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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Of course - this analysis needs input from immunologists, public health officials, epidemiologists, manufacturing experts, ethicists AND understanding of existing biases.
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Replying to @yellingatwind @zeynep and
You just said definitively it’s unethical to not consider it. So if immunologists are saying it’s unequivocally a bad idea, they are unethical. Why seek the input of unethical people?
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We're not asking immunologists if it is a good or bad idea. That's not an immunology question. (How could it be?) We're asking for a discussion of the trade-off curve so people can decide if it is a good or bad idea. Besides, fractional dosing for shortage is done (YF etc.)
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What is YF? This definitely seems like a case of shortage where fractional dosing could be considered. Fractional being defined as one shot instead of two -> or 2/3 shot or whatever.
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