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The UKs adoption of First Dose First is amazing and inspiring in a time when governments worldwide seem unable to operate effectively. There are 2 things every

The UKs adoption of First Dose First is amazing and inspiring in a time when governments worldwide seem unable to operate effectively. There are 2 things every country can do to save lives that have effectively zero cost and zero negative externalities: - lifting lingering vaccine bans (the US's ban of AZ is most glaring) - first dose first - the evidence is overwhelming at this point. These two things, which could be done almost certainly by Biden alone (in the US), would allow possibly everyone who wants a vaccine to get one by the end of March, instead of July with the current projections. And this decision is effectively zero risk.

bpodgursky 6y ago
The other almost-certain win would be half-doses of the mRNA vaccines (ie, double supply) given the antibody responses we saw with lower doses, but that's probably asking for too much...
prox 6y ago
What is first dose first?
- jedberg 6y ago
  The UK's policy of making sure everyone gets their first dose of the two dose vaccines before most everyone gets their second, setting the second dose at 3 months instead of 3-4 weeks.
  - ytwySXpMbS 6y ago
    This isn’t quite right. The UK has delayed second doses to 3 months after the first dose to enable more people to get their first dose quicker. The plan is all adults vaccinated by September, and they certainly aren’t delaying second doses until then.
    - timthorn 6y ago
      That's been brought in - all adults are now expected to be offered their first dose by 21 July.
- dan-robertson 6y ago
  See, for example, https://marginalrevolution.com/marginalrevolution/2020/12/first-doses-first.html https://marginalrevolution.com/marginalrevolution/2020/12/fi...
djrogers 6y ago
While those 2 things would help, I haven't seen any projections that could possibly put supply or distribution availability at ~400M doses in the next 5 weeks.
- alistairSH 6y ago
  We'd need about 278 million doses (in the US). We're approaching 15% vaccinated, out of a population of 328 million.
  - sib 6y ago
    Probably fewer, since much of the population (at least those under 16) isn't eligible.
jedberg 6y ago
> the US's ban of AZ is most glaring People said the same thing about the US's ban on thalidomide until it turned out they were right. In this case I'm ok with a little conservatism on the part of the FDA. The US is already in 4th place on vaccinations per capita, just barely behind the UK, without either of those policies. Copying from my comment below, a bunch of other examples of times when the FDA was right and European regulators were wrong: https://en.wikipedia.org/wiki/Lumiracoxib https://en.wikipedia.org/wiki/Lumiracoxib -- Approved in Europe, not the USA. Withdrawn from sales due to side effects. https://en.wikipedia.org/wiki/Zimelidine https://en.wikipedia.org/wiki/Zimelidine -- Same. https://en.wikipedia.org/wiki/Tolrestat https://en.wikipedia.org/wiki/Tolrestat -- Approved in Europe, failed stage 3 clinical in the USA https://en.wikipedia.org/wiki/Rimonabant https://en.wikipedia.org/wiki/Rimonabant -- Approved in Europe, failed in the USA, withdrawn worldwide because the side effects were so bad. Thalidomide is just the most famous because it was the most disastrous, but there are plenty of others. The FDA has a strong many decades track record.
- nickpp 6y ago
  It's been over 50 years since the thalidomide tragedy. Do you still let plane crashes of last century direct your choice of transportation?
  - jedberg 6y ago
    The point is the USA was right when everyone else was wrong and didn't bow to public pressure, and so I trust them a bit more when they are conservative with approvals.
    - nickpp 6y ago
      Yes it was right in that case, but blindly letting a single tragedy direct policy without taking into consideration current factors is extremely dangerous. People are dying of COVID right now. If fear of another thalidomide incident delays a saving vaccine we may end up losing more lives than potentially saving.
matwood 6y ago
Or even a hybrid. Age 65+ stays on the 2 dose schedule 3 weeks apart, and under 65 follows FDF.
dragonwriter 6y ago
> lifting lingering vaccine bans (the US's ban of AZ is most glaring) AstraZeneca vaccine was seeing rejections for a variety of reasons even before the South Africa variant which it doesn't work well against began spreading, and that variant is now in a lot of the US. If that's what you are referring to, whether or not there is a special “ban" on it in the US, I don’t see it as something that makes a lot of sense to add to the mix in the US now.

bpodgursky 6y ago

The other almost-certain win would be half-doses of the mRNA vaccines (ie, double supply) given the antibody responses we saw with lower doses, but that's probably asking for too much...

prox 6y ago

What is first dose first?

jedberg 6y ago
The UK's policy of making sure everyone gets their first dose of the two dose vaccines before most everyone gets their second, setting the second dose at 3 months instead of 3-4 weeks.
- ytwySXpMbS 6y ago
  This isn’t quite right. The UK has delayed second doses to 3 months after the first dose to enable more people to get their first dose quicker. The plan is all adults vaccinated by September, and they certainly aren’t delaying second doses until then.
  - timthorn 6y ago
    That's been brought in - all adults are now expected to be offered their first dose by 21 July.
dan-robertson 6y ago
See, for example, https://marginalrevolution.com/marginalrevolution/2020/12/first-doses-first.html https://marginalrevolution.com/marginalrevolution/2020/12/fi...

djrogers 6y ago

While those 2 things would help, I haven't seen any projections that could possibly put supply or distribution availability at ~400M doses in the next 5 weeks.

alistairSH 6y ago
We'd need about 278 million doses (in the US). We're approaching 15% vaccinated, out of a population of 328 million.
- sib 6y ago
  Probably fewer, since much of the population (at least those under 16) isn't eligible.

jedberg 6y ago

> the US's ban of AZ is most glaring People said the same thing about the US's ban on thalidomide until it turned out they were right. In this case I'm ok with a little conservatism on the part of the FDA. The US is already in 4th place on vaccinations per capita, just barely behind the UK, without either of those policies. Copying from my comment below, a bunch of other examples of times when the FDA was right and European regulators were wrong: https://en.wikipedia.org/wiki/Lumiracoxib https://en.wikipedia.org/wiki/Lumiracoxib -- Approved in Europe, not the USA. Withdrawn from sales due to side effects. https://en.wikipedia.org/wiki/Zimelidine https://en.wikipedia.org/wiki/Zimelidine -- Same. https://en.wikipedia.org/wiki/Tolrestat https://en.wikipedia.org/wiki/Tolrestat -- Approved in Europe, failed stage 3 clinical in the USA https://en.wikipedia.org/wiki/Rimonabant https://en.wikipedia.org/wiki/Rimonabant -- Approved in Europe, failed in the USA, withdrawn worldwide because the side effects were so bad. Thalidomide is just the most famous because it was the most disastrous, but there are plenty of others. The FDA has a strong many decades track record.

nickpp 6y ago
It's been over 50 years since the thalidomide tragedy. Do you still let plane crashes of last century direct your choice of transportation?
- jedberg 6y ago
  The point is the USA was right when everyone else was wrong and didn't bow to public pressure, and so I trust them a bit more when they are conservative with approvals.
  - nickpp 6y ago
    Yes it was right in that case, but blindly letting a single tragedy direct policy without taking into consideration current factors is extremely dangerous. People are dying of COVID right now. If fear of another thalidomide incident delays a saving vaccine we may end up losing more lives than potentially saving.

matwood 6y ago

Or even a hybrid. Age 65+ stays on the 2 dose schedule 3 weeks apart, and under 65 follows FDF.

dragonwriter 6y ago

> lifting lingering vaccine bans (the US's ban of AZ is most glaring) AstraZeneca vaccine was seeing rejections for a variety of reasons even before the South Africa variant which it doesn't work well against began spreading, and that variant is now in a lot of the US. If that's what you are referring to, whether or not there is a special “ban" on it in the US, I don’t see it as something that makes a lot of sense to add to the mix in the US now.