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Instead of debating 'first-shot' vs 'set-aside' vaccine approaches, hospitals' study should compare them

Hospitals could start studies of their own employees to answer important questions, including whether the first-shot approach has downsides when compared to the set-aside strategy.
Originally published on 01/04/2021 in STAT News

Two Covid-19 vaccines that have two-shot regimens will likely be in short supply for many months, and some experts have proposed using available vaccine doses under a "first-shot" strategy: give as many people as possible their first dose of the vaccine then deliver the second when supplies catch up.

The approach would differ from the current "set-aside" approach the U.S. uses now, where one dose of booster is reserved in parallel with each first shot delivered. Dr. Peter Bach proposes that we get more data - academic nonprofit hospitals in the U.S. can immediately start a study of their own employees. The data would clarify whether the seemingly intuitive first-shot approach has downsides when compared to the set-aside strategy by answering how long immunity form the first shot lasts, and how well the booster works when delayed. The primary endpoint would be differential rates of clinical Covid-19 beginning a week after the second shot is administered, and secondary endpoints would include rates of asymptomatic carriers. 

Read the full op-ed here.

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