Thread by @bopinion

Throughout the course of the pandemic, U.S. leaders have squandered:

⌛️Time
❓Trust
💰The economy

And they squandered the chance to do good science — testing vaccines in a way that serves the public interest rather than the interest of pharma companies bloomberg.com/opinion/articl…

There’s no question that Covid-19 vaccines and therapies will save many lives.

But we’re not doing the kinds of scientific studies needed to determine the best vaccines and therapies to maximize lives saved. It’s not too late to change course bloomberg.com/opinion/articl…

Some have raised the possibility that the return to normal could be advanced if Pfizer's vaccine is given as one shot.

Though trials determined efficacy for two shots, supplies are limited and there’s some evidence that one shot provides some protection bloomberg.com/opinion/articl…

A trial would be the only way to justify giving people a single shot.

The company could test the idea by picking a group of volunteers in the early rollout to get one shot, and compare them with those getting two bloomberg.com/opinion/articl…

Vaccines should also be tested against one another.

There’s valuable data that could be gathered quickly given that there are more than 40 vaccines in the testing stage bloomberg.com/opinion/articl…

Covid vaccines have many approaches:

💉Inactive virus
💉Pieces of the virus
💉Viral DNA
💉Messenger RNA

Some might be better at preventing high risk people from getting fatal cases, while others might be better for limiting the spread of the virus bloomberg.com/opinion/articl…

Some will be cheaper
Others will be easier to make
Some will induce fewer side effects
Others need extreme refrigeration
Some may be oral rather than an injection

The first vaccines with FDA authorization might not be the best ones for achieving immunity bloomberg.com/opinion/articl…

The way clinical trials usually work, companies design their own trials within some constraints established by regulators. But it doesn’t have to be that way.

With Covid-19, we should have a much more uniform standard for scientific testing bloomberg.com/opinion/articl…

A mandatory standard might have given us much-needed information on how well those newly approved Pfizer and Moderna vaccines protect against asymptomatic infection and thereby help us all achieve herd immunity bloomberg.com/opinion/articl…

Testing subjects regularly for Covid-19 would have told us this, but Pfizer and Moderna didn’t collect that data.

The AstraZeneca trial did collect data on asymptomatic cases, though the trial was marred by a serious mistake with dosing bloomberg.com/opinion/articl…

Contact tracing subjects might even help us learn if vaccinated people can transmit silent infections to others.

Those are not normal procedures, but this is not a normal situation bloomberg.com/opinion/articl…

The other looming mystery: How long does vaccine-induced immunity last?

The best way to learn about long-term safety is to keep the placebo-controlled trials going. But Pfizer is considering ending its trial by giving the control arm the vaccine bloomberg.com/opinion/articl…

Pfizer’s gesture may seem altruistic, but there’s a selfish side to it: It undercuts the ability to keep getting data and uncover less common safety issues.

The same applies to drugs that could treat Covid-19, which should have standard testing as well bloomberg.com/opinion/articl…

The public is grateful for any ray of hope — even though pharmaceutical companies are getting a great bargain out of this.

They deserve some praise, but not as much as the public deserves the best possible public health campaign bloomberg.com/opinion/articl…