UK JVCI: “There is very good immunological and vaccine effectiveness evidence that the longer you leave that second dose the better for Pfizer and eight weeks seems to be a reasonable compromise.” US did three weeks. CDC said six weeks okay but I know people asked & got refused.https://twitter.com/HugoGye/status/1417051348336529409 …
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I don't know the answer. I'm just saying these things can easily be studied by setting up trials as we administer things—usually classic phase IV studies but we're in a hurry. It may be a small difference, but would be good to know.https://twitter.com/AndreasShrugged/status/1417159207195971584 …
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I think UK's Recovery trial was exemplary, and I just wish we had more, both randomized and cohort studies. There's a bunch of things around which we don't have the clarity we easily could have had. (FWIW: this isn't saying any answer is wrong. I just want more trials).
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No, hard to get answers that way, different places and time periods. Again: trials, cohort studies, registries etc. doing (as best as we can) apples-to-apples comparisons is what we needed. Would have been really smart and cost-effective in the long run.https://twitter.com/LakePatina/status/1417166352717127682 …
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But amidst winter wave in US quicker second dose may have prevented more infections in vulnerable populations?
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I remember reading about HPV vaccine that they later realized interval could be much longer and that fewer shots were needed.
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Do you think the greater success rates in fully vaxed vs half-vaxed is due more to infections happening closer to the 2nd dose or first dose being earlier than infection and being more effective with time and date of 2nd dose inconsequential (or some complicated middle ground)?
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Yes, once they did that trial, that was the only data they had. They could speculate that more time would be good, but no data. And between vax 1 and 2 people were vulnerable. Tough call.
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I think it was mentioned on
#TWiV that the only reason they picked three weeks is that the virology textbooks have 3 weeks as the bare minimum, and almost all immunologists would agree that a longer interim period would mean *better* protection. -
Pfizer was actually allowed to be given at 17 days.
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I've yet to see the evidence on differences in asymptomatic breakthroughs. The immune data is nAb titer that may be larger boost with greater interval. But again - absolute threshold of protection is not something we can easily measure. And the tradeoff was time.
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I'm just annoyed that we don't set up trials for these things. We're administering hundreds of millions of doses in a hurry, why not randomize a bit among some less risky sub-population? UK Recovery seems to be the only proper effort, tbh, to measure the kitchen sink phase.
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