usually agree with both @StevenSalzberg1 and @nataliexdean. In this case agree with the cautious view. Even if safety were known (which I don’t think it is for this) RCT r really important for efficacy. Alternatives, which both @nataliexdean & I work on, are full of pitfalls.
The article by @StevenSalzberg1 just gets some things wrong. Published test of eg the Oxford vaccine had 126 and 253 vaccinated, enough to detect adverse events if occur in 2.3% and 1.4% respectively.
If we followed Steven's plan (widespread distribution before Phase 3 complete) we could have 230K adverse events from vaccinating 10 million-- this is why vaccines need (and always get) much more testing before rollout.
It is tempting to hope a vaccine that makes an immune response should be harmless - but that view has been proven wrong during trials. RSV, Staph aureus vaccine trials stopped when shown to make things worth, maybe HIV and probably dengue vaccines did so in a subgroup
We briefly review the case here in the section "Needed: Randomized trials." We should have been clearer: Needed: Randomized trials before rollout science.sciencemag.org/content/357/63…
This is not a new topic. @AlexJohnLondon for example onlinelibrary.wiley.com/doi/abs/10.111…
