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1. I’m not persuaded by this. Some reasons are specific to this case others apply more generally to arguments of the form—if we deviate from practices that are supported by the best evidence we can save even more lives. https://twitter.com/bob_wachter/status/1344667655324585986
2. Right now we are struggling to get vaccine into people’s arms. If we adopt a policy of 1 shot only, we could easily be in a situation in which more vaccine sits unused rather than in a situation in which x doses go into 2x arms.
3. Part of the bottleneck is overcoming the logistics of delivery. If a person has had their first shot, the the probability that we can get them a second and that they will take it is high. We might not be able to get that second dose to someone else who is willing to take it
4. We are already finding alarming rates of refusal even among health care workers. Some of the reported worries surround safety and efficacy in a highly politicized context dominated by terms like “Operation Warp Speed.”
5. Moving to a single dose increases uncertainty about a variety of issues and I think it is foolish to presume that whether a person takes the vaccine is independent of their perception of whether uncertainty is being handled responsibility.
6. Successful programs are contingent on buy-in and support. We are in the midst of a colossal failure of leadership, collective action, and public trust. Altering public health policy without compelling evidence of superiority can itself undermine that support and trust.
