I have a little (oversimplified!) mental model about this that I put on a post-it note to share. The key point is that vaccines are starting from a high level of protection, so a reduction in neutralizing antibody response need not translate to a big drop in efficacy. https://twitter.com/zeynep/status/1392137906362503171 …pic.twitter.com/Unh5hl31Xg
In my little picture, I imagined a two fold drop that took efficacy from 95% to 85% for disease. Efficacy against severe disease remained very high. Again, this is oversimplified, but I think pictures can help us see the weird effect of thresholds on outcomes.
This goes well with something Miles Davenport/UNSW/Kirby Institute showed at a Moderna Presentation(around slide 116)pic.twitter.com/qPEd0yfGey
I love your hand-drawn scientific sketches. I'm sure that someone then goes and tries to make a more "professional" version, but I think the hand-drawn ones are far more evocative.
Is that a log based hand drawn chart?
The fact that the Y axis is on a log scale is really important for understanding whether something like “4x reduction in neutralization” is something to be concerned about or not. Since it’s a log scale, 4x is a very small reduction relative to the preexisting variation.
I love this! thanks for sharing!
This mental model works well for other COVID interventions too. Masks, distancing & ventilation may work less well against variants, but still work well enough to prevent almost same proportion of infections.
I also think severe disease is as much overreaction by the T cell arm as it is prolonged infection (I get ... it is murky on precise dynamics) so another dimension to factor in
Good post. Neutralizing antibody levels don’t always correlate to clinical outcomes.