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michaelzlin's profile
Michael Lin, MD PhD 🧬
Michael Lin, MD PhD 🧬
Michael Lin, MD PhD  🧬
@michaelzlin

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Michael Lin, MD PhD  🧬

@michaelzlin

Associate Professor of Neurobiology & Bioengineering @Stanford ☘️🧪🦠🧠🌈🔬📖🇺🇲🌏 Molecular engineering for voltage, viruses, and SARSCoV2. Fan of facts.

Harvard/UCLA/HMS/UCSD/Stanford
linlab.stanford.edu
Joined July 2015

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    1. Michael Lin, MD PhD  🧬‏ @michaelzlin 22 May 2021

      For those following the less-perfect vaccines (what most of the world will get), a medrxiv study from Chile this week provides some very valuable data: neutralizing antibody levels after natural infection vs 1 or 2 doses inactivated virus or RNA vax.https://www.medrxiv.org/content/10.1101/2021.05.17.21257197v1 …

      2 replies 5 retweets 19 likes
      Show this thread
    2. Michael Lin, MD PhD  🧬‏ @michaelzlin 22 May 2021

      Most interesting finding: Similar nAb titers after natural infection vs. uninfected after 2 doses CoronaVac or after 1 dose BNT162b2 (Pfizer/BioNTech). These are columns 1, 6, and 8 in the below chart. What does it mean?pic.twitter.com/kDl9hp3uhJ

      2 replies 0 retweets 6 likes
      Show this thread
    3. Michael Lin, MD PhD  🧬‏ @michaelzlin 22 May 2021

      Several things: 1. The data are in line with Coronavac Phase 1/2 trials. There, nAb levels after 2 doses 4 weeks apart reached ~0.6x of convalescent sera. Here the graph shows nAb levels after 2 doses > convalescent sera, but the text says a bit less (1595 vs 1860, not sure why)

      1 reply 0 retweets 2 likes
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    4. Michael Lin, MD PhD  🧬‏ @michaelzlin 22 May 2021

      2. nAb levels here after Coronavac also exceed those in the Phase 1/3 participants dosed 2 weeks apart (~0.2x of convalescent sera). Today's study doesn't report the dose interval in Chile, but said blood was collected 20-30 d after dose 1 for 1-dose testing. So it was > 2 wks.

      1 reply 0 retweets 2 likes
      Show this thread
    5. Michael Lin, MD PhD  🧬‏ @michaelzlin 22 May 2021

      3. The better performance here of Coronavac here with a > 3-week interval vs the 2-week interval also corresponds with Chile's better results vs Brazil Manaus. Chile reports 66/80% efficacy in all/severe disease, vs 50/80% for Brazil.

      1 reply 0 retweets 5 likes
      Show this thread
    6. Michael Lin, MD PhD  🧬‏ @michaelzlin 22 May 2021

      4. Recently I reviewed the @naturemedicine paper correlating nAb levels to vax efficacy levels. That paper related 50% efficacy to 2-week interval-induced nAb levels.https://www.nature.com/articles/s41591-021-01377-8#MOESM1 …

      1 reply 0 retweets 2 likes
      Show this thread
      Michael Lin, MD PhD  🧬‏ @michaelzlin 22 May 2021

      If we add nAb levels of 1595/1860=0.86x of convalescent sera and 66% efficacy for Coronavac with 3-week dosing, we get the following.pic.twitter.com/fhAKEcRsDz

      2:53 PM - 22 May 2021
      • 2 Retweets
      • 7 Likes
      • Mehrnoosh Atmanirbhar Meow Penny Orton まっと@リアル🇮🇳町工場 Adam Claridge-Chang Andrew Hires Sharath C #SaveWater 🇮🇳
      1 reply 2 retweets 7 likes
        1. New conversation
        2. Michael Lin, MD PhD  🧬‏ @michaelzlin 22 May 2021

          Michael Lin, MD PhD  🧬 Retweeted Michael Lin, MD PhD  🧬

          5. I speculated ≥4-week interdose intervals and maybe a 3rd dose would be good for Coronavac. That appears true for all inactivated vax. It would get nAb levels above convalescent sera and get efficacy to >90%. But right now supplies are limited.https://twitter.com/michaelzlin/status/1394752409994293249 …

          Michael Lin, MD PhD  🧬 added,

          Michael Lin, MD PhD  🧬 @michaelzlin
          But overall it seems dosing amount and interval is important for inactivated vaccines. Chile's experience was that Coronavac had very low efficacy in just one dose alone. So that one in particular needs a higher dosage, and then perhaps 2 follow-up boosters spaced 1 month apart.
          Show this thread
          2 replies 0 retweets 7 likes
          Show this thread
        3. Michael Lin, MD PhD  🧬‏ @michaelzlin 22 May 2021

          6. One dose of Coronavac (and likely other inactivated virus vaccines) is ineffective. So it seems you need prime and boost to get decent antibodies with this approach. Ad is better because the virus backbone provides stimulation. RNA probably activates innate immunity pathways.

          1 reply 1 retweet 5 likes
          Show this thread
        4. Michael Lin, MD PhD  🧬‏ @michaelzlin 22 May 2021

          7. The RNA 2nd dose effect is pretty massive. No wonder people feel a bit of malaise for 1-2 days. A lot of cytokines are being released. And 1 dose of RNA vaccine indeed is pretty good protection. You predict nAbs ~ natural infection gives ~85% protection, as seen in the trials.

          1 reply 2 retweets 8 likes
          Show this thread
        5. Michael Lin, MD PhD  🧬‏ @michaelzlin 22 May 2021

          So to summarize, nAbs correlate with vaccine efficacy, and nAb/efficacy of 2 doses inactivated virus = 1 dose of RNA vaccine (with prefusion spike) = natural infection.

          2 replies 2 retweets 16 likes
          Show this thread
        6. Michael Lin, MD PhD  🧬‏ @michaelzlin 25 May 2021

          Interesting; as I had suggested, UAE is going to give third shots of Sinopharm's vaccine (which wasn't in the nAb study above, but seems to be slightly more effective than Sinovac's). Great that the health authorities are on top of it, and being flexible.https://www.scmp.com/news/world/middle-east/article/3133977/coronavirus-uae-offer-third-dose-recipients-chinas-sinopharm …

          1 reply 0 retweets 6 likes
          Show this thread
        7. Michael Lin, MD PhD  🧬‏ @michaelzlin 29 May 2021

          Sinopharma data are published! This is the UAE study that served as the basis for WHO approval. 78% efficacy for the HBO2 strain, 73% efficacy for the WIV04 strain overall for symptoms. Not enough data to tell about severe disease protection. https://jamanetwork.com/journals/jama/fullarticle/2780562 …pic.twitter.com/Gk1ZGSPtgZ

          1 reply 1 retweet 4 likes
          Show this thread
        8. Michael Lin, MD PhD  🧬‏ @michaelzlin 29 May 2021

          Interestingly just as for Sinovac, there's no noticeable benefit of the first dose. So this older classical approach of inactivated virus and adjuvant really does require the second dose (boost)pic.twitter.com/y5rIZ9zR9C

          0 replies 0 retweets 7 likes
          Show this thread
        9. End of conversation

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