One thing that struck me tonight is that the UK roll-out of vaccine is much more in line with public health and practicality than US rollout which is much more 'academic'. For those in academia, you know what I mean but we pay attention to every single detail of the trials-

In fact, an academic ID doctor worth their salt better know which HIV trial of the new injectable HIV medications allowed in a K103N mutation or not. However, when it comes to achieving herd immunity, we do not need 100% of the population to have 100% protection- we need as many

people as possible to get vaccinated as soon as possible with any of these vaccines, all of which encode for the entire spike protein and are very immunogenic. So, the UK authorized AZ/U of Oxford vaccine, Moderna, & Pfizer because the more you authorize the more supply you have.

UK putting 1st shots in as many as possible now with a plan for 2nd shots 12 wks later because later is okay (for instance, in childhood vaccinations, we don't want 2nd dose too soon but if child misses visit, fine to be late; AZ trial showed longer duration more immunogenic)

And if someone got a 1st shot and somehow wasn't recorded what kind, the 2nd shot can be another kind (I know, I know, not the trial design but no one cares at this point which HepB shot you get at 6 months if you forgot what you gave at 0 months). This is practical.

Practical will get us to herd immunity faster. So, would advise authorization of J&J vaccine ASAP as 1 shot is practical and having more companies provide vaccine will get more U.S. population immunized sooner; approve AZ/Oxford asap and that will make 4 vaccines. Academic

thinking and strict adherence to trial design may not be the most practical approach in a public health emergency when the tools are now available (vaccines) and time is of the essence.