(If we continue at the incredibly slow pace of vaccinations we're going, though, I wouldn't be surprised if experts start recommending people who have had Covid get lower priority. An expert recently shared that, at this rate, it will take ten years to get to herd immunity in the US. [1])
1. https://twitter.com/DrLeanaWen/status/1343920976854196225
I suspect many more doses have been given but not reported (B), and a lot more of the shortfall can be explained by A & C.
If that's true, we're going to be production limited very soon... though the decision to hold back more than half of the doses doesn't help.
Reaching phase 1B will help, too, because it will mean the opening of mass vaccination clinics, which can run in parallel to the remaining portion of 1A which is more targeted and logistically complicated. E.g. Santa Clara County Fairgrounds are set up for high throughput drive-through COVID testing and plans are to use the same infrastructure that can host massive numbers of cars and lanes to have massive numbers vaccinated and waiting out their 20 minute observation time. This site will be able to do thousands of doses per day-- >0.3% of the County's population per day-- alone, which exceeds the number of doses we can be expected to be allocated for quite some time.
Johnson and Johnson is the best hope for another near-term EUA, which could significantly improve vaccine supply in February.
The Oxford vaccine can be stored in a regular refrigerator, which drastically reduces infrastructure cost and makes it speedier to administer, since it doesn’t need to be carefully warmed to room temperature from subzero.
Oh, and it’s cheaper. That matters.
There's no guarantee things would be going any faster, but if anyone can walk into a pharmacy and get a shot it seems like it would speed up a bit.
But how is astrazeneca's methodology reasonable?
https://www.astrazeneca.com/media-centre/press-releases/2020...
>Over 23,000 participants are being assessed following two doses of either a half-dose/full-dose regimen or a regimen of two full doses of AZD1222 or a comparator, meningococcal conjugate vaccine called MenACWY.
The placebo in the study was a meningitis vaccine that actually caused issues that halted the study and because astrazeneca's vaccine was deemed more effective than that, the vaccine was deemed a success.
In what way is that anywhere near a reasonable clinical study?
They will have to do a proper job, if they haven't already. With the other two vaccines already approved, national health boards will be in no rush to fast track it.
It was not considered a failure. There have been some questions about what the best dosage and timing might be for the highest effectiveness, but I've heard the UK may approve it as early as tomorrow.
The USA may wait until the trial being run inside the USA is completed, but that has more to do with ensuring the vaccine is safe and works on their wide demographics than any concerns with how the UK and Brazil studies were done.
The vaccines have lots of side effects. If you give something with lots of side effects and compare it to a placebo with none, people have a good guess of what group they're in and behave differently. This is often considered more reasonable than comparing to a saline injection, and it's a reason why lots of drugs now are compared to e.g. ritalin-- something relatively benign with some side effect that feels like it is "doing something".
The half-dose/full-dose regimen was a mistake in a clinic administering the trial, though. A mistake that happened to look more effective than the overall vaccine population, which is a bit troublesome and a primary reason why AstraZeneca has problems now.
Now that we have effective COVID vaccines, we can run noninferiority trials-- e.g. comparing Moderna's vaccine to a potential new vaccine-- which get around a lot of the problems here.
More on that here: https://news.ycombinator.com/item?id=25548342
Oh, and it's not like the meningitis vaccine will confer any protection from covid.