The bigger issue is that it's quite likely a single-dose regime will produce much less durable immunity. Possibly as little as a couple of months, so implementing this without a trial is very risky. @VirusesImmunity, a leading immunologist, has commented specifically on this.
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Right, but we're balancing much "less durable immunity" against many many millions fewer *unvaccinated* people in US. What's the argument against immediate single-dose launch trial (among voluntary HCW without comorbidities maybe?). Nobody says this is ideal.
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What is stopping a health-care system from deciding on a one dose regimen for now (booster when available) if patients sign waiver? Decision-making under uncertainty is hard but critical in situation like we have now.
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Replying to @yellingatwind @zeynep and
Does "booster when available" work as well? Or will people have to start over from scratch? That could increase by 1/3 the needed numbers of doses.
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Replying to @stgoldst @yellingatwind and
Vaccine schedules aren't randomly cobbled together. They're based on evidence. The most reliable way to squash the pandemic is to vaccinate consistent with our best evidence for what works.
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Replying to @stgoldst @yellingatwind and
Vaccine schedules during a pandemic are not some perfect processes. Besides there is data on both sides. What does it mean to leave hundred million vaccinated, or to delay start to hold off for second shot compared with less durable immunity? That's a societal decision.
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Armchair epidemiologist (self-certified) Retweeted Armchair epidemiologist (self-certified)
Agreed. It is just hard for the people who are in charge of these decisions to do that. They are trained from day 1 in "protocols" and the danger of making exceptions. This works great, until you have the one time you should make an exception.https://twitter.com/yellingatwind/status/1336354474806239232?s=20 …
Armchair epidemiologist (self-certified) added,
Armchair epidemiologist (self-certified) @yellingatwindHey medical peeps - is there an ethical/practical case for giving twice as many people one dose of the Pfizer vaccine? Or is there something about this vaccine that means you must have the 2nd dose in 3 weeks or protection gone after short period? https://twitter.com/alexdfox/status/1336332746415775744 …1 reply 0 retweets 1 like -
Replying to @yellingatwind @zeynep and
I actually believe it is UNETHICAL to not consider strongly using whatever you have to vaccinate as many vulnerable people in hotspots as fast as possible.
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Replying to @yellingatwind @zeynep and
Oh, so now vaccinating per the successful clinical trial protocol is (all caps) unethical? That's a pretty staggering charge to level at people who are doing their best to follow the evidence.
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Replying to @stgoldst @yellingatwind and
Ultimately, do we need input from scientists at all really?
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We're all seeking the input, but the ethical trade-offs are societal decisions. A pandemic is a bunch of decisions made with imperfect data facing limited supplies with trade-offs and data on *both* sides of the equation.
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Replying to @zeynep @yellingatwind and
You’ve got my input, input from world-renowned immunologists. Take it for what it’s worth (maybe nothing!).
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Replying to @stgoldst @yellingatwind and
I have specific questions! I get the durable immunity unknown. What about shorter term? That's where the trade-off is most severe. (Besides the need for launching immediate trial...)
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