Yes, ideally there would have been a single-dose study as well. But here we are, and with a shortage that will mean many more people will die and everything else will be delayed. Personally, looking at that data, I'd quickly take one dose to give someone else a chance at one.
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zeynep tufekci Retweeted
Maybe. There are 1256 people who did not receive the second dose in the trial. Yes, small group but what happened to them? I get it, ideally, we have a single dose study. Not so ideally, we have this data and a severe shortage. Seems worth a discussion. https://twitter.com/Valentine721/status/1337048321026875394 …
zeynep tufekci added,
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Pfizer reports "52.4% efficacy" for single dose but that includes the first seven days, before things kick in, when most new infections happened. At 10-12 days, the chart (eyeballing, no underlying data yet) looks ~80-85% efficacy. Unpleasant trade-off but reality is unpleasant.
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I'm hoping for immunology/virology people to tell us the potential trade-offs here. We know one side: due to shortages, hundreds of millions of people will not get vaccinated anytime soon. What does the calculation on the other side look like?
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At a minimum minimum, there should be an immediate single-dose trial launched, like yesterday. We sadly have a raging epidemic and will get results quickly but I think not giving this real thought now—and an explanation to the public—would be a grave mistake, given the stakes.
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zeynep tufekci Retweeted Stefan Baral
Yeah, but given the stakes, "we don't know for sure so we won't vaccinate hundreds of millions" is not an acceptable answer. Shortage is a terrible trade-off, too. Why didn't they/we immediately launch a single dose trial after prelim data? They knew.https://twitter.com/sdbaral/status/1337053741015502850 …
zeynep tufekci added,
Stefan BaralVerified account @sdbaralReplying to @zeynepDose de-escalation/non-inferiority trials tend to be very difficult to get pharma to agree to. But indeed, it is an open question of the non-inferiority of 6 weeks after one dose vs 2 weeks after the 2nd dose. Imagine Pfizer/moderna fights back on behalf of their shareholders.14 replies 24 retweets 219 likesShow this thread -
Look, folks, like all things pandemic, this is a trade-off. The immunology people should weigh in and explain to us about one side of the trade-off. The other side is a societal/ethical decision because we're bouncing potentially less efficacious against *not at all vaccinated*.
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Replying to @zeynep
Not an immunologist so I too will wait for experts to form my final opinion. But am in pharma/biotech - therapeutics not vaccines. Dosing regimes based on available data, e.g. animal studies. Suspect in this case also past experience w/similar vaccines.
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It probably tells us something that both mRNA vax teams came up with 2 dose regimen. Suspect 2and dose is for longevity of response. But that is only an educated guess.
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People thinking they are protected when protection has faded would be terrible outcome for multiple reasons. For that reason it would be very risky to try a 1 dose regimen outside a clinical trial where outcomes and intermediate markers like Ab levels are monitored
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Hundreds of millions not getting vaccinated at all is also a terrible outcome, though.
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Replying to @zeynep
They will get it. That we have made other decisions that make the waiting period extra risky is a terrible tragedy. But at least people know they aren't protected yet. I also worry a prominent issue in this vax rollout could become ammo for anti vax in other diseases.
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