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Slack / Private Message Drop, p.375 [SLACK_000589] · slack_pm:msg:03904

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Oh my - that's concerning if this is what emerges out of close to "herd immunity."

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2021-01-10 11:17 Andrew Rambaut open

Yes. Confidentially this has come from Manaus - i.e., super high seroprevalence.
2021-01-10 11:27 Robert F. Garry

Oh my - that's concerning if this is what emerges out of close to "herd immunity."
2021-01-10 11:32 Andrew Rambaut open

That is the main point - close to herd immunity is the worst for selecting for escape. Why vaccination needs to befast and comprehensive. Its also why I am going more in favour of delaying second dose if you can get universal coverage quickly but the worse would be slow and delayed.
2021-01-10 11:39 Robert F. Garry open

How about splitting up the doses? Like they have done for smallpox...
2021-01-10 11:41 Robert F. Garry open

"Slow and delayed" is definitely the Trump approach.
2021-01-10 12:07 Robert F. Garry open

This might be worth considering and based on the above there is not a minor chance of this making it worse. Nevertheless - Looking back at least at the Pfizer vaccine they got very similar immunological/neut results with 10,20 and 30 ug doses - yet they went with the 30 ug dose in the phase 2/3. Don't know why. The pfizer vaccine isdiluted to about 2 ml per vial. 0.3ml dose. 5-6 doses per vial. I bet based on the Phase I you could double thevolume of the diluent and inject 0.2 mls instead of 0.3 mls and get similar immunity. That's 15-18 doses per vialinstead of 5-6.