3/ …(like food handlers, police, firefighters, & teachers); and people at high risk for bad outcomes (people over 65 and those w/ preexisting conditions). One can make an argument for all of them to get vaccinated as soon as possible. Alas, we quickly run into a math problem…
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14/ Whether it’s anti-vaxxers or Russian bots, if somebody wants to turn every post-vaccine illness into a “See, I warned you” canard, there’ll be ample fodder. We’ll need a strong campaign to combat it, ie this https://tinyurl.com/y5ym92c5 Nothing I’ve seen in 2020 reassures me here.
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15/ I also worry about next 6 mths – will folks let their guards down because vaccines are coming? That would be a terrible mistake – while vaccines will protect the recipients, they’ll do little to protect others in the community until we reach herd immunity levels next summer.
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16/ Other worries: reviewing Biden’s appointees, from Covid task force to chief of staff Ron Klain, I have great confidence in their ability to pull off the logistics effectively, safely, & with minimum drama. But the first month of distribution will be done by Trump's team…
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17/ … and, while they’ve managed Operation Warp Speed well, the Trumpers seem poised to throw monkey-wrenches into the handoffs. I doubt this will screw the whole thing up, but even a few weeks’ delay will lead to millions of preventable cases & thousands of preventable deaths.
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18/ I worry about the impact of approved vaccines on ongoing trials. If we can get EUA’s for Pfizer, Moderna & Astra Zeneca, that’s probably a deep enough bench to vaccinate everybody in the U.S. But more would be better, particularly as we think about the vast worldwide needs.
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19/ It’s going to get tougher to do placebo-controlled vaccine trials.(Is it ethical to randomize to placebo once 95% effective vaccines are available?). We may be forced to evaluate new vaccine candidates based on their similarities to ones we know work, which is a bit dicey.
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20/ I worry about kids, since we haven’t even begun to test vaccines in them. But if we can reach herd immunity by vaccinating everybody else (incl. teachers), we may not need to obsess about reaching kids, particularly the youngest ones (who are at low risk for illness/spread).
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21/ As I’ve said, while I do worry about uptake, I don’t worry too much. Unlike childhood vaccines, many people know friends & family who were sickened or died from Covid, & everybody wants their lives back. I’ll bet that uptake is going to be quite high, esp. in hi-risk groups.
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22/ I do worry about keeping track of who got which vaccine. Who will remind a pt to come in for a 2nd dose, and be sure that the 2nd dose is the same brand as the first? If we had a national medical record (like the VA or the NHS), this would be easy. But in the U.S., it’s not.
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23/ I worry a bit about how long immunity lasts, but also not too much. We’re now pretty confident that immunity lasts for >1 yr. If it turns out that we need a booster in 2-3 years, that'll be a small price to pay to save tens of thousands of lives and a return to normal life.
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24/ So, yes, I do have worries. But let’s not lose sight of the fact that, on November 1st, we didn’t know for sure that we would have ANY effective vaccines. Today we have at least 2-3 highly effective ones, an impressive safety track record, and millions of doses ready to go.
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25/ So yes I have worries, but the light at the end of the tunnel is increasingly bright. We just need to get there. How confident am I? First, I’ll get my shot the day I’m eligible. And I just booked a golf trip in Sept. Perhaps living dangerously, I didn’t ask about refunds.
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End of conversation
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