[monkeypizza]

from an earlier post in the series:

Michael Osterholm, Regents Professor, McKnight Presidential Endowed Chair in Public Health, the director of the Center for Infectious Disease Research and Policy (CIDRAP) and state epidemiologist for the Minnesota Department of Health:

    …Imagine you are setting across the table from two people both of whom are 65 or older, both with underlying health conditions. You have two doses of vaccine, one in each hand. And you say to them I can give two doses to you or to you but then the other person gets nothing. Or I can give one dose to both of you. And this is what I know. At the very least, one dose is likely to prevent serious illness, hospitalization and death. Two doses will probably even prevent clinical disease with B.1.1.7. But the other one of you; if you get infected with this virus, which I think substantial numbers of Americans will, things are not looking good for you. What do you want me to do?

    If that is your Mom or Dad. Your Grandpa or Grandma. What would you do?

    This is where the rubber meets the road. I think if the data bears it out we can save so many lives in the upcoming weeks and we are missing that opportunity.

    I have already made my choice. I am postponing my second dose. I want my second dose. But I am confident that I can wait. And I can only hope that my second dose, which I have just deferred, will go to someone who it will save their life. It will make a totally different world for that family.

    You know some could argue that this could be the end of my career. But I could not sleep with myself at night if I didn’t do this. I just know in my heart of hearts that this is something we must do if we are going to save lives.

https://marginalrevolution.com/marginalrevolution/2021/02/os...

[DanBC]

(I upvoted you, and I'm not sure why you're getting downvotes).

> > Or I can give one dose to both of you. And this is what I know. At the very least, one dose is likely to prevent serious illness, hospitalization and death.

We don't know this from testing. We know it from real world data -- we've given a bunch of people their first dose and then we measured what happened.

Imagine you tell people "we're going to give you two doses of this vaccine. You'll have the first dose today, and then you'll have your second dose in X weeks. We know this is safe and effective from the clinical trials. Do you want to go ahead?"

And then, after you've given them the dose, you say "well, actually, looks like vaccine production is pretty slow, and we really need to vaccinate as many people as possible, so we're going to delay giving you your second dose".

There's a strong argument for doing that, but it's not obviously the right thing to do. Informed consent is an important part of healthcare everywhere. And vaccinations are so important that anything that interferes with trust needs to be really carefully examined.

[monkeypizza]

Good point. I'd imagine we could leave it voluntary, and just start the "delayed 2nd dose" policy later.

[JohnicBoom]

Just so you don't have the wrong idea, Osterholm's suggestion is that everyone who has already been given the first dose already should get the second dose as planned. Only for new vaccinations should we apply the new plan.

[melling]

... or you could give both doses to the other person because I can wait 3-4 months.

In the US there are

- 25 million Americans over 75

- 50 million 65 and older, including the 75 year olds

We have given out 70 million doses.

I think we’re around 40 million jabs a month, hopefully that increases to 60 million soon

There’s no need to experiment.

However, if we find >3-4 weeks between jabs is fine, let’s do it.

[monkeypizza]

The comparison was between

    giving 2 doses to one person over 65, and nothing to another other person over 65
    giving one dose each to two 65+ people

We have evidence that total harm prevention under the second case is higher than the first case, and it also makes perfect logical sense, and there are public health officials confirming this.

On the other hand we have tradition, custom, specific tests.

Say vaccines were tested based on administration in a blue room, but weren't tested in a room painted red. Why are you able to assert without tests that the room color is irrelevant, but are asking for proof that giving two people 85% resistance is better than one person with 95%, when all the evidence supports it? What is leading to wanting to strictly adhere to the exact tested procedure? How do you square your disagreement with the public health officials actively investigating this issue in the linked posts?

[monkeypizza]

> There’s no need to experiment.

People who haven't caught coronavirus yet are still likely to catch it and be at risk. That is, new people are still being infected and are likely to be for a few more months yet.

What calculation are you running to say that changes to policy which might increase first-dose protection are not worth making to protect them?

[wang_li]

We did 50 million in the last thirty days.

[monkeypizza]

Canada came out with support for first doses first: https://www.canada.ca/en/public-health/services/immunization...