Very detailed and helpful paper. Upshot:
- found a small (non-significant) *decrease* in full vax rates in Ohio post lottery
- found a small (non-significant) increase over all lottery states
Agree: "unlikely there are hugely positive or hugely negative effects"
As a non-expert, I like the preregistration & use of synthetic control. Some remaining questions
- is theirs the right counterfactual? (see thread)
- is the proper outcome to measure full vax, as they did, or 1 dose (I'd actually think 1 dose is the more lottery-relevant outcome)
Disappointingly, the quote tweets of the paper mostly seem to read "lol, vaccine lotteries didn't work"

People should read the whole thread & embrace the acknowledgement of substantial uncertainty that the authors recognize! (I know this runs contrary to twitter norms.)
My guess is we'll soon see many papers assessing vaccine lotteries, using different counterfactuals (which is good!).

Some will find + effects, some fail to reject a null hypothesis, some may even find - effects.

Similar to challenge of assessing if min wage affects employment
Also, as with the min. wage debate, the way people--especially lay popularizers--interpret evidence will probably end up being driven heavily by their prior hunches, and/or their normative beliefs about vaccine lotteries' acceptability or lack thereof
Something else that would be really interesting: comparing the vaccine lotteries that at first glance appear to work well vs. not work: Is the difference between states the design of the lottery? Demographics of the state population? Some other factor?

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More from @GovindPersad

22 Apr
"77% of white adults who want a shot have gotten one, compared with 60% of Black adults and 55% of Hispanics who want one."

Not everyone who WANTS a vaccine has been able to get one. "The survey suggests that vaccine access is at least as big of a problem as vaccine hesitancy."
"The racial gap persists across income levels, but is widest among people making less than $50,000 annually: 72 percent of white adults in that group who want a shot have gotten one, compared with 57 percent of Black adults and 47 percent of Hispanic adults in that income range."
"Otis Rolley...of The Rockefeller Fdn's U.S. equity and economic opportunity initiative, said the emphasis on vaccine hesitancy puts the burden on individual people rather than on institutions that should be providing information about the shots and making it easy for people."
Read 4 tweets
19 Apr
You may have heard @washingtonpost published an op-ed by @WF_Parker and I over the weekend

We argued ACIP was wrong to extend the pause on J&J vaccine in the middle of a pandemic

Thread for those who were enjoying a weekend off Twitter, incl. answers to some objections

1/12
COVID-19 remains a pandemic that causes serious, widespread, not fully understood harms

Universally stopping an efficacious COVID-19 vaccine should only be done after seriously weighing the harms of stopped access against side effects of the vaccine

ACIP didn’t do this

2/12
ACIP justified not rigorously weighing harms/benefits b/c other vaccines “are available”

“Availability” doesn’t mean equally easy access & uptake, equally quick protection, identical acceptance

Not every J&J vaccine appt became a Pfizer/Moderna one

3/12
Read 12 tweets
15 Apr
A lot of praise for #ACIP's transparency

But de facto pausing for 7-10 days got the *substance* wrong, as @ashishkjha et al. observe

Understanding the expertise of ACIP members (deep but too narrow) can help understand why these decisions need diverse experts, not just MDs

1/6
For vaccine allocation, CDC/NIH called on @NASEM_Health committee: nationalacademies.org/our-work/a-fra…

Not just MDs but:
- health econ (@healthecon_dan)
- behavioral health (@abuttenheim)
- literally wrote the book on "nonmaleficence" (Jim Childress)
- tribal health (@echohawkd3)
et al

2/6
In contrast, every #ACIP voting member (exc 1 community member) is a MD/DO/RN. Couple w/a MPH. But no health econ. No ethicists. No behavioral sci. No tribal health experts.

Great group for indiv patient care & virology expertise

Not for managing trade-offs in a pandemic

3/6
Read 9 tweets
13 Apr
I agree that a pause isn't permanent & the FDA should track safety concerns

But forced "pausing" (AKA cancelling people's J&J appointments) isn't the right move

People should be given the info & allowed to choose

Deaths from Covid b/c you weren't vaccinated are permanent

1/3
This feels like Germany's mistakes on AZ's vaccine

I thought the "precautionary principle" popular there might be why nytimes.com/2021/03/19/wor…

But it seems telling people stuck on the trolley tracks they can't use a ladder to get out isn't confined to that side of the pond

2/3
Imagine if we'd had a J&J vaccine that was 10% less *effective* than our current one, but didn't potentially have any rare side effects

That vaccine would lead to more deaths than the one we have

Yet I'd guess FDA would have no problem letting people choose to use it

3/3
Read 4 tweets
10 Apr
This mechanistically backs up the evidence of vaccine benefits 10 days after *first* dose from the original Pfizer trial

Underscores the extremely strong precautionary and benefit maximizing case for surging vaccines to Michigan
We have the luxury of two very good options

We have enough supply that we could send MI more vaccines. Only Jeff Zients’ bizarre burden-insensitive conception of “fairness” prevents this

Or we could let MI extend dosing intervals by 2 weeks to get first doses to more people
But apparently sticking w/an ethically ungrounded Trump Admin holdover policy of giving vaccines only proportional to population (which many states aren’t doing intra-state), & an arbitrarily selected dosing interval, is more important than letting people in MI protect themselves
Read 4 tweets
20 Dec 20
For those following #ACIP vaccine prioritization debate - proposal to have 75+ alongside frontline workers in phase 1B is interesting, and different from prior discussion. But there are still pitfalls with any age cutoff, whether 75 or 65, as I explained in a comment to ACIP /1
Down Syndrome deaths are disparately high and happen before 75. 54%, 61%, and 69% of Black, Hispanic, and AI/AN deaths (respectively) happen before 75. I haven't seen US data on income x age at death, but a similar gradient is plausible, and may help explain the race data. /2
So I continue to think #ACIP should encourage states & localities to look at overlapping risk factors like housing+age as LTCF priority did and @CDCDirector suggested, rather than using age cutoffs that sweep in ppl at very different risk & exclude some /3
Read 6 tweets

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