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"No data" is wildly incorrect. We have priors from other vaccines and vaccine candidates, and the data from these trials. All data about the first dose suggests

"No data" is wildly incorrect. We have priors from other vaccines and vaccine candidates, and the data from these trials. All data about the first dose suggests strongly that 1 dose provides very strong protection against severe disease, and solid protection against mild disease. Most vaccines have increased efficacy when spreading out the doses, so the same is likely true here, which means this is most likely to increase efficacy. We don't have data on lots of things, like what if we vaccinated people in cars instead of indoors? We can't run RCTs for everything in this world. People are also not advocating for 1 dose only, rather spreading the doses out more to get more people vaccinated faster. 1 dose first, followed by another 12 weeks later is almost certainly going to be highly effective and it's almost certainly going to be safe. This is also not a binary decision. To let you to 10M people try this regime while watching the data has as close to "only upside" as you can get in medicine. If the FDA approved Astrazeneca now, and the states focused on getting first doses, we could be done with this pandemic in like 45 days. It's worth taking a tiny amount of risk that this group of 10M might not have effective immunity and need to be revaccinated.

credit_guy 6y ago
Wholeheartedly agree with this. EUA means Emergency Use Authorization. Emergency, yes, that's what Covid is. As such, leadership means taking some calculated risks. What FDA essentially does is "you can't get fired for buying IBM". They stick to "we don't have any data for this and that", "this is what the science shows", and people out there are dying. A perfect demonstration of lack of leadership.
murgindrag 6y ago
It does provide protection, but what we don't know is: 1) For how long 2) How it impacts future vaccination efforts (As well as a slew of other things) If it was just #1, I'd be with you. If we give a big chunk of the population a vaccine which lasts 6 months and makes them unimmunizable, we've changed a serious problem into a serious, serious problem.
- zaroth 6y ago
  > ...and makes them unimmunizable... Is there any scientific basis for this hypothetical?
  - murgindrag 6y ago
    Yes. It's pretty common for vaccines. One mechanism: If you have a vaccine designed to deliver a spike protein (without a virus) surrounded by a carrier. The body learns to destroy the carrier. On future doses, the body recognizes the carrier, and the vaccine is destroyed before the body can react. Of course, a vaccine with a different carrier won't be affected by this mechanisms, but there are many other mechanisms as well. I'm not an expert, and I don't know all of them. I'm not sure science knows all of them either, for that matter. There have even been instances of vaccines making diseases worse too (actually, viruses not too dissimilar to COVID19). And there are a bunch of other possibilities. I'd buy the basic premise of giving each person one dose for giving everyone imperfect immunity if not for these sorts of complications. I'd rather just wait a few more months than risk a small (but definitely non-zero) chance of something really, really bad.

credit_guy 6y ago

Wholeheartedly agree with this. EUA means Emergency Use Authorization. Emergency, yes, that's what Covid is. As such, leadership means taking some calculated risks. What FDA essentially does is "you can't get fired for buying IBM". They stick to "we don't have any data for this and that", "this is what the science shows", and people out there are dying. A perfect demonstration of lack of leadership.

murgindrag 6y ago

It does provide protection, but what we don't know is: 1) For how long 2) How it impacts future vaccination efforts (As well as a slew of other things) If it was just #1, I'd be with you. If we give a big chunk of the population a vaccine which lasts 6 months and makes them unimmunizable, we've changed a serious problem into a serious, serious problem.

zaroth 6y ago
> ...and makes them unimmunizable... Is there any scientific basis for this hypothetical?
- murgindrag 6y ago
  Yes. It's pretty common for vaccines. One mechanism: If you have a vaccine designed to deliver a spike protein (without a virus) surrounded by a carrier. The body learns to destroy the carrier. On future doses, the body recognizes the carrier, and the vaccine is destroyed before the body can react. Of course, a vaccine with a different carrier won't be affected by this mechanisms, but there are many other mechanisms as well. I'm not an expert, and I don't know all of them. I'm not sure science knows all of them either, for that matter. There have even been instances of vaccines making diseases worse too (actually, viruses not too dissimilar to COVID19). And there are a bunch of other possibilities. I'd buy the basic premise of giving each person one dose for giving everyone imperfect immunity if not for these sorts of complications. I'd rather just wait a few more months than risk a small (but definitely non-zero) chance of something really, really bad.