Covid-19: Oxford-AstraZeneca coronavirus vaccine approved for use in UK
bbc.com
bbc.com
You have an expensive two dose vaccine which has very high confidence but demands explicit temperature protocols be matched, and limited supply.
You have a cheap two dose vaccine with some evidence of at least 50% and probably better coverage, which can be mass produced quickly and issued to any doctor or pharmacy for use, with no stringent temperature protocol.
There is evidence of increased virulence in the infection.
The hospital system is at its breaking point operating over 100% capacity with severe staffing issues.
What do you do?
Chasing perfection when it turns out statistically giving more people a lower confidence single dose now can save more lives...
This is what operations research is all about.
I mean, there is zero drawback from administering a vaccine. There is no need to pick between vaccines. Vaccine cost is also not a constraint.
Thus the optimal solution is, unequivocally, administer as many vaccines as possible, regardless of their effectiveness.
The only thing that qualifies as a operations research problem is how to distribute a limited output of vaccines across a population in order to minimize the epidemic's spread and fatalities.
Thats exactly what I am talking about.
There are at least two choices: give to higher risk elderly people in care homes and care workers first, or give to frontline health staff first, and a pair of parallel choices of give one dose to as many as possible or give two full doses to the people who get the first dose, alongside which of the three currently qualified vaccines to give.
This is precisely what I think is the O/R decision. What to do, with limited vaccine and multiple choices of how, and who to give it to.
People are already arguing about what maximises benefit.
Blair publicised a logical choice to give the maximum number of people one dose now, and give the second dose when more arrives. This invites the question if 80-90% coverage of fewer people is better or worse than 70% coverage of more people. He didn't think of it btw, he just publicised it. If this is called "the Blair choice" it will be a crying shame.
There will be around 6 distinct vaccines soon. What if different vaccines give better response, than giving the same twice as a booster? (this is a possibility)
People are trying to maximise benefit to the individuals, and to the economy. So its two-outcome maximising with at least 4 and very probably more like 8 or 10 distinct choices of outcome.
>> There are three figures doing the rounds - 62%, 70% and 90%. The first analysis of the trial data showed 70% of people were protected from developing Covid-19 and nobody developed severe disease or needed hospital treatment.
>> The figure was just 62% when people were given two full doses of the jab and 90% when they were first given a half dose and then a full one.
>> The Medicines and Healthcare products Regulatory Agency (MHRA) has approved two full doses of the Oxford-AstraZeneca vaccine.
>> However, unpublished data suggests that leaving a longer gap between the first and second doses increases the overall effectiveness of the jab.
This description of the results doesn’t inspire confidence.
The biggest advantage that this vaccine seems to bring to the table is logistics. The mRNA vaccines produced so far require extremely cold storage temperatures which makes logistics harder and slows down actual administration as each shot has to be heated up, administered, wait for allergic reactions, and then re-frozen again.
The idea that they would be thawing and freezing the vaccines for every shot doesn't seem plausible.
As far as I can tell, cold storage is only needed for long term storage of the mRNA vaccines. They'll both last for days at normal refridgeration temperatures, and the Moderna one is fine at room temperature for 12 hours.