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Single-Shot and First Doses First

by  Alex Tabarrok February 27, 2021 at 7:23 am in

  * Current Affairs
  * Medicine

The FDA panel voted unanimously to authorize the J&J vaccine. Good.
Note, however, that the single-shot J&J vaccine is quite comparable
to the first dose of the Pfizer and Moderna vaccines. Yet, few people
are demanding that J&J be required to offer a second shot at all, let
alone in 3-4 weeks (What about vaccine escape! How long does immunity
with a single-shot last! What about the children!). It really is
scandalous how these objections to a single-shot have disappeared.
This is evidence of what I call magical thinking-an undue focus on
the clinical trial design as having incantatory power.

Why did J&J focus on a single-shot? Was this because of "the
science", i.e. something unique about their vaccine? No. J&J focused
on a single-shot vaccine for the same pragmatic reasons that I favor
First Doses First.

    J&J representatives said they chose to begin with the single shot
    because the World Health Organization and other experts agreed it
    would be a faster, more effective tool in an emergency. (emphasis
    added).

My view is that it would be good if the J&J vaccine was followed by a
booster-perhaps of some other vaccine-but that it's individually fine
and in fact socially beneficial to get more people protected quickly
by delaying the booster for at least 12 weeks to when vaccines are
less scarce. I don't currently see a reason for thinking differently
about the Pfizer and Moderna vaccines.

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