James Krellenstein
@jbkrell
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nuclear power, hiv+mpx+covid (previously), energy, physicist by training, gay
bushwick
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When I was 22, I watched a friend become HIV+ cuz he couldn't afford Truvada PrEP which cost s$1,300/m but costs <$6 to make. CDC invented & patented PrEP, but they refused to stop Gilead's price gouging for yrs. Today, the the same thing is happening with remdesivir for COVID.
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🚨BREAKING: If you are 🏳️🌈🏳️⚧️ in NYC and had multiple sex partners over the last 14 days you can get vaccinated for monkeypox today at the Chelsea Clinic (303 9th Ave.)Vaccines are availble 11 am to 7 pm Monday, Tuesdays, Thursdays, Fridays, & Sundays.
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This means that USG can license remdesivir to generic manufacturers while paying no (or very little) $ to Gilead. Remember remdesivir costs less than $1 to make a dose, yet Gilead charges over $350 a dose for it. Our government could stop this price gouging today, but will they?
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So this is a common question to ask -- if Moderna has pledged to not enforce their patents, why can't we start production everywhere? Three reasons:🧵
Since Moderna announced they won't enforce their patent on their vaccine, has that altered production plans in other countries or is the mRNA platform too fussy/boutique to ramp up mass production? I can't seem to find the answer to this.
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Last month,
@cmorten2
& I showed that not only did (h/t
@zainrizvi
) the US government spend >$70 million on developing & inventing the drug, the government is legally entitled to be co-owners of the patents for remdesivir.
PrEP4All
We fight to put lifesaving medication into the hands of everyone who needs it.
prep4all.org
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in 2018, some queers started to get together over beer to figure out how everyone who needed PrEP could access it. we called ourselves "prep4all". today, the Biden administration announced a multi-billion dollar program to do this. They are calling it... " PrEP For All".
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Please support and follow
@PrEP4AllNow
to learn more about our work to ensure that everyone can access the HIV And COVID-19 medications they need!
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tl;dr -- we need three things: 1. A TRIPS waiver, 2. public funding for scale up of vaccine manufacturing, and 3. facilitated tech transfer to transfer know how to other manufacturers. cc:
@kenyonfarrow
@chrislhayes
@gregggonsalves
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The 1st, Moderna doesn't own every patent that is used in its vaccine and in the machines used to make their vaccine. Put simply, it can't pledge to not enforce patents it doesn't own. Let's take the most obvious example of this. 2/n
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Moderna did not invent this technology! Rather Drew Weissman & Katlin Kariko invented it at Penn and patented it (e.g. U.S. Patent No. 8278036B2). Penn than exclusively licensed this technology to Cellscript. Cellscript than sublicensed this IP to Moderna and BNT for $75 mil each
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Here is the thing -- Moderna could give up its patents (they are not doing that), but anyone who tried to make a copy of mRNA-1273 could (and would) be sued by cellscript. There are a bunch of other patents here that Moderna has licensed or uses that it does not own, but uses.
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Both NIH/Moderna & Pfizer/BioNTech vaccine use modified nucleosides, specifically n1-methylpseudouridine (rather than uridine, the "U" in the RNA genetic alphabet). in their mRNA This allows the vaccine to express a protein without triggering a cell's antiviral defenses. 3/n
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This is especially true of machines that are used to make the vaccine, for example microfluidic lipid nanoprecipitate mixers. Which brings us to the second and 3rd reason, it is pretty difficult to scale up manufacturing of this vaccine without significant funding and tech trans.
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Appaling tweet. Arguing that USA should get “Lamborghini” vaccines, while Latin America, Africa & Asia (i.e. POC) should get “Hyundai” vaccines is disgusting. Even worse, the entire premise — that we can’t make more mRNA vaccines — is false.
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I know we are all applauding
@JoeBiden
for his response to India today, but, to be honest, I think Biden's response is actually really bad. And it shows that nearly 100 days into his administration, they still don't have a plan for ensuring global vaccination. 🧵
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The CDC, today, could go to court and demand that
@GileadSciences
radically reduce the price of Truvada. They could demand that Gilead pay them BILLIONS of dollars they owe, and use it to ensure that every American who needs PrEP can get it.
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Truvada (the drug used for PrEP) is an incredibly cheap drug to produce – FDA approved generic versions are available *today* in other countries for less than $6 a month.
@GileadSciences
currently charges over $2,000 per month. (2/9)
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@Phrma
’s normal excuse for this egregious price gouging is that R+D costs so much, they need to recoup their investment. But in the case of PrEP, taxpayers, not
@GileadSciences
, spent over $100 million developing PrEP.
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We, the American people, funded the invention of Truvada as PrEP. We funded the initial animal experiments, we +
@gatesfoundation
funded the clinical trials that proved it work. We, thru
@CDCgov
, literally own it, through three rock solid patents protecting its use.
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This
@mattyglesias
tweet is getting a lot of play, but it is fundamentally wrong. Let's start with the basics; Omicron is not the "South African variant"; although it was first *detected* in South Africa, it probably did not *originate* there. Short 🧵
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Isn’t it kind of perfect that PrEP+ is super exclusive (while getting a shit ton of press)? I mean it is like PrEP itself — by design, most people who need and want it can’t get it — despite the facade of accessibility.
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Proud of the activism
@PrEP4AllNow
and others did to get CDC to send more
#monkeypox
doses to NYC & US. Due to that work, vaccinations will restart soon. But Biden's vaccine strategy is too small & slow to protect 🏳️🌈🏳️⚧️ communities. We must demand better. What needs to happen: 🧵
🚨BREAKING: If you are 🏳️🌈🏳️⚧️ in NYC and had multiple sex partners over the last 14 days you can get vaccinated for monkeypox today at the Chelsea Clinic (303 9th Ave.)Vaccines are availble 11 am to 7 pm Monday, Tuesdays, Thursdays, Fridays, & Sundays.
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1. We scaled industrial mRNA production capacity from 0 in Feb 2020 to 3 billion dose py capacity by Dec. 2020. There is nothing from preventing further (rapid) scale up, except our decision not to further scale up production for lower and middle income countries.
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The public spent $2.5 billion on developing the Moderna vaccine. We paid for the trials, the factories, & bought millions of doses before we knew it worked. Moderna refuses to takes step to ensure global access. The
@NIH
has the power to force them to do so. We demand they use it
🚨 BREAKING: We, along with 5 other NGOs, the deans of 3 public health schools & 11 leading scientists are asking the
@NIH
&
@HHSGov
to use a key patent, owned by the US Government, to increase global access to the
@moderna_tx
vaccine.
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Its time for this to change. The US healthcare system already spends enough money on PrEP to ensure that everyone in this country who needs it can get it and get the clinical care they need for it. The CDC could of prevented my friends infection and tens of thousands more.
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Ironically, Truvada would be generic today, if we, thru the
@NIH
and the
@DeptVetAffairs
, had not funded the research that led to the patents that Gilead now uses to sue generic manufacturers (and illegally pay them off). The
@NIHDirector
could stop this as well but he wont
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4. Finally, let’s not compare life saving vaccines that cost $2 a dose to super luxury sports cars that cost $200,000 a vehicle. Healthcare is a right, having idiotic super cars to compensate from some Freudian insecurity, is not.
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The
@Dereklowe
piece sort of misses the point. Yes, there is no idle mRNA vaccine production capacity in the pharma industry that could simply be repurposed to make more COVID-19 vaccines. But we could rapidly *build* more capacity, as we did across the world last year. 🧵
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As the world reels this morning from the
@AstraZeneca
news, remember that this problem + the general difficulty of comparing different COVID-19 vaccines is due to a decision by the
@NIH
to not run head to head trials because pharma *didn't want them to*. 🧵
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The
#ebola
outbreak in Uganda is alarming. Already the 3rd largest outbreak of Sudan virus in history, with 54 suspected/confirmed cases since it was detected <2 weeks ago. The response is a perfect example of what is going right & wrong with global pandemic prep.🧵w/
@Garrett_W_
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New York State just approved 2 offshore wind projects with a strike PPA price for $150 per MWh. Key question for
@NYSDPS
would you approve a *nuclear* project for the same strike price?
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I am usually a big NRC defender but this is terrible science communications. The fact that an NRC video doesn’t mention that no one was hurt or injured at TMI or that the maximum dose of radiation to the public was less than a tenth of a CT scan is pretty irresponsible.
On this day in 1979, the Three Mile Island Unit 2 reactor experienced a partial meltdown. The unfolding of this would turn out to be one of the most significant events in commercial nuclear power history. Watch the full video at:
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3. These exact sort of arguments, about why e.g. Africa can’t handle mRNA vaccines are scarily reminiscent to the racist arguments about why we couldn’t scale up ART in the late 1990s to e.g. Africa. And they are equally bullshit.
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Tl;dr the world scaled mRNA vaccine production capacity by more than 6 orders of magnitude in less than a year. there is nothing that stopping us from scaling up more now, except our will.
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There are 1.4 million doses of Jynneos — the monkeypox vaccine being given out in NYC— filled, finished, labeled and ready to go in the Strategic National Stockpile. Vaccines need to be in 🏳️🌈🏳️⚧️ arms not freezers.
@JoeBiden
@ASPRgov
get your shit together.
NYC has only been given about 1,000 doses of the monkeypox vaccine. This is far, far too little. And now people are literally been turned away.
We need the feds to dramatically up our allocation ASAP.
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the dirty little secret is that nuclear can ramp up and down perfectly well (some recently built reactors can increase/decrease power at over 10 megawatts (elec) per *second*), it just not done in the US because nuclear fuel is cheap and doesn't pay to load follow here...
the dirty secret of wind and solar is that they play nice with natural gas
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Its why a lot of us are so pissed at Fauci about this. We (myself including) have been yelling for months for
@NIAIDNews
to increase funding for global sequencing coverage. Tony doesn't do this, then he implements a travel ban that will do nothing. FIN
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I am a little confused by this
@nytimes
reporting by
@MarcSantoraNYT
and
@RebeccaDRobbins
on the new AZD1222 data. First of all, the claim that this data is the “first” to document evidence that a COVID vaccine can result in a reduction in transmission seems to be wrong.
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The 1st time I met Larry Kramer in person, I was 24. Before this, we had been fighting for about a year, with increasing vitriol directed towards each other. When Truvada was FDA approved as PrEP back in 2012, Larry, among many others, was a vocal critic of those who used it. 1/n
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I am concerned that the Biden administration is already talking about "eradicating" monkeypox, when right now, as
@CDCgov
&
@NIH
officials have warned us, they lack the resources to conduct the basic scientific research needed. 🧵
@SherylNYT
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France's nuclear fleet anticipates a capacity factor of only 60-65% in 2023. Importantly, without constructing a single new plant, we could generate an additional 150 TWh of electricity if we brought the capacity factor to 90%, enough to power the whole nation of Austria — twice.
Maybe, finally EDF will start to gain the full financial benefits of its nuclear fleet given the changed energy landscape
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.
@tednordhaus
's "It's the Nuclear Regulation, Stupid" reduces an intricate engineering & policy challenge to a simplistic slogan. Catchy rhetoric? Sure. Supported by evidence? Hardly. Let's dissect this claim. 🧵
New essay about the new conventional wisdom among many pro-nuclear progressives that insists that the lack of standardization and various other non-regulatory factors are the real reason that nuclear energy got so expensive. 🧵
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So the basic jist of
@mattyglesias
tweet, i.e. cuz 🇿🇦 recently asked to for a pause in vaccine deliveries, vaccine inequity cannot be the cause of Omicron, makes no sense, because its likely that Omicron didn't *come from* South Africa.
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First, as
@zainrizvi
has pointed out, the WH was clear that the materials that would be sent to Serum Institute of India would be for Covishield (the SI version of AZ/Oxford). The only problem? There was NO materials shortage for Covishield that was inhibiting production.
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This is undoubtedly good news. But the world is playing a dangerous game — everyday we delay scaling up global production and access to vaccines, we increase the probability that we will develop a truly vaccine resistant variant. There is no time to lose.
We just announced that the Moderna COVID-19 Vaccine retains neutralizing activity against emerging variants first identified in the U.K. and the Republic of South Africa. Read more:
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Here is our plan to scale up mRNA vaccine access and production:
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People reviewing the SARS-CoV2 humoral immunity literature be like
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This is the case in much of e.g. southern Africa.🇿🇦is an exception, it has built a world class molecular surveillance system. But that also means that if a new variant developed somewhere else, it is likely to be the first place to *detect* it, even if its from somewhere else.
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🚨BREAKING $MRNA (Moderna) is in a patent dispute with the
@NIH
over the COVID vaccine Moderna and NIH co-developed. Great quotes from
@cmorten2
,
@zainrizvi
,
@AmeetSarpatwari
and yours truly (from
@PrEP4AllNow
).
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The USG OWNS more than a MILLION doses of monkeypox vaccine *ready to go* stuck in freezers in Denmark. These doses COULD have been brought to the US weeks ago had the Biden admin. ordered
@US_FDA
to inspect the facility, but they didn't, so now they may not come till AUGUST.
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@stevemorris__
We are not for NYC specifically. We know there are 1.4 million doses in the stockpile
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In the rare cases where travel bans works, its when we can detect the spread of a new variant extremely quickly after they emerged. The lack of sequencing means this almost never happens, and why Omicron is probably all around the world already.
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As
@_HassanF
has pointed out , a major problem with vaccine administration in South Africa is the "drip, drip, boom" model of the way Pfizer and J&J have delivered vaccines to SA . It is hard for any system to evolve from extreme scarcity to abundance. from
@HealthJusticeIn
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So once again, it is totally possible (and even likely) that the Omicron variant arose in neighboring countries, because of lack of vaccine access, wouldn't be detected (until it spread to🇿🇦), thus making Matty's argument bullshit.
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New variants of SARS-CoV-2 are detected by RNA sequencing. But inequity in healthcare systems means in much of the world, few if any, cases of COVID are sequenced. Of the 6 states that border🇿🇦, 5 have been unable to sequence a *single case* in the last 30 days. From
@GISAID
.
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In fact, just last week, Israeli researchers documented a 50% reduction in both symptomatic and asymptomatic infections in individuals who took a single dose of the Pfizer mRNA shot in a retrospective cohort study.
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Interesting that Ed Lyman treats an inspection report that found only findings of “very low safety significance” (in
@NRCgov
words) as “unbelievably bad”. Does Ed have any scientific or engineering justification for disagreeing with the NRC’s risk assessment?
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Before we get deep into the weeds, lets remember, in January/Feb, the world had basically no commercial scale mRNA vaccine production capacity. By December, private industry (with a lot of public funds) built 3 billion+ doses / year scale capacity
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Fellow PrEPers, can we talk being pressured by our doctors to switch to Descovy? As 👇 explains, whether Truvada or Descovy is safer for *PrEP* is actually an open question, and the campaign to switch us all is more about protecting
@GileadSciences
profits than our health. THREAD
Is TAF/FTC really better than TDF/FTC for
#PrEP
? Don't be so sure.
Today in
@AnnalsofIM
:
@douglaskrakower
,
@DrDemetre
, Judith Feinberg
@HIVMA
, and I make the case that when people think of PrEP, they should still think of TDF/FTC.
THREAD. 1/
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.
@PrEP4AllNow
has been meeting w/ senior Biden officials for months now, on increasing vaccine production and the world, as
@peterstaley
said “has nothing to show for it”. Time is up. Biden’s inaction on vaccine access threatens us all.
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And once again, we see that the same states where inequity prevents adequate sequencing are the same states who suffer most from vaccine inequity. Many of the states near 🇿🇦 have been able to vaccinate less than 10% of their population.
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Rest in power, Paul. This is heartbreaking.
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I support the bipartisan ADVANCE Act's goal of reducing regulatory costs & incentivizing new
#nuclear
plants. However, the current bill text discourages developers from pursuing proven, built, reactor tech in favor of first-of-a-kind designs. That's not good policy. 🧵
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.
@moderna_tx
currently has *131 million* doses of vaccine waiting to be bottled, enough to fully vaccinate every adult & child in a country the size of 🇿🇦S. Africa. This is inexcusable in a pandemic that kills 15,000/day. Stay tuned to
@PrEP4AllNow
, we have a lot more to say (🔥)
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First they mock you…
NEW: A senior official at DOE's loan office said Vogtle has drummed up interest in building more large-scale -- not SMR/advanced/micro -- reactors.
Yep, you read that right:
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Instead,
@SerumInstIndia
cannot access supplies for the OTHER COVID-19 vaccine it produces, Covovax, their version of
@Novavax
, *and not Covishield*. Serum Institute has been 100% explicit about this (once again h/t
@zainrizvi
):
Here’s Adar Poonawalla of SII admitting on CNBC TV18 just 2 days ago that the US embargo on raw materials DOES NOT AFFECT PRODUCTION OF COVISHIELD.
The embargo affects “Covovax” which is a vaccine under development that’s not yet been approved anyway.
(1/2)
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One last thing, don't use this thread as way to justify
#antivax
bullshit. The trials that were done perfectly evaluated safety, and these vaccines are, without a doubt, very safe. I would take any of the EUA'd vaccines, and in fact, just completed my Pfizer course.
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But we also need to point out that the great inequities in sequencing coverage means that we are "flying blind" in this pandemic. Lack of sequencing means it can be weeks\months before a new variant is detected. Its why people like
@gregggonsalves
r pissed about the travel bans.
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A lesson we learned from 1918 flu -- speed matters. St. Louis implemented social distancing 2days after it detected its first cases, Philly waited ~2 weeks. The result -- the peak death rate was 729% higher in Philly than in St. Louis. Let's not make the same mistake w/
#COVID19
.
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Larry's death represents another turning point. We are in the midst of another fucking plague. The question, I think, Larry would ask all of us is what are we doing to fight back? ARE WE ANGRY ENOUGH? ARE WE ORGANIZED ENOUGH? BECAUSE, RIGHT NOW, WE ARE AS GOOD AS DEAD. 4/n
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@LiebnizsLaw
Because there are drug regimens, known as pre-exposure prophylaxis or PrEP, that dramatically reduce the risk of HIV acquisition by more than 99%. The only two currently FDA approved are Truvada and Descovy, both manufactured by Gilead.
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Concluding thoughts: The last couple of years have shown we are entering an era where outbreaks will occur more frequently. Problems we don’t solve now will continue to cost lives and livelihoods.
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What steps should we demand the admin take now? On Tuesday,
@prep4allnow
&
@PIH
urged the administration to pursue a three step strategy to ensure robust vaccine supply over the coming weeks. Admin’s response? Crickets.
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.
@PaulDorfman3
continues to spread dangerous climate misinformation about one of the most vital technologies to get off fossil fuels. tl;dr fast reactors have been operating commercially for 40+ years & provide zero carbon electric power far more reliably than solar or wind. 🧵
@letsreplanetUK
@letsreplanet
@mark_lynas
@alexralph
Fast reactors do not work, have never worked. A simple fact.
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This is what NIH originally proposed. But as
@carlzimmer
reported back in Oct., pharma rejected this idea precisely because it would *work*. That is, it would show which vaccines are better than their competitors.
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The two doses of the Moderna/NIH in my arm are the product of tech transfer. A factory in New Hampshire run by a company HQ'd in Visp, Switzerland made the drug substance, a factory in Indiana run by
@CatalentPharma
bottled the vaccine. Tell me again why we can't scale globally?
Totally disingenuous argument from the CEO of
@moderna_tx
. Tech transfer for mRNA vaccines works to rapidly scale up production, even when there is no available manufacturing capacity. How do we know? This is the exact approach Moderna *itself* used to scale their production🧵
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Pretty shocking (but not surpassing) that in
@ScienceMagazine
's survey of *pharma employees*
@moderna_tx
is the *only company* the industry's own employees do not think is "socially responsible". How bad of company for even pharma to object?
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Is this a mistake
@JakeSullivan46
? But regardless, we have seen nothing from the administration on how the US is going to scale manufacturing capacity for both raw materials and consumables (biorx bags, filters/columns etc,) necessary for scaling up vaccine production globally.
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In fact, the administration has had US$10 BILLION, authorized by the COVID rescue package, to do exactly this since MARCH, and yet has to done nothing.
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I never want to see another tweet from fucking Facebook or Instagram about how they celebrate pride. They literally censor lifesaving info for the queer community.
Yesterday, we posted on
@instagram
a NBC article about how
@CMSGov
is now requires insurers to cover PrEP without any out of pocket $, lifesaving info for queer people. This AM, they deleted it, saying it is against their "community guidelines". This is deadly homophobia. Mini🧵
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Larry, and a whole generation that preceded us, taught us how to fight back against a plague that at one time also seemed hopeless. They fought heroically and won. But the generations who came after them us can no longer depend on just them to fight for us. It's our turn now. 5/5
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We could provide enough doses for all of the most vulnerable people rapidly if steps are taken now. The U.S. owns an additional >15.2M doses of vaccine that just need to be put into vials. But the admin. has no plan to get this done, despite repeated warnings from experts.
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Hey
@rajpanjabi
,
@FDACommisioner
,
@ASPRgov
, when you get a chance, can you know, respond to our letter? I know y’all are busy, but our communities kind of can’t access vaccines, and are unnecessarily getting infected?
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A common antinuclear talking point is that hotter river water due to
#climatechange
is reducing nuclear energy production in France. The truth? In 2022, one of the hottest years on record, French nuclear production dropped only 0.18% due to hotter river temps. h/t
@MyrtoTripathi
Nach Angaben des französischen Rechnungshofs betrug der Produktionsausfall der Kernkraftwerke durch hohe Wassertemperaturen im Jahr 2022 gerade mal 501 GWh oder 0,18 % der Jahresproduktion. Ich habe meinen Artikel entsprechend ergänzt.
@Nuklearia
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The problem is that each COVID-19 vaccine was evaluated in its own clinical trial(s), each with a different statistical design, end point definition, recruitment strategy etc. A better way would have been to compare each vaccine against each other in a "platform clinical trial".
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