What to Know About Delayed Vaccine Doses and the Potential for Mutation

I'm opposed to delaying doses in the absence of data, but it should be noted this theory of escape mutants has become controversial. In the area of antibiotic treatment it's a fairly standard idea but has been increasingly questioned, and it's not clear it applies to vaccines as readily anyway (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378080/).

The idea of making this pandemic last longer in order to prevent a future pandemic seems to fail any reasonable cost benefit analysis. That's because it is not based on any such analysis, it's based on people myopically looking at RCT for answers and ignoring all other forms of reasoning.

To those that suggest we don't have data on the regime are wildly incorrect. (1) we have data from the 2 dose trials in Pfizer and Moderna (2) we have data from Astrazeneca showing improved efficacy with a delay (3) we have priors based on other vaccines, where a delayed second dose almost always confers more immunity. (4) our models of the human immune response suggest delayed vaccination helps more.

So there is every reason to believe, and all data suggests, that delaying the second dose is better. We also have the ability to change our mind if it looks like it doesn't work.

If the proposed standard for any medical treatment was to ban any use that has not had a randomized control trial, then we should issue fines for people who don't complete antibiotic regimes, people who don't show up to their follow up appointments, and disallow off label use.

I see the developments so far in two stages:

1. The vaccine development and trials more or less happened in a science-backed way (not saying this was perfect but it was say 90% right way to do) 2. The actual deployment : this is worrying because the scientists who have developed the Pfizer/BioNTech vaccine and the Moderna one haven't tested delayed doses and are rightfully raising the alarms. The Oxford-AZ one is tricky because they have only tested the two full dose regimen with the right sample sizes and that's the one approved. From memory, there was some noise about delayed doses being approved but this is really shaky ground. Respected journals like BMJ [0] are questioning the lack of data around this.

tl;dr : Delaying doses not tested as per protocols and seems to be optimising for reach disregarding the fact that it wasn't tested and should rightfully worry most of us :(

[0]https://www.bmj.com/content/372/bmj.n18

Why does medium have an official coronavirus blog which they use to badmouth right wing governments?