January 10, 2021

HMM: Biden to release all available COVID-19 vaccine doses later this month.. “When he takes office later this month, President-elect Joe Biden will move to release every available dose of the coronavirus vaccine, breaking with the Trump administration’s policies, a transition team spokesman said Friday. Rather than holding back enough vaccine to provide a recommended second dose for those who receive an initial dose — as the current administration has done — Biden will instead release ‘available doses immediately.'”

This isn’t crazy — there’a an argument that giving twice as many people a shot that will provide 85% immunity is better than giving half as many people a shot that will provide better than 95% immunity — but it has the potential to be a debacle if it leads to a lot of people never getting a second shot, and thus not developing long-term immunity. As the article notes, the FDA just considered and rejected the idea of a single shot for this reason. Quoth the FDA:

Using a single dose regimen and/or administering less than the dose studied in the clinical trials without understanding the nature of the depth and duration of protection that it provides is concerning, as there is some indication that the depth of the immune response is associated with the duration of protection provided. If people do not truly know how protective a vaccine is, there is the potential for harm because they may assume that they are fully protected when they are not, and accordingly, alter their behavior to take unnecessary risks.

We know that some of these discussions about changing the dosing schedule or dose are based on a belief that changing the dose or dosing schedule can help get more vaccine to the public faster. However, making such changes that are not supported by adequate scientific evidence may ultimately be counterproductive to public health.

As a rush for herd immunity, as I say, it’s not crazy. But it’s a risky scheme, and I wonder if the older patients — the very ones who need the most immunity — will be less likely to follow up in time.

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