“A Better Way to End the Pandemic Quickly” (MedPage Today):
The current plan is to give two doses, 21 days apart for the Pfizer product and 30 days apart for Moderna’s. Alternatively, all available doses could be given immediately, doubling the number of people who could be reached. Both Pfizer and Moderna report that the efficacy of a single dose is only about 50%. But a closer look at their incidence curves suggests that immunity appears to be maximized about 14 days after the first dose. In the Moderna trial, for example, most of the cases in the vaccine arm occurred during the first 2 weeks following the initial dose. We recognize that the vaccine was developed and tested on the assumption that two doses are necessary. Yet, the trial data suggest that a single dose provides substantial immunity. During this severe pandemic, it seems reasonable to use the available supply to reach as many people as possible in the short term. Delaying the second dose would maximize limited resources and could reduce serious illness and death. A recent projection suggests the U.S. will receive 40 million doses of the two mRNA vaccines by early 2021. A rough calculation suggests that vaccinating 40 million persons with these 40 million doses versus 20 million persons with two doses each could prevent over 100,000 severe cases and save over 10,000 lives.
Despite that fact that the Moderna vaccine was developed nearly a year ago (see “We Had the Vaccine the Whole Time”), testing has been so slow that we can suspect, but don’t know for sure, that one dose is sufficient!
If the MedPage Today authors (Michael H. Criqui, MD, MPH, and Robert M. Kaplan, PhD; maybe they are colleagues of Dr. Jill Biden, MD?) are correct, we are going to be wasting half of our vaccine supply by giving two doses when one is sufficient.
How might we waste half of the remaining half? By giving the vaccine to people who are already immune as a result of previous infection (nearly one third of the U.S. population had been infected as of November (NPR/CDC), which means it will be closer to 165 million by the time the vaccine is available to the average person).
[In the Department of Prescience: “Up to 150 million Americans are expected to contract the coronavirus, congressional doctor says” (March 11, 2020).]
Interesting idea but that would drastically shorten market time for the merchants of doomsaying.
Also worth noting that the second shot has a much higher incidence of adverse reactions. Do we know why? Is the full dose second shot even a good idea?
It looks like we might waste tens of millions of doses anyway, as vaccine distribution has been slow and reluctance has been rising due to press around the reactions.
https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/
P.S.
OT, but imagine my disappointment when I saw this headline, only to realize they are talking about the epic and not the minivan.
“A Massachusetts school has banned ‘The Odyssey.’”
https://www.wsj.com/articles/even-homer-gets-mobbed-11609095872
@Steve: From what I’ve been able to ascertain (which isn’t much!) “we” do not understand what is causing the adverse reactions, including the more severe, anaphylactoid reactions, in the first place. And we do not know why people are having more severe reactions with the second dose, which may be a completely different phenomenon. Some observers think the anaphylactoid reactions are down to the PEG (polyethylene glycol) nanoparticle capsule surrounding the mRNA, but nobody will commit to saying that definitively, because the studies haven’t been done and they don’t want to lose their jobs.
“NIAID is also setting up a study in collaboration with FDA to analyze the response to the vaccine in people who have high levels of anti-PEG antibodies or have experienced severe allergic responses to drugs or vaccines before. “Until we know there is truly a PEG story, we need to be very careful in talking about that as a done deal,” says Alkis Togias, branch chief of allergy, asthma, and airway biology at NIAID.”
https://www.sciencemag.org/news/2020/12/suspicions-grow-nanoparticles-pfizer-s-covid-19-vaccine-trigger-rare-allergic-reactions
Polyethylene glycol has never before been used as a vaccine adjuvant, although it is found (in various formulations) in laxatives, shampoo, cosmetics (none of which are regularly injected) and even as a component of the solid rocket fuel in a Trident II ICBM, where it is used as a binding agent for the HMX high explosive!
“PEG has also been used as a propellent on the UGM-133M Trident II Missile, in service with the United States Air Force.[19]”
https://en.wikipedia.org/wiki/Polyethylene_glycol
Now I’m really angry. This is disgusting.
“In Massachusetts, the Moderna vaccine design took all of one weekend. It was completed before China had even acknowledged that the disease could be transmitted from human to human, more than a week before the first confirmed coronavirus case in the United States…By the time the first American death was announced a month later, the vaccine had already been manufactured and shipped to the National Institutes of Health for the beginning of its Phase I clinical trial..”
I suspected we had the vaccine formulated by February but wasn’t sure until I read this post. I knew in March that we had the sequence and we knew the structure of the spike protein but I didn’t make the leap to think we had already made the vaccine. Why wasn’t Fauci (or anyone else) talking about that this entire time?
I’ll bet if you polled 1000 people randomly, right now, and asked them: “When was the vaccine for COVID-19 developed?”
A) January, 2020 B) May, 2020 C) August, 2020 D) November, 2020 E) None of the above
The vast majority of people would answer “C” or “D”.
Why wasn’t this the top-line message at every press conference in February, March, April, etc.?
“We had the vaccine formulated in January and shipped to the NIH for testing in February, and there are more on the way.”
Another way to read that article from the Intelligencer is:
“The Trump Administration did everything right in terms of the vaccine. We had it manufactured and in testing by February of 2020. Operation Warp Speed streamlined and expedited the trial process to an unprecedented degree. And all of us in the Elite Media knew that, but that didn’t stop us from calling Orange Man a murderous imbecile.”
And frankly, I’m astounded that Trump wasn’t talking about these facts in March, April, May, and all the rest of the intervening months. How on Earth does that happen?
The election was a sham! We were way ahead of everyone, and then we sped things up even more, and yet, Trump still got all the blame for this. Heads should roll.
Should be plenty of vaccine, no one seems to want it. Y’all can fight over my dose, I’m good with sunshine and not being fat.
https://www.zerohedge.com/medical/major-covid-vaccine-glitch-emerges-most-europeans-including-hospital-staff-refuse-take-it
A former Harvard medical school prof reports however that:
https://www.forbes.com/sites/williamhaseltine/2020/12/22/the-moderna-vaccines-antibodies-may-not-last-as-long-as-we-hoped/
” The Moderna Vaccine’s Antibodies May Not Last As Long As We Hoped”
Again there is a Science magazine blog discussing “Antibody Dependent Enhancement”:
https://blogs.sciencemag.org/pipeline/archives/2020/12/18/antibody-dependent-enhancement
with the interesting issue being the comments which point out the author missed the broader issue of “vaccine enhanced disease” the FDA notes is an “important risk” after the initial immunity wanes: i.e. those vaccinated may get a more severe case of covid-19 after that than they otherwise would have (as in the case of children of a certain age after the dengue vaccine faded and they had an 8 times higher risk of hospitalization).
Hopefully this won’t happen: but some journal articles suggest its a concern for vaccines that only target the spike protein (as the initial ones do). It seems like people are engaged in wishful thinking since the data simply is not there yet to know one way or another since the trials haven’t gone on long enough.
Again: severe covid-19 isn’t caused by a lack of immune response: its caused by a dysfunctional response. A vaccine primes an immune response: but what are the odds its dysfunctional? The initial level of antibodies may be a great response: but once that fades, the remaining immune response may be dysfunctional: they simply don’t know yet, and there is reason for concern.