Trial designs are rarely perfect, and drug companies will try to stack the deck. That being said, trial designs aren't made in isolation without consultation.

Trial designs are rarely perfect, and drug companies will try to stack the deck. That being said, trial designs aren't made in isolation without consultation. Moderna's press release about this (https://feeds.issuerdirect.com/news-release.html?newsid=7346090610333866&symbol=MRNA https://feeds.issuerdirect.com/news-release.html?newsid=7346...) indicates that 2024 CDC said that performing an efficacy trial without using the higher dose would likely cause complications for recommending the mRNA vaccine for the >65 age group, but would not impact overall approval.