The worst case scenario is that we do this, but don't collect data. If there is a significant downside (like very rapid waning), we should monitor. The numbers on the side of rapid mass vaccination aren't minor either, but public trust is crucial, and that requires transparency.
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Trying to think if I've seen a *single* BIPOC scientist with relevant expertise speak out in support of single-dosing. Coming up empty.
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zeynep tufekci Retweeted Rajeev Venkayya MD
You mean delayed booster? That's the debate. One, I know many. For example. Two, looked from an actual position of global equity (which was my biggest initial concern, tbh, as someone from the global south), trust me, there are many who'll take that side.https://twitter.com/rvenkayya/status/1345026172074262528 …
zeynep tufekci added,
Rajeev Venkayya MDVerified account @rvenkayyaIn my view, the immediate priority is prevention of severe disease that drives deaths and the strain on health systems. Efficacy against severe disease is likely better than overall vaccine efficacy. Data after the first dose is promising although the numbers are small. 8/ pic.twitter.com/vxrNPzV4vFShow this thread1 reply 0 retweets 1 like -
Rich nation debate is "we have an excellent double-dose vaccine, why tinker with it." I get it. The global question is there are billions who will be denied any vaccination or vaccines with higher-efficacy because rich nations have bought up all those excellent doses. Real issue.
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There are a bunch of vaccines in the pipeline that will be cheaper, easier to produce at scale, and have better shipping and storage characteristics than the mRNA jabs.
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Right, and we're telling people in the global south—where the actual "BIPOC" majority lives—to wait in line while we get our excellent coverage first. I'm just pointing out that you made an argument from equity, and that's where we stand with equity. It's reality.
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Who are the BIPOC scientists with relevant expertise who are calling for single-dosing?
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Spacing booster, not single dose—that's all anyone is debating. I cited some above and the moment this debate goes to where the actual BIPOC scientists live—should the rich nations space boosters and give the rest of the world a chance at supply? If that's what we're going by...
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IMO changes to spacing will de facto become a single dose regime for a huge fraction of recipients.
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And, again, people with less reliable access to care could be disproportionately harmed.
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I think those are real risks, and all the more reasons to collect data so we know what we're doing. Still does not resolve the fact that—you think few, I do not have a survey, I see many—leading vaccine/immunology people are in favor of spacing, and equity issues are global.
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How many is "many"? A dozen? A score?
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