What about an immediate call for volunteers for a randomized group among the many millions who'll get the first shot? Data-wise, some of the initial groups aren't that high risk at the moment (<65 HCWs). The vaccine shortage is going to have huge implications on overall deaths.
-
-
Yes, this is exactly what is meant by a follow on study to assess the non-inferiority of a single dose. I think we’re all saying the same thing! This is worth studying further in a rigorous trial. But I don’t think we should tinker with the current rollout for EUA populations.
4 replies 2 retweets 49 likes -
Agree. And we should remain open to change SHOULD additional studies suggest it is better for public health. I worry once we get something set, its incredibly difficult to change. Heck, we can't even get FDA to recognize that antigen tests don't look for residual RNA.
3 replies 2 retweets 19 likes -
Exactly. I think the idea that single dose may offer a reasonable, potentially excellent, trade-off is something to get out there right now because once something is set as standard, it's practically impossible to change even if it means billions are denied vaccination in 2021.
1 reply 2 retweets 14 likes -
Replying to @zeynep @michaelmina_lab and
Rajeev Venkayya MD Retweeted Prof. Akiko Iwasaki
Agree with supply urgency, but wouldn't overstate what we know about efficacy of a single dose. Second dose is likely to help with *magnitude* and *quality* of immune response through affinity maturation. 1/https://twitter.com/VirusesImmunity/status/1336323016737755142?s=20 …
Rajeev Venkayya MD added,
Prof. Akiko IwasakiVerified account @VirusesImmunityThe estimated vaccine efficacy after the 1st (82%), between 1st and 2nd (52.4%) and after the second dose (95%) are all impressive! However, high affinity Ab and long term immunity likely require the 2nd dose and we should all adhere to the recommended regimen. (2/n) pic.twitter.com/hSmSURkVTDShow this thread1 reply 0 retweets 4 likes -
Replying to @rvenkayya @zeynep and
Rajeev Venkayya MD Retweeted Deepta Bhattacharya
The good news is that we can study “missed 2nd dose” in the Ph3 and post-authorization populations, and hope to have a correlate of protection soon to make single dose studies easier without efficacy studies. 2/https://twitter.com/deeptabhattacha/status/1337147845686611968?s=20 …
Rajeev Venkayya MD added,
Deepta Bhattacharya @deeptabhattachaAfter the second Pfizer dose, the nAb titers go up 10-20-fold (https://www.nejm.org/doi/full/10.1056/NEJMoa2027906 …). That leaves a lot of room for decline while still maintaining protection. Even if every antibody-producing cell died en masse, all at once, theShow this thread1 reply 1 retweet 8 likes -
Replying to @rvenkayya @zeynep and
Rajeev Venkayya MD Retweeted
So fully agree this needs to be studied, but until we have the data, we shouldn’t give the impression that one dose of this vaccine is just as effective as two. It could undermine compliance with vaccine schedules beyond this one. 3/ https://twitter.com/K_G_Andersen/status/1337160738851287040?s=20 …
Rajeev Venkayya MD added,
This Tweet is unavailable.1 reply 0 retweets 2 likes -
Replying to @rvenkayya @michaelmina_lab and
I don't see anyone suggesting "effective as two" or not communicating the uncertainty. But if single dose is not put on the agenda soon, to be trialed ASAP, it will never happen because that's how it works. We're looking at a difference of billion+ vaccines in 2012.
@K_G_Andersen1 reply 0 retweets 5 likes -
This Tweet is unavailable.
-
Replying to @K_G_Andersen @rvenkayya and
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.
1 reply 0 retweets 3 likes
On the trust: coming from this from the sociology side, I think the medical people are underestimating how much of the lack of trust is coming not from communicating uncertainty/complexity but from the opposite—too little complexity. We can communicate uncertainty and earn trust.
-
-
This Tweet is unavailable.
-
Replying to @K_G_Andersen @rvenkayya and
I hear all the immunologists concerned about durability of protection. OTOH I think a one-dose trial could actually increase confidence even if the results were "less protection after a few months but we can get an extra billion+ people vaccinated in 2021".
1 reply 0 retweets 7 likes - Show replies
-
Loading seems to be taking a while.
Twitter may be over capacity or experiencing a momentary hiccup. Try again or visit Twitter Status for more information.