Thread by @ProfLWiley

It’s not (just) fairness. Goal = reduce cases/hospitalizations/deaths as much as possible w/ scarce doses. Haphazard delivery to any readily available arm rather than doing the work to get it right -> running out b4 we reach those whose vax will most improve the situation for all

https://twitter.com/farzad_md/status/1344352826844192768

If we have (or expect very soon to have) enough doses for all, then by all means, take a shotgun approach (while tracking who gets what so appropriate follow up/2nd dose can be ensured) but we don’t have enough doses to do that yet.

If doses have been thawed & need to go somewhere ASAP, better to get them in any available arm than toss them. But even better to plan to avoid that scenario if possible.

Within any particular hospital system (eg Stanford) expecting enough doses to vax all staff within a matter of days, getting day-1 doses to people behind the scenes ahead of front-line workers could be tragic at individual level, but won’t have a big population-level impact.

But if we’re talking about the state level (eg Florida), pushing doses out to relatively healthy 65 yos who have time/resources to wait in line, instead of doing the work to deliver them to folks in higher risk groups will prolong death & overwhelmed hospitals, bad for everyone.