And then there were three.

The FDA has officially issued an Emergency Use Authorization [EUA] for the J&J vaccine.

It's one dose and easy to store. It's 100% effective against hospitalization and death.

It's 66% effective against contracting symptomatic Covid and is nearly as effective against the 351 variant.

J&J expects to deliver 20 million doses in March. Sanofi announced it would also produce the J&J vaccine in their factories. They can make an additional 12 million doses a month.

Beyond J&J, we got more good news about vaccines we'll be getting in March. Pfizer expects to start shipping 13 million doses a week, up from 5 million doses a week in early February. Moderna says it will be able to do 10 million doses a week by April.

Yesterday we set a US record for vaccinations in a day at 2.4 million doses. I think this week it's likely we'll have our first 3 million dose day. California has given 15% of the population their first shot, and we've had several days with over 250,000 doses given. Over 50% of people over 65 have been vaccinated.

In the 79 days since the first vaccine was authorized, we've given 72 million shots. I think we can do that many in the next 30 days.

My big concern is that case counts are no longer falling. In most US, the drop has stalled over the last few days, and even more concerning in New York and Florida, the daily infection rate is still extremely high. In Florida, it's likely driven by the 117 variant, which is more contagious, and that may be what is driving NY as well. 117 is now 10% of new cases in the US vs. 1-4% only a few weeks ago.

In Denmark, 117 is now dominant, and the case count is still rising even though they have a lockdown. Only 7.1% of their population has received the first dose, so they don't have much inoculated immunity.

I suspect over the next two weeks, we'll continue to see hospitalizations fall, but the case count remain stubbornly high. In general, this is great. Fewer hospitalizations mean fewer deaths, but long Covid is real and understudied, so we should continue to try to stamp it out as fast as possible.

This past week had several poorly written news articles about new variants of Covid or scariants as they're being called. Earlier in the week, I said, "any scientist who jumps to the LA Times before the article has been peer-reviewed to say "The devil is already here" is either a fear monger, a press hound, or a moron and should be treated as such." I stand by that statement.

It's important to remember that the virus is continually mutating. Sometimes new variants will become dominant not because they are more dangerous but due to outside factors. Given the high prevalence of the new variants and the fact that case counts have continued to drop over the last few months in California, it seems less likely they're radically different.

One of them does contain one of the mutations that 351 also has that may help resist the vaccine.  However, in the South African trials where 351 is dominant, the vaccines still prevented hospitalization and death. Overall I continue to be most concerned about 117 and 351 but believe that we're on a vaccination trajectory that they will not be a significant issue.

The FDA announced it would use the same process to update the flu vaccine for Covid updates. This involves a short study with human volunteers, no randomized controlled trials, which take a long time. Moderna also announced they beat their prior record for creating a new vaccine from the first sequence. It took them only 30 days, simply incredible.

Moderna has completed enrollment for its study in 12 to 17-year-olds. They have a phase II studying kicking off soon for six months olds - 11-year-olds. Novavax announced that its' US trial is fully enrolled, and they expect results in Q2.

Studies released this week showed that being vaccinated significantly reduces, but does not eliminate, transmission. This isn't surprising, but it's great to have it confirmed.

As I said last week, it looks like we'll have more than we need for doses. The over-ordering for us will benefit the world as we donate the excess. The factories we funded will churn out more doses faster than they otherwise would have. And when Covid is over, those factories and technologies will change how we fight disease forever.

I'm confident we can handle anything Covid throws at us. Over the past year, we've honed a system to detect, understand, and eliminate this threat. Our factories can now produce billions of doses a year. Our scientists have shown they can turn out new vaccines faster than we ever thought was possible.

This is the inflection point, almost as big as the day the first vaccine was approved. This is the week a trickle of vaccines becomes a flood. This is the week where you can start to make plans for the summer, to know you can see your friends and families soon.

But we still need to stick the landing. Today is not the day to throw a rager. Don't be the last person you know to get Covid.

It's going to be a fantastic summer, let's get there together.

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