2/ Ideal would have been for Pfizer & Moderna to invite participants in the placebo group to be randomized between 1 vs. 2 doses, but unfortunately that is not going to happen.
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3/ Next best is to do trials among people who aren't going to be eligible for vaccination under the EUA for a while. The incentive to join the trial and get vaccinated now would be strong.
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4/ Even better would be for Moderna & Pfizer to run a joint trial that allowed direct comparisons between 1 and 2 doses of both vaccines. That could be the start of the platform trial we urgently need.https://jamanetwork.com/journals/jama/fullarticle/2774383 …
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@CohenProf sees potential research ethics challenges. I'm not concerned. There's a pressing scientific question and, even if 1 dose (or a delayed booster) is less protective than 2, informed adults can accept this risk for themselves. https://twitter.com/CohenProf/status/1339912099166887936?s=20 …This Tweet is unavailable.Show this thread -
6/ Further, we gain protection 2 ways: by protecting ourselves, and by reducing spread in the population*. If vaccinating twice as many does more of the latter, we all benefit from that.
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7/ *The caveat, of course, is that we don't yet know for sure that the vaccines reduce asymptomatic infection and ability to transmit disease. These data are coming, and urgently needed, but are not in hand yet.
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But aren't some in the high-risk groups in such groups because they are older and have less robust immune systems? Would good test results of a single dose in a low-risk group be meaningful as to that high-risk population?
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So... why are these low-risk populations first in line for the vaccinations??

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I think this means low risk of severe disease if infected, not low exposure risk.
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