Hey, just one option. Was responding to idea we needed placebo.
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Replying to @gregggonsalves @michaelmina_lab and
It’s worth trialing, but let’s be clear about the priors. The scant data we have are consistent with the expectation of a short-lived and non-anamnestic immune response after a first priming dose. It would be great if the SARS-CoV2 spike protein is the exception to this rule.
10 replies 20 retweets 177 likes -
Replying to @jallepap @michaelmina_lab and
This is
#publichealth#epitwitter at its best.7 replies 5 retweets 61 likes -
Replying to @gregggonsalves @jallepap and
The durability of the immunity is the biggest concern we heard—also even with a booster. When is the next booster? In addition, one option is spacing the booster a little farther—especially for younger cohorts and/or people with prior infections: aka front-loading the supply.
6 replies 1 retweet 56 likes -
Replying to @zeynep @gregggonsalves and
Another advantage to an immediate trial is having a better sense of the scale/scope downsides. Some people are going to miss the booster, and require allocation of (limited) resources to track down. So who and when? A trial would help shed light on that.
3 replies 1 retweet 30 likes -
Replying to @zeynep @gregggonsalves and
The problem isn’t trial design. Every one of these options has been written up, designed, proposed. The problem is how many efficacy trials can a society support with finite # of investigators, volunteers, cash and morale, all in the face of multitudes of other important studies.
2 replies 2 retweets 56 likes -
Replying to @k_stephensonMD @zeynep and
In truth, this is the most limiting resource. Ideas are easy, but execution (in this case, of an informative experiment, much less 5 or 10 of them) is the hard(est) problem.
1 reply 0 retweets 16 likes -
Replying to @jallepap @k_stephensonMD and
And suppose a single dose candidate without the need for a (super) cold chain emerges, less expensive and easier to produce? As
@k_stephensonMD suggests the trade-offs are larger here: what do we do with limited time, resources and money? 1/1 reply 0 retweets 12 likes -
Replying to @gregggonsalves @jallepap and
Important thing here is not to ask is this a good idea, but in the words of one of the smartest people I know (
@ADPaltiel), but to ask compared to what? Choices are trade-offs. Have to pull out and look at the entire landscape of vaccine development. End/1 reply 1 retweet 23 likes -
Replying to @gregggonsalves @jallepap and
Resources are limited to the degree there is no push for more resources. We live in very very wealthy countries, and if we start “with resources limited” and stop there we don’t get the resources. It’s exactly the reason to push for more.
2 replies 2 retweets 30 likes
If an idea is baseless or has already been shown to be pointless sure no need to waste more resources on it. But if that’s not yet the case, I don’t see the point of negotiating ourselves down without even asking for trials? Trillions are being spent on all this.
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Replying to @zeynep @gregggonsalves and
Totally agree - we need to keep fighting for the $$$ and investment in science infrastructure, especially for public health-focused studies and not just licensure studies. I only point out that if even $ were available, the staff for the trials are at the breaking point.
2 replies 0 retweets 14 likes -
Replying to @k_stephensonMD @zeynep and
We can run trials much more efficiently than we usually do. Particularly with a vaccine now being rolled out. We are talking about a trial of tens of thousands, to potentially improve access and early receipt for billions. We can do these trials if we wanted.
2 replies 1 retweet 13 likes - Show replies
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