Thread by @JeromeAdamsMD

Good protection for many (w/ 1 shot) is better than great protection for a few. 2000 people a day are dying because they can’t get a 1st #covid19 shot- not because they can’t get a 2nd...

One dose or two? Fauci says U.S. must stick with two-shot plan. washingtonpost.com/health/2021/03…

Pivots on mask wearing and on school closures show advice can be well intended, and scientifically grounded, yet still need to be changed based on the reality on the ground. The risk for most of no protection at all >> than the risk of breakthrough variants at this point.

And as @Atul_Gawande has pointed out, simply affording states the okay to be somewhat flexible could unleash millions of doses sitting on shelves (out of fear of not having the golden 2nd dose for people, and getting in trouble). Push out all doses NOW, and lean into production!

Delaying a 2nd dose doesn’t have to be a foregone conclusion- it just has to on option, to unleash maximal 1st dose administration. If 2nd dose is delayed a bit, emerging data suggests the harm is minimal compared to the harm of someone else having no protection whatsoever.

And one more critical point about equity: Given that minority populations are already WAY behind in vaccinations, holding 2nd doses (for disproportionately non minority populations who got 1 dose already) vs ⬆️ available 1st doses for minority communities is ⬆️ disparities! 🤯

And my apologies for the mistake and for messing up the thread- but it was Dr Jha who most recently pointed out the harm of stockpiling due to “fear of missing 2nd dose” (though Dr Gawande has weighed in on this too):

https://twitter.com/ashishkjha/status/1366236095340511233?s=21

https://twitter.com/ashishkjha/status/1366236095340511233