I agree. Too much uncertainty in short- and long-term efficacy. And the optics of changing the plan now, for a regimen that hasn’t been tested directly, are not great. Follow on studies can assess non-inferiority of a one dose regimen, but for now the data support two doses.
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What if there's a single-dose-so-far arm in an ongoing trial? (Don't know but plausible, no, given ongoing trials?). Would you be for converting that to single or spaced out dose? We know the reasons against retrospective analyses but we also have the other side of the trade-off.
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That we didn't immediately launch a third arm for single-dose soon after the initial data were in—despite looking at a terrible fall/winter ahead—tells us how it works. I think our inability to adapt—with data—cost us so much already in this pandemic.
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(Missed second dose in phase III for Pfizer is ~1250 which is a small number but is matched by almost equal size miss in placebo arm, suggesting some randomness, and maybe can help signal alarm: if big spike in disease, that's info).
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