I’m seeing discussions again about changing the timing of the second dose of the COVID vaccines, with what seems to be a goal of reaching herd immunity sooner. I see two problems with this.
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First, messaging *why* the dose is being delayed while maintaining public confidence wont be easy. This might be addressable — “not easy” isn’t the same as “impossible” but it deserves a lot of careful consideration & planning, IMO.
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Changing the schedule probably doesn’t help us it it decreases the number of people who feel comfortable getting vaccinated.
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Second, and I think this is the bigger issue, the herd immunity threshold depends on vaccine efficacy not just on virus characteristics. The threshold gets higher the less-effectively people are immunized. Let’s walk through the numbers.
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Replying to @EpiEllie
Two things though. (Disclosure I co-proposed essentially an adaptive trial on delaying boosters in December exactly because I focus on the trust side). The goal wasn’t herd immunity but expanded earlier coverage. Different considerations.
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Replying to @zeynep
Could you explain a bit more about what you mean by “expanded earlier coverage” as a goal? Maybe it’s just my epi bias but I don’t really understand a goal that isn’t about either deaths, hospitalizations, or infections.
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All those, which are not identical to herd immunity, no? So the goal UK committee stated wasn’t quicker herd immunity.
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