweeted Eric Meyerowitz, MD

      7. implications of monoclonal post-exposure prophylaxis data on transmissionhttps://twitter.com/EricMeyerowitz/status/1354231883190722571?s=20 …

      Aaron Richterman, MD added,

      Eric Meyerowitz, MD @EricMeyerowitz
      1/ Key question right now is how much SARS-CoV-2 vaccines will decrease transmission. Data from Regeneron mAb cocktail prevention press release may help us think about this https://investor.regeneron.com/news-releases/news-release-details/regeneron-reports-positive-interim-data-regen-covtm-antibody …
      Show this thread
      1 reply 0 retweets 7 likes
      Show this thread
    5. Aaron Richterman, MD‏ @AaronRichterman 3 Feb 2021

      Aaron Richterman, MD Retweeted Aaron Richterman, MD

      8. More on why reducing symptoms/severity w vaccines will probably reduce transmissionhttps://twitter.com/AaronRichterman/status/1351548094710652928?s=20 …

      Aaron Richterman, MD added,

      Aaron Richterman, MD @AaronRichterman
      These two statements are at first confusing, but crucial to understanding prevention of cov2 transmission, including through use of vaccines. https://twitter.com/BogochIsaac/status/1351544832771186691 …
      Show this thread
      1 reply 1 retweet 8 likes
      Show this thread
    6. Aaron Richterman, MD‏ @AaronRichterman 3 Feb 2021

      8a. (Aside - Good paper with biases to be mindful of when comparing secondary attack rates of symptom/asymptomatic in households (page 19). h/t @mugecevik) https://dash.harvard.edu/handle/1/37366192 …pic.twitter.com/ez5IssUk0F

      1 reply 0 retweets 6 likes
      Show this thread
    7. Aaron Richterman, MD‏ @AaronRichterman 3 Feb 2021

      Aaron Richterman, MD Retweeted Aaron Richterman, MD

      9. Some more discussion on Moderna dose 2 testinghttps://twitter.com/AaronRichterman/status/1350591945702318083 …

      Aaron Richterman, MD added,

      Aaron Richterman, MD @AaronRichterman
      Here is one more look at Supplementary Table 18 from the Moderna NEJM paper, the best direct data we have on this question. Follow me here for a moment 🧵 /1 https://twitter.com/zeynep/status/1350586029359702016?s=20 … pic.twitter.com/7ID8Tjlq0u
      Show this thread
      1 reply 0 retweets 4 likes
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    8. Aaron Richterman, MD‏ @AaronRichterman 3 Feb 2021

      Aaron Richterman, MD Retweeted

      10. Implications from regular pcr monitoring after natural infection. Less infections, lower viral load, more asymptomatic. Will reduce transmission. https://twitter.com/dylanhmorris/status/1357003968208121861 …

      Aaron Richterman, MD added,

      This Tweet is unavailable.
      1 reply 0 retweets 8 likes
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    9. Aaron Richterman, MD‏ @AaronRichterman 3 Feb 2021

      Aaron Richterman, MD Retweeted Aaron Richterman, MD

      10a. That said, similar caveats as below re whether those were even all reinfections.https://twitter.com/AaronRichterman/status/1355567294882131972 …

      Aaron Richterman, MD added,

      Aaron Richterman, MD @AaronRichterman
      Important thread below on immunologic basis for skepticism of 0% protection by prior natural infection on reinfection with B1.351 suggested by the small novavax study in S Africa So why else might they have found identical cases by sero+/-? Speculation before seeing full data: https://twitter.com/profshanecrotty/status/1355552010158764036 …
      Show this thread
      1 reply 0 retweets 5 likes
      Show this thread
    10. Aaron Richterman, MD‏ @AaronRichterman 6 Feb 2021

      11. More data from the Oxford/az randomized clinical trial. Vaccinated ppl who developed infection had lower viral loads and were pcr+ for one week shorter time relative to placebo. True for both asymptomatic and symptomatic cases. =>reduced transmission https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3779160 …pic.twitter.com/NsnUzCmrZk

      2 replies 3 retweets 16 likes
      Show this thread
      Aaron Richterman, MD‏ @AaronRichterman 8 Feb 2021

      Aaron Richterman, MD Retweeted Yaniv Erlich

      12a. And real world data from Israel. Interesting analysis inferring vaccine status by age and following cycle thresholds over time, suggesting lower VL in vaccinees w infection. Cool time series. Caveat: unclear what symptom status is but assume mostly symptom prompted testing.https://twitter.com/erlichya/status/1358477762495930368 …

      Aaron Richterman, MD added,

      Yaniv Erlich @erlichya
      Idea💡: we know the age of the person and the date of the test. Since vaccination was started with 60+, we can compare the average Ct value positives in this age group as a function of time and compare to 40-60 as a control. Here are the results: [Red: 60+;Blue:40-60] pic.twitter.com/X24YG5SCmZ
      Show this thread
      6:04 AM - 8 Feb 2021
      • 1 Retweet
      • 5 Likes
      • Fredric Douglas Bellamy Ben Cochez Deirdre Connolly¹ Eric Meyerowitz, MD Julian Donald Verger 💖🦋🌼🌻🌺⛅️💖
      2 replies 1 retweet 5 likes
        1. New conversation
        2. Aaron Richterman, MD‏ @AaronRichterman 10 Feb 2021

          12b. Here are the pre-prints from the two real-world Israel studies of time series w viral load reduction after mrna vaccination. Some limitations including unknown symptom status, but suggestive. https://www.medrxiv.org/content/10.1101/2021.02.08.21251329v1 … https://www.medrxiv.org/content/10.1101/2021.02.06.21251283v1 …pic.twitter.com/z7yOhh6GPi

          1 reply 0 retweets 5 likes
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        3. Aaron Richterman, MD‏ @AaronRichterman 22 Feb 2021

          13. Nice study of healthcare workers after Pfizer vaccine with regular PCR screening every 2 weeks. They found 70% reduction in all infections (asx or sx) dose1+3wks, 85% dose2+1wk. May be overestimated if vaccine ⬇️ duration of pcr+, but expect large transmission ⬇️pic.twitter.com/okdA1wLh0U

          2 replies 13 retweets 46 likes
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        4. Aaron Richterman, MD‏ @AaronRichterman 22 Feb 2021

          13a. Link for that last study: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3790399 …

          1 reply 0 retweets 2 likes
          Show this thread
        5. Aaron Richterman, MD‏ @AaronRichterman 24 Feb 2021

          Aaron Richterman, MD Retweeted Aaron Richterman, MD

          14. 75% protection against asymptomatic seroconversion in J&J vaccine trial.https://twitter.com/AaronRichterman/status/1364575515978440708 …

          Aaron Richterman, MD added,

          Aaron Richterman, MD @AaronRichterman
          Transmission prevention: 74% efficacy against seroconversion without prior symptoms ie protection against asymptomatic infection. They have only completed planned serologies on a subset of participants but extremely promising for this vaccine to prevent transmission. pic.twitter.com/xlGh2dca5P
          Show this thread
          1 reply 2 retweets 7 likes
          Show this thread
        6. Aaron Richterman, MD‏ @AaronRichterman 24 Feb 2021

          14a. Important for those worried about b1.351. While this prelim analysis of asymptomatic infection after j&j is based on 29% completed serology data, most of the serologies from South Africa had been done.pic.twitter.com/PeFLn5jhbT

          1 reply 0 retweets 3 likes
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        7. Aaron Richterman, MD‏ @AaronRichterman 26 Feb 2021

          Aaron Richterman, MD Retweeted Eran Segal

          15. No posted pre print yet but if this holds we now have 3 lines of evidence suggesting 85-90% reduction in all infections by the mrna vaccines (moderna RCT, Pfizer UK regular screening healthcare workers, 👇🏻 Israel regular screening). H/t @EricMeyerowitzhttps://twitter.com/segal_eran/status/1365263943229452289 …

          Aaron Richterman, MD added,

          Eran Segal @segal_eran
          Israel: Vaccines may reduce infections by 88% Key in this study by the national covid center, is use of **routine testing** of nursery home workers, thus less biases Based on 8300 vaxed and 2600 non-vaxed workers under 65 y/o Note lower rise in vaxed 7-10 days after 2nd dose pic.twitter.com/68mKv5Sa3i
          1 reply 1 retweet 8 likes
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        8. Aaron Richterman, MD‏ @AaronRichterman 26 Feb 2021

          15a. There is a little separation in the first few days so will need to see what kind of adjustment has been made here.

          2 replies 0 retweets 2 likes
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        9. Aaron Richterman, MD‏ @AaronRichterman 28 Feb 2021

          16. On interpreting cross-sectional pcr during vaccine trials (i.e. moderna asymptomatic swabs at the time of dose 2) https://twitter.com/mlipsitch/status/1366172405119541250?s=20 …pic.twitter.com/7aHfqRYV5N

          2 replies 0 retweets 3 likes
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        10. Aaron Richterman, MD‏ @AaronRichterman 4 Mar 2021

          17. Another study with regular (weekly) asymptomatic screening of hcw finds large reduction in pcr+ after Pfizer vaccine. The case for a large transmission reduction w vaccine seems closed at this point but will keep collecting these for now.https://www.authorea.com/users/332778/articles/509881-single-dose-bnt162b2-vaccine-protects-against-asymptomatic-sars-cov-2-infection …

          1 reply 14 retweets 49 likes
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        11. Aaron Richterman, MD‏ @AaronRichterman 4 Mar 2021

          17a. At least until these stop coming on a daily basis... https://www.nytimes.com/live/2021/03/04/world/covid-19-coronavirus/its-unclear-how-easily-vaccinated-people-may-spread-the-virus-until-the-answer-arrives-scientists-urge-caution … https://www.google.com/amp/s/www.wired.com/story/we-still-dont-know-how-well-covid-vaccines-stop-transmission/amp …

          2 replies 0 retweets 14 likes
          Show this thread
        12. Aaron Richterman, MD‏ @AaronRichterman 9 Mar 2021

          Aaron Richterman, MD Retweeted Laura Waters

          18. Neutralizing antibodies (like those induced by vaccines) reduce infection by 50% overall and in those who become infected there are fewer symptoms, lower viral load peak, shorter infections ~> large reductions in transmissionhttps://twitter.com/drlaurajwaters/status/1369328999944568836 …

          Aaron Richterman, MD added,

          Laura Waters @drlaurajwaters
          #CROI2021 REGEN-COV vs placebo to asymptomatic #COVID19 contacts: 100% protection against symptomatic infection & 50% reduction in infection overall. All infections in active arm asymptomatic with lower peak & shorter duration viraemia, less transmission potential & FEWER AE! pic.twitter.com/oq5X5EBonk
          1 reply 2 retweets 6 likes
          Show this thread
        13. Aaron Richterman, MD‏ @AaronRichterman 9 Mar 2021

          Aaron Richterman, MD Retweeted Laura Waters

          18a. Same thinghttps://twitter.com/drlaurajwaters/status/1369323658821464067 …

          Aaron Richterman, MD added,

          Laura Waters @drlaurajwaters
          #CROI2021 Myron Cohen presented BLAZE-2: bamlanivimab vs placebo - 80% reduction in symptomatic #COVID9 in residents & 72% amongst high risk staff, lower viral load & shedding if infected. 4 deaths, all on placebo. Hugely exciting data for monoclonal antibodies!! pic.twitter.com/2ojbSy43Xs
          1 reply 1 retweet 2 likes
          Show this thread
        14. Aaron Richterman, MD‏ @AaronRichterman 10 Mar 2021

          19. Interesting study of pre-procedural asymptomatic cov2 pcr screening - 80% reduction (95% CI 56-91%) in asymptomatic infection after both doses of mrna vaccines. Similar reduction after a single dose.https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab229/6167855 …

          1 reply 3 retweets 6 likes
          Show this thread
        15. Aaron Richterman, MD‏ @AaronRichterman 12 Mar 2021

          20. First observational study of household members of healthcare workers receiving mostly pfizer vax. After adjustment, 54% reduction in risk for household members (95% CI 30-70%) after both vaccine doses +14d in hcw. H/t @mugecevik https://github.com/ChronicDiseaseEpi/hcw/blob/master/vaccine_manuscript.pdf …pic.twitter.com/izXumhKISL

          1 reply 2 retweets 6 likes
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        16. Aaron Richterman, MD‏ @AaronRichterman 12 Mar 2021

          20a. Remember that this is not a contact tracing study and so reduction can be thought of as lower bound from the vaccinated household member since exposures may have occurred elsewhere

          1 reply 0 retweets 3 likes
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        17. Aaron Richterman, MD‏ @AaronRichterman 26 Mar 2021

          Aaron Richterman, MD Retweeted Neil Clancy

          21. Systematic surveillance in nursing homes - greater than 2 log decrease in viral loads in infected residents shortly after first Pfizer dose. Likely to be associated with large drops in transmission potentialhttps://twitter.com/ClancyNeil/status/1375421980829175809 …

          Aaron Richterman, MD added,

          Neil ClancyVerified account @ClancyNeil
          Our paper on impact of single dose #Pfizer #COVID19 #vaccine in our nursing home residents is out at Clin Inf Dis. >2-log viral load reduction in asymptomatic persons. Systematic surveillance screening, so all cases captured. @CarlosdelRio7 @walidgellad https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab263/6188727 …
          Show this thread
          1 reply 0 retweets 1 like
          Show this thread
        18. Aaron Richterman, MD‏ @AaronRichterman 26 Mar 2021

          22. Systematic screening during nursing home outbreaks - Pfizer vaccine 63% (95% CI 33–79%) effective at decreasing infections (symptoms or no). Early during vaccination period so likely an underestimate.https://www.cdc.gov/mmwr/volumes/70/wr/mm7011e3.htm …

          1 reply 0 retweets 1 like
          Show this thread
        19. Aaron Richterman, MD‏ @AaronRichterman 29 Mar 2021

          Aaron Richterman, MD Retweeted Chise  🧬 🧫 🦠 💉

          23.https://twitter.com/sailorrooscout/status/1376512132318121990 …

          Aaron Richterman, MD added,

          Chise  🧬 🧫 🦠 💉 @sailorrooscout
          Good news! An updated study has found that ONE dose of either Pfizer’s OR AstraZeneca’s vaccine led to a 62% reduction in the risk of ANY infection and lower viral loads in those that were infected after 28 days. Long-Term Care Facility/High-Risk Setting. https://www.medrxiv.org/content/10.1101/2021.03.26.21254391v1 …
          Show this thread
          1 reply 0 retweets 3 likes
          Show this thread
        20. Aaron Richterman, MD‏ @AaronRichterman 29 Mar 2021

          Aaron Richterman, MD Retweeted CDC

          24.https://twitter.com/CDCgov/status/1376552681255399424 …

          Aaron Richterman, MD added,

          CDCVerified account @CDCgov
          A new @CDCMMWR finds mRNA #COVID19 vaccines highly effective in preventing COVID-19 among health care & other essential workers. The mRNA vaccines reduced the risk of infection by 80% after the 1st dose and 90% following the 2nd dose. Learn more: http://bit.ly/MMWR32921 . pic.twitter.com/alDyojp0v1
          1 reply 1 retweet 2 likes
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        21. Aaron Richterman, MD‏ @AaronRichterman 28 Apr 2021

          25. Really nice household transmission study (first of its kind that I've seen). ~50% decreased transmission potential among people infected 21d after first dose AZ or Pfizer. This is on top of very high reductions in infection risk. https://khub.net/documents/135939561/390853656/Impact+of+vaccination+on+household+transmission+of+SARS-COV-2+in+England.pdf/35bf4bb1-6ade-d3eb-a39e-9c9b25a8122a?t=1619601878136 …pic.twitter.com/sO1RQo2uJj

          0 replies 0 retweets 8 likes
          Show this thread
        22. End of conversation

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